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Greetings from Mayoville

Posted Nov 19 2009 10:00pm

From outside my hotel window, I can see the looming granite edifice of one of the four main buildings that comprise the Mayo Clinic.  Because my digestive system and heart continue to be troublesome, my doctors in Montana arranged for me see a gastroenterologist, a cardiologist, and any other –ologists deemed necessary here in Rochester, Minnesota.

My view of Mayo’s facade is impressive, as is the facility’s efficiency.  I’m used to making medical pilgrimages to hospitals that aren’t set up for out of town customers.  I’m used to having to fuss to get tests scheduled, to see appropriate specialists after seeing the main “expert” I’ve gone to see. It is quite the opposite at Mayo. I feel almost like a high school freshman, stumbling my around unfamiliar buildings with a horde of other new students. We clutch the helpful schedules that Mayo prints up for us. But instead of finding our way to lockers and the room for Algebra I, we make our way to Gonda Building, Ninth Floor, Desk 9 South or to the Hilton Building, Court Level, Desk C, also known as “Venipuncture Specimen Collection.” At the latter site, a helpful receptionist gives me what looks like a shopping bag from an upscale department store, inside which she places a labeled “specimen container” and proceeds to list all the “specimen” carts throughout the buildings where I can leave the bag when I’ve done my business. “Talk about discrete and well-planned,” my husband Jay said. He was right. The beige bag was totally opaque. If I didn’t have my own, I’d assume that the five hundred other people toting identical bags around with them had just gone shopping rather than being prepared to drop off warm loads of crap.

Mayo’s commitment to efficiency and to accommodating medical travelers is on display everywhere. My schedule of doctors’ visits and tests includes instructions on how to try to make appointments earlier, just in case the “first available” one they give you is after your flight home. As in airline travel, there is a procedure and a protocol. The printed schedule tells you what desk to appear at and how to make your request. It’s the medical equivalent of flying standby—looking for a cancellation instead of an open seat. Come to think of it, after dealing with surly flight attendants and chaotic airplane boarding, the airlines could learn a thing or two from Mayo—the inventors of the pneumatic tube system, we’ve learned. Rather than having to wait at one of Mayo’s desks, for instance, for a patient not to show up, the clinic will ring you on your cell phone if you pledge to make it there when told. (Of course that system won’t work if you camp out in the waiting room – Mayo’s commitment to efficiency is such that they simply block all interior cell phone traffic rather than having to go through the hassle of posting “Please Turn Off Your Phone” signs.) You can see the same type of organizational brain that conjured up the concept of sending tubes arcing through buildings behind Mayo’s giving you a pager when you check in to see the doctor; rather than bellow your name across a room and chance that you’ve wandered out of hearing to get a sip of water or use the restroom, you are paged.

The reality, though—no matter how many bells and whistles Mayo adds, no matter how easily they schedule me for tests and procedures ranging from a biopsy of my small bowel to a cardiac MRI to a simple EKG, no matter how thoroughly their managerial minds have streamlined every process—is that I am still seeing White Coats and still having my physical self violated in ways miniscule and significant. I am still a bit doctored out and tested out from my most recent stay in the hospital in Montana. I am tired of having cameras put in places unimaginable, tired of reciting the litany of events related to the past five years of sarcoidosis, tired of being cheerful and good-natured about stripping to be examined, rolling up my sleeve to have blood drawn, carting around my crap in a beige bag, and, later today, about swallowing a capsule endoscope and some other tools. I am, in short, simply tired.

I’m not stupid enough to think that I’m not lucky to be able to be seen here, or to not recognize that things could be a lot worse—hence my efforts to be cheerful and good-natured. But I’m also not stupid enough to be placated by the medical equivalent of bling. Even though the blood pressure machine in the cardiologist’s office was automated and fancy and took my blood pressure six times in a row to provide a more accurate, averaged reading, I still had to deal with the cardiologist—who was, quite frankly, an arrogant asshole who expected patients to be seen and not heard, unless and until he stared down from his metaphorical mountain where the doctor gods live and deigned to ask me a question. He is well-qualified and extremely competent, I am sure. I don’t doubt that he has ordered the proper tests and will read them accurately and make an accurate diagnosis of my heart. But I don’t like him. Equally well-qualified is the gastroenterologist, I am certain, who has a personality almost exactly the opposite of the cardiologist and who I liked a lot.

I have a week more of tests and appointments inside the well-oiled machine that is the Mayo Clinic. I know I will be all right, no matter if I have to spend more time with the jerk of a cardiologist, no matter if he or his colleagues order additional unpleasant testing, no matter if they discover something terrible, or discover nothing new at all (which will make me wonder if this whole adventure in Minnesota was a colossal waste of money and time, even if that time was finely managed). Having lived in Chronic Town for five years has prepared me well for Mayoville. Now, if you’ll excuse me, I need to consult my schedule and see what desk to show up at for my next appointment.

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