Chapter Nineteen: Doctor Shopping

When I was about to graduate from university, I learned about an organ transplant support group in my local area from the hospital where I received my second kidney transplant. Every third Wednesday of every month, a meeting was held where an individual related to the organ transplant or healthcare community did a presentation and us organ transplant recipients/candidates and family members or friends gathered together at a recreational community center to share good conversation, healthcare tales, and the fresh tray of fruit, unlimited coffee and tea, and golden cookies.

I attended the meetings very sporadically because of academic requirements tugging at me at the time, but, most of all, I felt very out of place in a room full of fellow organ transplant recipients and candidates who talked about political issues affecting the organ transplant community, children, grandchildren, jobs, retirement, and the volunteer activities that they regularly participated in. I was just starting to scratch the surface on the organ transplant community by attending these meetings, and I was honestly at a stage of my life where I was creating my own life by cutting apron ties with university and begin my job hunt. The moral majority of members were waiting for a transplant, received an organ transplant, or had their first transplant in a shorter amount of time that I had two kidney transplants. My feeling of not belonging was never because of them, and always because of me. They enveloped me with understanding, sympathy, and admiration towards me and treated me as though I was their surrogate child that was young, cute, and innocent with a bright, gap-toothed grin. There were some brief moments while I sipped on tea and munched on cookies I was comforted with this sense of belonging that someone (anyone) finally understood what I had went through with my transplants. When I finally confessed that I could no longer see my pediatric nephrologist and had to make the transition to an adult nephrologist, my fellow organ transplant recipients and candidates in that support group eagerly began to share stories of their doctor comparison shopping.

“You have to go a good one who regularly checks your bloodwork and tells you clearly what you have to do!” One of the members with a poof of gray curly hair said to me.

“Well, I do not want a doctor to tell me what to do. I mean, I want to work together with my doctor to take care of my health,” I admitted.

She gave me a strange look, ignored what I said, and asked: “Well, who did your pediatric nephrologist suggest you see?”

“**Dr. McFort or **Dr. Friedman,” I confirmed.

“Oh, definitely go to Dr. McFort!” a man who received a kidney transplant said to me.

“Yes, you have to go to her!” another woman practically squealed and who also received a kidney transplant continued, “She is the best! She is so thorough, caring, and just knows what the hell she’s doing! I’m not sure about Dr. Friedman, though. I went to a colleague of his, though, and he was awful. I practically had to beg him to put me on the transplant waiting list and I had to remind him about me getting my bloodwork done.”

“You both see Dr. McFort now?” I asked.

They nodded enthusiastically and, before I knew it, another voice piped up: “She is the greatest! I had a couple doctors before her and no one compares to her. Such a sweetheart, and she’s got the cutest Irish accent!”

I raised my eyebrows in surprise. They all smiled in unison at me and then told me that I had to tell them how the appointment with Dr. McFort went. They continued to chatter on about the magic that Dr. McFort had with kidneys and about previous doctors they had who could not even possibly compare to her. I was about 95% persuaded, but to make it to 100%, I had to do a little research on the Internet. At this point, the Internet was practically booming and people clung on to websites and computers as though they were byproducts of the Holy Bible or Koran. With a click here and there, Dr. McFort’s years of medical school and residencies popped out at me along with a picture of a statuesque woman with short, cropped blonde hair, twinkling eyes, and a sparkling smile. I realized as I read her biography that I never had a female doctor before. I was looking forward to a different perspective from this popular kidney female doctor that could perhaps understand my kidneys AND hormones. “What a great combination!” I thought to myself. With over thirty years of working with kidney transplant patients and her welcoming smile, I was at 100%, picked up the phone, and scheduled my very first appointment with her.

No more than a couple weeks later and with my arms wrapped protectively around my huge, black health binder, I sauntered into Dr. McFort’s practice with an overly positive demeanor and expectations. Almost as soon as I completed the normal first-time paperwork, I was called in by Dr. McFort’s nurse practitioner, **Gertrude. She was short and stout with a tightened smile. A sinking feeling began to stir in my stomach. I did not know why, but I just had a bad feeling about her. She stuck out her hand, introduced herself, and said that she was going to do the typical routine of vitals. She then brought me to the examination room where I was told that she would be right back for me. I held my breath as I waited to see Dr. McFort. I wondered if she was as good as her biography and what the other support group members said about her. She had to be. She just had to be. I heard a knock at the door and plastered on my smile, all excited to meet Dr. McFort, but was stunned to find Gertrude again with another woman who said that she was Dr. McFort’s fellow. Where was Dr. McFort? When was I going to meet her?

They both took an extensive medical background on me, writing everything as fast as possible and oohing and aahing over my life experiences and health binder that I made. Though I was smiling on the outside, my mind was in overdrive of asking: “Where the hell is Dr. McFort? When am I going to meet her?”

I was pulled out of my obsessive thoughts when Gertrude and the fellow lady stood up, grinned, and said: “Well, we are going to get along so great with one another! You just have to get your bloodwork done and see Dr. McFort at least every month and we are going to refer you to a gynocologist and dermatologist. You really should be going to a gynocologist at your age and you are susceptible to skin cancers because of the medications that you are on.”

They were about to leave when I piped up: “Wait. Where is Dr. McFort? Aren’t I going to see her? I also do not need to get my bloodwork every month because I was only getting my bloodwork done 2-4 times a year with Dr. Winthrope and that is because my second kidney transplant has been going for almost 10 years now. There is really no need to get the bloodwork done that often. You are going to end up harming my kidneys rather than helping them.”

Their smiles were shaky and beginning to scare me. “Well, Dr. McFort always wants all her patients to get routine bloodwork at least once a month…at least in the beginning until she gets to know your kidney function and kidneys.”

I snapped without thinking: “Well, every patient is different. Anyhow, where is Dr. McFort so I can actually speak to her about what the both of you are prescribing and not what she is prescribing?”

“These are all mandatory medical orders that really should not or do not need to be questioned,” Gertrude said sharply. Though she was smiling, I could see the slight snarl and frustrated gleam in her eyes.

It took every ounce of energy for me to control myself from flaring up at her angrily at what she just said to me. I took a deep breath and then said carefully: “Okay, I see what you are saying, but I would just like to speak with and Dr. McFort. It is important for me to see her because, because, you know, what happens if there was an emergency with my kidneys? I want to know that she will be around in case something bad happens.”

Getrude’s mask of bordering politeness fell away and she said curtly: “If there is ever an emergency or you need anything, you go ahead and call me, because Dr. McFort is too busy.”

Her words stung like a slap in the face. Perhaps I had heard her wrong? That Dr. McFort was too busy to see her patients? What the hell was going on? Was this how the medical field was with a patient spending more time with a nurse practitioner and nurses rather than the nephrologist himself or herself? Had I really been spoiled and pampered by my pediatric nephrologist because I was a sick child rather than a tough-skinned adult from the real world? I was speechless. I was shocked. My expression must have said more than any words because Gertrude repeated again with her barely calm fa├žade on: “Dr. McFort will be in shortly.”

I was literally shaking with confusion and anger at this Gertrude lady and that I had not even met Dr. McFort yet because she was perhaps too busy or too important. Certainly, much more important than me. Dr. Winthrope was never that way. I was going over and over again in my head with how personal Dr. Winthrope was when the ever-important Dr. McFort came in. She was thin, tall, and elegant with glass blue eyes. She stuck out her hand to shake mine and I winced at how icy cold her hands were and how quickly she ended the handshake.

“Mary, it is so nice to meet you,” she said in her infamous Irish accent.

I opened my mouth to say: “Yes, nice to finally meet you, too,” when she continued on: “My medical staff is saying that you are edgy about the frequent bloodwork appointments. You know, these are really mandatory and necessary. There is no other option.”

I almost sputtered: “There is always an option!” Instead, I said tightly: “I understand that this is something that you require of all of your patients. However, I’m sure Dr. Winthrope forwarded my medical records and files to you that my kidneys have been in the best condition with a creatinine ranging between .8-1.0 in almost 10 years since I received my second kidney transplant. I only went to Dr. Winthrope 2-4 times a year along with routine bloodwork. I really do not see the point or necessity for so much bloodwork.”

Her smile vanished and a tight line was the replacement. “Well, what can I say? I am just doing what is medically necessary for your kidneys. I cannot force you to do it, but if you will not do what my medical staff and I order then we cannot work together.”

It sounded like she was threatening me or giving me an ultimatum. I did not know what to say. Before I knew it, Dr. McFort was gone and Gertrude was in front of me with a happy grin on her face that seemed to say loud and proud: “I told you so.” While she wrote out the orders for additional bloodwork and a string of additional doctor referral orders, I said: “I’m sorry. I can’t do all the bloodwork tests. I won’t.”

Gertrude gave me a quick glare, but then her scowl turned into a saccharine smile just as quickly. She was like a snake ready to bite. “I know it is a change for you to go from Dr. Winthrope who you knew for so many years to Dr. McFort, but, really, we only have your best interests in mind.”

I was about to puke at how fake she was. I just shook my head, disgusted, and walked out of the office. I was still trembling with anger and confusion when I left Dr. McFort’s office. I was like a volcano ready to erupt. Was I really so unreasonable and overly critical and judgmental with Dr. McFort and her practice? Was it wrong for me to ask so many questions and to refuse their orders? Should I just have nodded like a puppet and did whatever they told me to do? When I thought about how Gertrude and Dr. McFort said that I had to do what they ordered because they did the same thing with all their other patients, that bubble of fury just burst out of me because each patient and person was different. How could they possibly treat every patient the same? How could patients just go along with whatever she ordered and would not even think of other options or work together with their doctors? How could Dr. McFort come so highly recommended? Was there something wrong with me? I surely knew that I was in the wrong to compare her to Dr. Winthrope who had the patience of a saint to deal with the proactive and pesky patient in me, but I did not think for one moment that I was wrong to ask questions, know about my health, and know about my kidneys and body. For my sake and especially my kidneys, I could not and would not accept just going along with whatever I was told, and I certainly was not going to return to Dr. McFort and her nasty and scary nurse practitioner Gertrude.

However, within two weeks later, I was back at Dr. McFort’s office to see a colleague nephrologist of hers that my aunt went to by the name of **Dr. Goldberg. My aunt raved about his uncanny ability to work in tandem with patients and to know what tests to order and how much to order. I was nervous and wary again that Dr. Goldberg would be identical to Dr. McFort with a nurse practitioner doing all the frontline work, but when he greeted me directly and with a warm smile and handshake in the examination room, my nervousness fell away.

With my already thick chart on his lap, he said to me: “Looks like you have a very complicated medical history. Let’s just review everything again so we can work together to take care of those kidneys.”

I grinned like an idiot. So far, Dr. Goldberg had said the magic words of “we,” “work together,” and “take care of those kidneys.”

So far, I was one happy and relieved patient with him reviewing my entire medical history until he got to the question of my supposed sex life. He read off the paperwork that he was looking at: “Are you sexually active? Are you a virgin?”

I honestly said: “No, not sexually active. Yes, I’m a virgin.”

He looked up and his eyebrows shot to his receding hairline of in shock: “Really?”

My response was shock at his unprofessional response to the way I honestly responded to his question. Not to mention that I felt like some prissy, goodie-two-shoes for being a virgin. I managed to mutter: “Uh…yeah, really.”

There was this strange look in his eyes and he murmured: “Interesting.”

The wheels in my head began to move at full speed. Did he really just say that?! I could not believe it. My stubborn streak and quickness to criticism reared its ugly head again at cutting off any possibility of him being my nephrologist. I mean, seriously, what kind of doctor responded that way to someone’s sex life, or lack thereof?! I was silently fuming and biting my sharp tongue again as Dr. Goldberg wrote out prescriptions to get bloodwork four times a year and to see him in three more months. On the way out of the office, I crumpled up the prescriptions and threw them out. No way in hell was I going to see him again. He was probably some secret nymphomaniac.

After two strikes with two doctors, I returned home that night with a fierce and fiery determination to do whatever it took to find the right nephrologist. My Dad saw how infuriated I was and said tentatively, “Uhh…guess this is strike two.”

“It went horrible,” I spat out.

“You can’t be so judgmental and critical of people when you first meet them. You should trust Dr. Winthrope’s recommendations. Forget about Dr. Goldberg, and maybe you should give Dr. McFort another chance,” my Dad said gently.

“Are you kidding me?” I asked incredulously. I continued ranting: “First of all, I would not be giving Dr. McFort another chance. I would be giving that Getrude witch another chance. Second of all, they flat out told me that if I refuse their orders then I can’t see them, and I refused.”

“You are too stubborn,” My Dad said bluntly, “It just goes like this that Mary is going to do whatever she wants to do. It is like your friend Claudia says that a normal person just listens and does whatever the doctor says, but you have to question every little thing.”

“What’s wrong with that? Why does everyone make it seem like I’m a criminal for wanting to know what the hell is going on with my body and my kidneys and for refusing the doctor? She’s a human being. She’s not God. I’m sick of this. I just want to go back to Dr. Winthrope. He was the best. No doctor compares, and no one in hell gets it or understands me.” My head was burning up and infuriating tears stung my eyes.

I was about to storm to my bedroom when my Dad said firmly: “You need to stop it. Stop acting like that. So, you and this Dr. McFort didn’t click or whatever. So, it did not work out with Dr. Goldberg. So, you have to grow up and stop seeing Dr. Winthrope and someone new. It is not the end of the world. Just because things don’t go your way doesn’t mean that you give up. You have to adjust to things that happen in life. You can’t feel sorry for yourself, or shut out the world out.”

I took a few deep breaths. My head was beginning to lose its heat but it was still slightly spinning, and my pounding heart was beginning to resume its normal and rhythmic beats. There was an awkward pause in the kitchen. I surrendered and hiccupped, “Okay, I hear what you are saying.”

“Good,” My Dad said, “So, what you do is you email Dr. Winthrope and ask his advice. He said you could email him anytime.”

I met my Dad’s gaze and said: “You know, you are right. How come you are always right?”

My Dad did not say anything, but just smiled half-heartedly. I went to my bedroom, turned on my desktop computer, and went on the Internet to check my email. For a few moments, I stared at the “compose email” screen with vacancy. What if Dr. Winthrope thought what most people thought that I was some patient from hell? I hated that I was so emotional, oversensitive, and took everything so personally and to heart. I took a deep breath. “Here goes nothing,” I muttered to myself.

Without going into too much detail about Dr. McFort and the spat that we had over the frequency of me getting stuck by a needle and Gertrude’s attitude problem as well as Dr. Goldberg’s fascination with my sexless life, I wrote as honestly and emotionless as I could to Dr. Winthrope in the email that I needed an adult nephrologist that I could work together with as I had worked together for so many years with him. I plead for his candid thoughts, opinions, and a referral to a suitable nephrologist for my supposed high-ended demands and expectations and the proactive and pain-in-the-ass patient and person that I was about my health.

The next day, there was a fresh email waiting for me in my inbox. I breathed a sigh of relief when I scanned the email. Dr. Winthrope first wrote that he understood my concerns and then reminded me that he had mentioned Dr. Friedman as another nephrologist and to try him first. If it did not work out with Dr. Friedman, he said he would refer me to someone else. I felt so silly and stupid that I had not tried that second adult nephrologist. I scrounged around to find the Dr. Friedman’s information. When I did, I was dreadful and fearful. The other members of the local support group said that Dr. Friedman’s colleague was a disaster. What if Dr. Friedman was the same way? What if Dr. Friedman had a bipolar and moody nurse practitioner that I had to deal with like Gertrude? What if he was also in shock about my sexless sex life? I was starting to feel sick, and I started to feel sicker as I researched more about Dr. Friedman on the Internet. He looked like a commanding or military officer with a struggling smile on his face. I knew I was judging by physical appearance and that there was more to what was beneath the surface. I was so tempted to email Dr. Winthrope back and beg him to take me as his patient again, but I heard my Dad’s voice and words ringing in my ears that I had to grow up.

I punched in the phone number and pleasant, yet extremely professional voice greeted me. We got right down to business with scheduling an appointment and making sure that my medical records from Dr. Winthrope were forwarded over.

On the day of the appointment, I was nervous and sick to my stomach as though I was going on some blind date, but the flitting butterflies that tangoed in my tummy came to a stop when I drove into a tiny parking lot of a small, cute, and cozy white house with black shutters and a little porch that resembled something from “The Brady Bunch” or “Little House on the Prairie.” A house? Porch? Was this right? I checked the number on the house again with a quizzical expression just to make sure I had the right building. I got out of my car and was shocked that Dr. Friedman practiced in a building that looked straight out of a family TV sitcom.

I was compelled to knock on the door because it was a house, but opened the porch door instead with hesitation. My mouth dropped open. Holy shit.

Inside was nothing like a doctor’s office. It was a cozy and warm home setting. The waiting room consisted of four plush and bordering on antique chairs with old-school magazine racks, end tables, and landscape paintings. The person who greeted me was **Erin with a bright smile and long eyelashes that fringed her almond-shaped eyes.

“You must be Mary!” Erin exclaimed.

I chuckled nervously, which sounded like I was choking. “Yeah, I must be.”

She gave me paperwork to complete. I sunk down in the plush chair that enveloped me with warmth. Comfort and peacefulness settled right over me. How was it even remotely possible to feel at home at a doctor’s office?

“Mary?”

A deep and stern voice startled me. I hoped it was the nurse practitioner because as soon as I came face-to-face of who was before me, a quiver of fear zigzagged within me. No such luck. It was Dr. Friedman. He was tall with pepper-colored hair and a firm expression on his face. He looked like a military captain and gazed at me as though it was time for me to undergo boot camp. Dr. Friedman appeared the complete opposite of my jolly and child-friendly Dr. Winthrope with the upturned caterpillar moustache. Gosh, I was scared.

I gulped. “Yeah, that’s me.”

He broke out into a boyish grin, stuck out his hand, and shook my hand so hard and with such gusto that I was sure my fingers were going to break. He practically boomed: “I’m Dr. Friedman! So good to meet you! I’ve heard great things about you from Dr. Winthrope!”

He sped-walked to his office and I had to hurry to catch up with him. In less than ten minutes, I was quick to mentally bash myself at my fast criticism and judgment of people just because of how they physically appeared. Dr. Friedman’s loud and booming voice that had greeted me turned surprisingly soft-spoken when we began to speak about my medical history and pour over my medical records together. Intellectual and medicinal linguistics quickly spilled out from his mouth faster than I could keep up, and he was hilariously blunt and funny.

When I asked him: “How often do you think I need to get bloodwork?”

“Well, I saw your medical records that you did not get poked or prodded more than four times a year so I say we keep it at that and see one another two to four times a year or so. I don’t want you to get sick of me too fast—hmm…pardon the pun. Don’t worry. It takes awhile to get to know one another. We will work together.” He winked at me.

I burst out laughing. This was my first sign that I had found my match in Dr. Friedman as my adult nephrologist.

When I looked back, many people may have found Dr. Friedman’s blunt humor to be intimidating, but I found it refreshing and easier to handle this hilariously blunt Dr. Friedman over Dr. McFort’s curious disappearing act as well as Dr. Goldberg’s strange responses. My first consultation with Dr. Friedman continued on with discussing many health factors from the obvious that a plan was needed to carry on the outstanding kidney function that Dr. Winthrope had achieved to our hobbies and interests. I was pleasantly surprised that our conversation turned from my kidneys to him sharing about an upcoming ski trip. Upon a hearty discussion with Dr. Friedman about my health, a swell of happiness and relief filled me that I had found the right nephrologist match for me and endured this transition relatively painlessly and easily, all things considered.

Dr. Friedman restored my faith and hope in the patient-doctor relationship that I had had for over ten years with my pediatric nephrologist Dr. Winthrope. Most of all, Dr. Friedman taught me that people were not as they appeared on the surface and that all the recommendations from the Internet and other transplant recipients or candidates meant nothing because, in the end, I was going to be the one dealing with the doctor and vice versa. The transition from pediatric nephrologist to adult nephrologist made me see that it was rare these days for doctors and patients to work together. Many patients and doctors did not communicate with one another or there were doctors that acted as dictators and patients as slaves or the other way around. As a patient, it was natural for me to point the finger and place the blame on physicians who had never been a patient and who naturally focused more on the illness and tests rather than the person as a patient. As a person, my search for the adult nephrologist made me see that doctors these days are very much at the mercy of a billion-dollar worth maze healthcare system, headaches of health insurance, and the all-mighty power and convenience of Google as a doctor than an actual human being as doctor. I was one of the lucky ones who had Dr. Winthrope for so many years and who also managed to mesh with Dr. Friedman to takeover from my childhood, though it was not the easiest road to get to him. Though the road was bumpy with Dr. McFort and Dr. Goldberg to arrive at Dr. Friedman’s cozy doctor office, I had no regrets and I knew I would do whatever it took (including a head-banging and frustrated search if need be) to find the doctor for my kidneys and me. I refused to settle as a patient, because settling meant giving up on my kidneys and this life that I fought so hard for. I would not lose these kidneys that were going on ten years.

The final confirmation that Dr. Friedman was the doctor meant for my kidneys and me was when I received a phone call from him at 9:00PM at night just a few days after my first round of routine bloodwork. At first, I thought that my eyesight was playing tricks on me because even Dr. Winthrope had never called me so late at night, but then my heart jumped in my throat because I immediately thought the bloodwork reported that something was wrong with my kidneys. I practically dove for the phone and said nervously: “Yes? Hello?”

“Mary?” Dr. Friedman asked.

“Yes.”

“This is Dr. Friedman. I just wanted to review your bloodwork results with you…you know, since you went through all that trouble to get stuck by a needle for me.”

I laughed aloud. He almost made me forget why I was initially so panicked when I saw him on the caller ID, but then I asked rather anxiously: “Is everything okay?”

“Oh, yes. Your kidneys are doing beautiful and smiling. .8 Creatinine. You can’t get any better than that! The only thing is that your red blood cells look a little low, so I am going to call in a prescription for you to take some folbee or B-Complex to boost up your red blood cells. Are we good?”

I breathed a sigh of relief. “Yes, you can’t get any better than that, and yes, the prescription is fine.”

“So, because of beautiful kidneys, I won’t see you for the next four months or so, okay?”

“Yes, okay,” I agreed.

“Great. Don’t miss me too much and behave yourself. We want those kidneys beautiful and smiling the next time I see you.”

I laughed again. “Okay, Dr. Friedman.”

“Be well, sweetie.”

Even after we hung up the phone, I smiled and then laughed aloud all over again when I thought of Dr. Friedman’s mismatched struggled smile, soft-spoken voice when explaining medical bits and pieces, and loud laugh and sense of humor. It looked like the doctor shopping had finally come to an end. I had found the perfect adult nephrologist for my kidneys and me.

**denotes fake name to protect privacy of individual


2 comments:

Jennifer said...

great write up Mare!

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