The Meltdown

Change is never easy, but as a change agent in my professional life I’ve always been willing to suck it up.  I don’t always like it, but I can usually find a opening that appeals to me and warms me to the change.  Or, if I can’t, then I find another option all together.  Sometimes this happens seamlessly, other times it happens with me exchanging words.  But I never quite lost it in the process.

Last night I had a meltdown of epic proportions.  And it all began with a trip to meet my new oncologist on Thursday.

I was looking forward to meeting her.  My former oncologist was clearly one in a million, but that didn’t mean that I couldn’t forge a relationship with a new professional and partner in my treatment going forward.  I liked the hospital and every physician and professional I encountered was positive so I had high hopes.   Notwithstanding my usually high bar, I went in with an expectant and open mind.

I waited an awfully long time, but I figured that there has been a lot of change in the facility and maybe folks were adjusting.  She entered the room and we shook hands, and she asked me how things were going.  That was asking a lot, so I started with the pain management and she looked at me curiously.  And I became all too aware that she had never read my chart before walking in that door.  She listened to me talk about pain management and had no follow up questions, so she went directly to the desktop and pulled up my information.  She rifled through entries, trying to familiarize herself and ask me questions at the same time.  Clicking one line to the other with the mouse was annoying me.  Her cellphone rang and she said she had to answer it because she was covering another department.  She pulled up the report of a CT guided biopsy and looking through it hurriedly told me that the results were confirmed.  I said, “That’s curious, because it is my understanding that it was indeterminate because such a small sample was aspirated.”   She looked at it again, “Oh, yes.  You’re right.”  She pulled up a PET scan from August and began talking about the results and I had to correct her and tell her that a more recent PET scan was conducted on November 9.  She looked at the report and proceeded to tell me that there were two lesions in L4 and S1.  “These are bones in your lower back,” she said.

CaptureWait.  She really said that, didn’t she?  Because a woman who is 52 and has known that she has cancerous lesions in her lungs and her vertebrae for the past five months would not know that L4 and S1 are “bones in [my] back.”   Wow.

“So, are you going to have any blood work today?”  I thought that was a pretty odd question, considering that any woman who doesn’t know that vertebrae are bones in her lower back would probably not be allowed to order her own blood work.  My answer betrayed my annoyance.  I asked her about out patient charges for injections that I receive and she made it clear that she wasn’t going to talk about this, that I should speak to the “experts” in the office.  I had hit a dead end–I didn’t even bother to tell her that the “experts” had already referred me to her.  Her cellphone rang again and I waited .

It only got worse.  She wanted me to  lean back so she could examine my breast and I told her that I couldn’t; I was still experiencing a lot of back pain and I couldn’t lay back while still in a sitting position.  She seemed really annoyed by this and asked me why I couldn’t lean back; I told her again.  Visibly affronted, she quickly grasped for the leg extension on the exam table and I was able to lean back.  To be honest, I’ve performed more substantial exams on a loaf of bread.  After months of breast exams I can sort of attest to their thoroughness.  She paid no attention; almost seemed as if she were going through the motions.  I told her that I would be having an MRI ordered by my former oncologist that evening–she never asked me about it.

I was struck.  Dumbfounded.  My usual spark for calling someone out on egregious behavior was lost under the total shock and disbelief in how I was being treated.  I asked her about surgical options–lumpectomy, etc. I had asked my former oncologist about this too and he answered the question and I was satisfied, but I wanted to hear her answer.  “Well, in cases like yours we treat the entire body.”   Dismissed!

Did I need any more Tamoxifen?  She sent through a ‘script.  Even though I was struck silent, I had enough in me to try one more thing and I tested her.  She asked me if I had any complaints, and I told her that I was experiencing some significant blurry vision from the Lyrica I am taking.  I was pretty sure it was the medication, and just sitting across from her I had to keep blinking my eyes because she was so blurry.  “Oh, that’s not good,” she said and proceeded to tell me she’d see me in two months.

I knew I would never see her again.

When I went downstairs to get my monthly shot of monoclonal antibody goodness (Xgeva), I struggled to hold back the tears.  I asked the nurses about this doctor–what was her reputation?  Did they like her?  What was the word on the street?  They were professional and diplomatic, no one said anything negative–and no one said anything particularly positive either.  I just cried.  I said I felt like I was walking naked down Cancer Street and no one gave a good damn.  Just the thought of having to launch yet one more search for a good oncologist daunted me.  I couldn’t believe something so great had gone straight to hell in a little under fifteen minutes.

I went home and didn’t have time to think about it.  I was meeting two good friends that I hadn’t seen in some time so I didn’t have an opportunity to reflect on this bizarre encounter.  I had my MRI that night and the following day a nerve block with the pain doc (who is awesome!) and I just didn’t have an opportunity to think about it in any concentrated way.


And then on Saturday night it happened.  The meltdown.

Without warning, I began to sob uncontrollably.  I didn’t know what was happening at first, but it didn’t take long for me to realize that I was finally processing that Thursday appointment.  It wouldn’t stop.  I couldn’t stop.  I was hyperventilating.  I walked through my home in sheer panic.  From room to room (and there aren’t many) I was trying to find some center to calm down and I couldn’t.  The sobbing wouldn’t stop.  I couldn’t breathe and I was afraid I’d pass out.  This went on for nearly an hour and I saw no end to it.

I reached out to social media and people answered.  It was amazing, actually.  I never thought to even call my best friends because I was so out of sorts and in such an extreme panic.  Frankly, I don’t think my friends would know what to do.  They had never seen me in such a state.  I never experienced anything like it before.  Dr. Attai talked me down and made some inquiries on my behalf.  Kathi Kolb was her Amazonian self and talked me down at the same time on FB.

I went into that appointment expecting that I would be met with respect and was, instead, dismissed, treated like an imbecile, and disrespected in a way that I could have never anticipated.  I am still shocked.  Everyone has an off-day, but this went well beyond an off day.  My only regret is that I didn’t tell her to go fuck herself at all.

CaptureThe core of the matter is this: I’m facing a terminal illness.  All that I know for sure is that I can manage this disease but I’ll never beat it.  And while I can manage it, I am also scared.  So what I expect from the oncologist with whom I work is a partnership; one in which we respect one another as intelligent individuals and a mutual trust that is earned on both sides.  And, as a patient, I need to know that my oncologist has my back.  Medically this will be the most important person in my life.  I don’t intend to settle.

I reached out to the right person and I am hopeful that I can be matched with an oncologist with whom I can forge a productive relationship.  This meltdown was traumatic and, twenty-four hours later, I haven’t quite recovered from it physically.

As open as I want to be about the experience, there is a certain modicum of shame involved.  Five months ago this would have been nary a wrinkle in my napkin.  I would have confronted someone like this, crushed them like a bug and never thought twice about it.  But after three months of constant pain, physical setbacks, and my personal and professional identity under siege, I suppose even I had to break  at some point.

I can forgive myself for that.

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53 Responses to The Meltdown

  1. I am GLAD you took the time to blog about the whole thing. I am tempted, SO TEMPTED to start a “Rate My Doctor” site….. If students can do “Rate My Professor” why aren’t we rating our doctors?????

    • Acacia says:

      Angie’s List tried to do it, but doctors threw a huge hissy fit and threatened to sue. I don’t know how it all turned out.

    • Scorchy says:

      I am also glad that I documented that experience. I did not reveal her name (but would if someone requested it privately), and if I had the opportunity to “rate” her performance I certainly would. There are sites where docs are rated, but nothing coordinated; and there should be one that is moderated to exclude ad hominem attacks (which I don’t think would be appropriate). I did not reveal her name because my intent was not to poison a career (and I realize that my blog is forum that reaches many people) nor did I want to get sued for libel. But I documented that experience to explore, as I have done consistently on The Boob, the process of navigating breast cancer. Interactions with physicians are part of that experience.

  2. Deborah says:

    Just love love love to you. And prayers.

  3. You should remember that it is never too late to tell a doctor to go fuck themselves. It wont actually help anything, but you’ll feel a little better for it.
    …and another thing. I wish there was a different button to push other than the “like” button. I like reading your words. I hate what you are going though. I pray that your words will continue for longer than your ordeal. May 2013 bring you comfort. Happy new year scorchy!

  4. Juneaubugg (aka Jennifer) says:

    I love you…. Happy new year Scorchy! Glad you got all that frustration out and now can focus on finding a great MO.

  5. dear scorchy,

    when i first started reading this post i was so impressed with your attitude and positivity about the change from the oncologist you adored, and taking on such a wise and open-minded point of view. and then…reading on… that stupid fuckhead RUINED everything! no wonder you had such a horrific emotional response – you must have felt like the floor was falling out from under you…and it just got worse and worse…falling farther and farther into nowhereville. the combination of shock and bewilderment at an obvious lack of preparedness, not connecting the dots with your back pain and being unable to lay back on the table, no clue about the tests, their results, her rudeness, disrepectful attitude and complete lack of compassion – you must have truly felt you were in some weird kind of nightmare – how could you, how could anyone have put into words what you were going through, what you were reeling from.

    the delayed reaction, your meltdown, at least allowed all those tears to release some good measure of stress. and your brilliant written account is bringing you lots of validation and support. you WILL find exactly the right oncologist, i know it. and you can be sure that what you gleaned from the other clinicians about that screwed up excuse for a doctor – nothing bad but NOTHING GOOD – was spot on. i am a nurse, and i know that drill.

    i am sending you waves and wave of healing and hope. i wish with all my heart i could give you a gentle hug – sending my best vitual one, none the less heartfelt.

    love, XOXO,

    karen, TC

  6. Susan Zager says:

    Scorchy I had to read this again because I am still furious with that idiot. I know you are going to find the right oncologist. She deserves to be reported for her medical mishaps. I know what you mean about when the Doctor is unprepared with your chart. It is infuriating. Especially when you are a new patient. My oncologist left her practice and my new one (in a different office – I was lucky I had a couple of referrals all pointing to her) sat with me in her office for at least a half an hour going over my whole case. There were seven years of notes with a recurrence that for me was fortunately local, and she gave me all the time I needed with all of my questions and was on time. I also got a real hug at the end of the visit with a recall in four months. She was amazing. Because you are stage IV I am shocked and amazed at how inhumane your onc was. On top of that answering her cell phone during your visit. Excuse me! i don’t think so lady. I totally understand your delayed response. You were shocked by this office visit. Take a good deep breath and I promise you are going to have an awesome new oncologist. Anyway I just had to say more about this and I am looking forward to hearing about your new oncologist…. Meanwhile know how much we all love you and if I lived near this woman’s office I would go in there screaming like a crazy woman at what an idiot works there so her whole waiting room could hear it with a video camera so you could enjoy the playback of my outrage. One thing I am sure of, she’s history and we are on to the next. And let all of your feelings out. You are so justified. Love and hugs (and I so wish I could give you one i person.)…..Susan

    • Scorchy says:

      Susan, I honestly thought something of the same would happen. Hell, I’m an archivist and I like to get detailed updates on projects. I don’t think she knew I was stage of until she opened up the medical record.

      What an experience. We’ll meet someday and we can exchange that hug. 🙂

      I know it will work out. I like the center and love the hospital so I think a good match can be made.

      • Susan Zager says:

        We will meet someday I am sure of it..Meanwhile since you like the center I know you will find the perfect match. I really want this bee-itch to lose her license. I have no idea how she slipped through the cracks. Extra hugs to you and I am so glad you shared this with us. XoXoXo-Susan

  7. Tracy says:

    Excuse my foul language but fuckwits seem to come in all shapes, sizes and walks of life and that, dear Scorchy, is what you encountered… Fuckwittery at its best. You’ve nothing to feel bad or ashamed about, like you I would meltdown if this happened to me. Anyone remotely human would. Love to you and big heaps of shame on this Onc!

  8. Susan says:

    I am really upset that you you were treated poorly. You are absolutely justified to have reacted as you did. You are to be treated with respect and deserve so much understanding. Also when you are in pain on top of the disease making constant havoc with your hormones, your oncologist is the person that should be compassionate and understanding. They should be ashamed of themselves! I am with you all the way Scorchy. Happy New Year and a huge Hugs to you! You are awesome.

  9. Dara Insley says:

    I was treated this same way once, I sent an email to the Dr’s boss, I got an apology from the boss and the boss let me know she had already discussed my poor treatment with the other doctor. I encourage you to do the same!!! I melted down on the way home from mine. You can check my website too if you like. My best to you !! Great write up. xo

    • Scorchy says:

      I do think I will eventually. I just need to put some space between the event so that I can write intelligently. The Center is premier and I have no wish to malign the organization.

  10. WOW. I hear you loud and clear. On EVERYTHING. I am so sorry. Please try to give yourself a break. There is no shame to be felt here. You have been stripped raw, you are in “survival” mode (I don’t mean “cancer survivor,” I mean in the mode of getting through the day-to-day hell this disease has wrought), your usual defenses have been worn thin, and in my humble opinion, you were quite simply abused and bullied by this oncologist. Shame on HER. Sending you lots of love and luck for 2013.

  11. Scorchy dear, I am facing the same! Thank you for sharing this. I linked to it in my hurried blog post this morning. You getting it on paper (computer screen) urged me to let some of mine spew out before all my stewing was complete.

  12. bcrcrider says:

    I second, third, etc. what all have been writing…totally understandable (I had to fire a doctor spectacularly too – I threw mine under the bus with the hospital CEO here: – meltdown (check) (mine led to upping my anti-depressants and eventually having tranquilizers on hand) I completely recognized myself in your meltdown description – just do what you can, when you can…sometimes it helps me and sometimes it doesn’t, but . . . You Are Not Alone.

  13. Acacia says:

    Oh Scorchy, even the toughest among us break down. I crack a little every day since the brain mets dx.

    We walk into a doctor’s office expecting at the very least, courtesy and competence. We’re vulnerable, especially after as much suffering as you’ve been through and to be treated so cavalierly is something you can’t really prepare for.

    Since you are being treated at a hospital, this woman must have a superior and the hospital should have advocates available to work on your behalf. Don’t leave your story on the blogosphere, report her behavior to everyone with any authority you can. Turn this post into a letter and let the hospital administration know.

    The weight of pain, terminal disease, managing our doctors and being our own advocates can be crushing at times. Breaking down is less important than the fact that you’ve already stood up again.

    • Scorchy says:

      You nailed it:
      The weight of pain, terminal disease, managing our doctors and being our own advocates can be crushing at times.

      We all deserve so much better. It’s hard.

  14. Scorchy, as you may know, in my professional life I am a psychologist. It is therefore my expert opinion that your meltdown was totally understandable and does not detract from your obvious fortitude and kick assedness. I’m so sad this happened to you but I know you will prevail and probably knit something cool in the process.

    • Scorchy says:

      Thanks for the affirmation, doc. I know it was probably well overdue and it was going to happen sometime. I just hope it doesn’t happen again. As I think about it, I’ve been very weepy lately. I guess it’s been building for some time, and all I needed was a catalyst. And was that some catalyst!

  15. Bat freakin excrement. That sucks so much. It’s bad enough to go through this crap when your docs are good. But when they’re ditzoid and don’t take the time to prepare. Ugh. And it’s the feeling marginalized, diminished that really hurts. At some point, all the crap gets to be too much and you have to melt down. But Bah. Bah. Bah. It doesn’t feel good. But don’t feel shame. I think it’s a self-protective thing to melt down.

    I hope you can find a decent doctor attentive to you. When you feel comfortable enough to do this, I would write a letter to the hospital/practice administration. I think docs need to know when their treatment falls short.

    THinking of you and wishing you a happy new year!

  16. marie says:

    I am appalled and sickened by this. I am so sorry you had to go through it. You are amazing and brave and remarkable to share it.

  17. Scorchy, tears are healing ~ you need to let out the pain, anger and sadness that you’ve been enduring. Be kind to yourself ~ know that we are all sending you hugs, support and strength! xo
    P.S. Fire that incompetent oncologist…I’m so sorry you had to deal with her. Such unprofessional is inexcusable.

  18. Tam says:

    Scorchwood, it is perfectly okay to have meltdowns – even healthy. When I have them, as painful as they may be, I completely give into them. Get it out, let your self feel.

  19. I am so sorry you had to deal with such an incompetent, unfeeling assclown of a doctor.

  20. Knot Telling says:

    I am so sorry. Been there (both the experience and the sudden nuclear-scale meltdown) and it sucks. I don’t have anything really helpful to say, just that you’re not alone.

  21. Meg says:

    Although your reaction to this new “boob” was delayed it was real and proportional to the situation. You do not need to feel shame. A measured portion of anger would be great!! You will find the onc you need and want. Take in the comfort sent to you and begin the search again. After what you have been through, you will react differently because your being is fighting to LIVE. Sounds like a confrontational dismissal of this idiot would have taken more of your needed energy. Save that energy for the search.

  22. dglassme says:

    Scorchy, I’m so sorry to hear this (I know you don’t like a bunch of coddle sh!t) but, you’re not alone in your experience, and once again a brilliantly written piece that truly expresses the essence and importance each little nuance plays and how lively it can become. It’ll be hard to match your old oncologist’s nonetheless it does not mean you should settle for far less. Your old oncologist wasn’t a Super Hero so there are others out there similar to him, you’ll just have to find them and leave this traumatized experience in your wake. D

  23. @rupertbu says:

    I send a HUGE hug to you, my new-found friend of 2012

  24. I completely misunderstood your tweet, and responded inappropriately, I had no idea you had been through such an horrendous experience – I am truly sorry.

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