RIPOSTE
by RIP RENSE |
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DR. DUDE
Jan. 27, 2010
I’m
writing this with somewhere between one
and two kidneys. Not that this interferes with
typing, but it can sort of theoretically compromise, oh. .
.life.
It all started with
kidney stones, and a visit to a doctor who perhaps thinks he
should have been a character on “E.R.” The late-30-ish,
brilliant, cool dude with longish locks who saves lives
with a laser.
Dr. Dude will not be
named here, because he would certainly sue me, and frankly, he
has done enough harm. Unwittingly, unintentionally, yes, but
harm is harm. Besides, I’m willing to bet that Dr. Dude plucks
stones out of kidneys the way Hillary Hahn plucks a violin, that
he is veritable poet of his trade, a renal Rimbaud. That in
surgery, he is to kidney stones what the alcalde was to
Zorro.
But he has a thing or two
to learn. Or three. And if you are reading, Dr. Dude, pay close
attention. I ain't kidneying around.
I had two
stone attacks in late November. For those who have not
experienced this ecstasy, it is rather like being hit with a
sledgehammer, except the impact does not diminish. It stays
constant for hours. It makes you understand why wounded soldiers
want to be shot, and why women who have had both stones and
babies say that babies don’t hurt as bad.
So I went to the doctor.
It’s what you do when you have kidney stones. Unless you are me,
fifteen years ago, when I just rode them out. For six months.
I’m now too old to ride.
Dr. Dude appeared
casually, with nearly shoulder-length hair worn back. I
thought this boded well. I have often had such ridiculous
thoughts. Truth be told, and it seldom is, I liked Dr. Dude. At
first. He actually listened to my detailed description of my
symptoms, unlike 99.9 percent of other doctors I have visited in
my life, and then he said, glibly:
“I agree with your
diagnosis!”
Next he asked what sort
of writing I did, and after I said, “I was a newspaper
reporter,” I was barely able to get another word in. Dr. Dude
went on a jag, a monologue, a declamation, all about an article
in the Wall Street Journal he had just read about Rupert
Murdoch. . .
And what a great man
Murdoch is.
Cough.
The reader should
understand something here: telling me that Rupert Murdoch is a
great man is rather like a Holocaust denier telling a Jew that
Hitler did a lot of good for Germany. I admire the late, great
writer, Dennis Potter, who, when fatally ill, allowed that if he
had one more task to fulfill in life,
it would be
to “kill Rupert Murdoch.” Murdoch makes William Randolph
Hearst look like an egalitarian philanthropist, a paragon of
journalistic virtue. He is venality and cynicism personified,
nothing less than the most dangerous and harmful force in media
on the planet.
Other than that, he’s
okay.
So I gritted my teeth
and smiled politely, and said something about how Murdoch
probably wasn’t such a good thing for journalism. Which prompted
Dr. Dude to disagree! That’s correct, suddenly there was a
debate. Go to a doctor, have an argument! “Well, he’s a real
newspaperman,” said Dr. D., and I refrained from saying
that Madonna is a real composer. I mean, I had gone to
the goddamn clinic for help with kidney stones, and was not only
getting a protracted speech about Murdoch, but the guy was
interrupting me to tell me I was wrong. . .
While he was giving me an
ultrasound exam!
Yes, folks, my gut was
hanging out, all greased up, and he was running his little gizmo
over it looking at the stones, while he carried on and on about
Murdoch and why newspapers are dying---all in this very cool,
calm, what-seems-to-be-the-trouble-today monotone, an
almost Xanaxed hum of voice. And then---
“I just went to Bob Hilburn’s
book-signing.”
Aieeeee!
Forget that his ideas
about the problems with newspapers were ill-informed,
amateurish, and off the mark. Forget, even, that he regarded
Murdoch as a great man. So does the Catholic Church (which
made him a knight after he donated $10 million.) But. .
.(former L.A. Times pop music critic) Robert Hilburn? To
name-drop Hilburn in “conversation” with me, while running a
science-fiction device over my Vaselined midsection? And to
carry on about how great Hilburn’s new memoir is? I mean, give
me another kidney stone, please.
To be fair, I suppose,
Dr. Dude obviously thought he was making interesting
chit-chat in order to put me at ease and take my mind off my
troubles. Fine. Except I didn’t want my mind taken off my
troubles. I had come to him in order to deal with my troubles.
And he didn’t know my opinion of Murdoch, or that I enjoyed
working with Hilburn when I freelanced for the Times every bit
as much as I enjoy gum injections. Never mind that I think
Hilburn was one stinko critic. But. . .
What are the odds? I had
called a kidney-stone brother for a referral to a good doctor,
and wound up listening to a worshipful discourse about two of
the journalism figures in the world I least admire. Vicodin!
Still, I overlooked this,
and in the end, Dr. Dude informed me that I had one stone stuck
in the ureter, which had caused some edema, and one stone
“obstructing” the kidney. He gave me some Flomax, a nasty drug
that promotes stone passage, and instructed me to get a CT scan
in order that he could see things more clearly. The next day, I
readily subjected myself to the mini-Hiroshima that this test
entails, in order that Dr. Dude might more clearly read my
entrails. So to speak. Two days later, he phoned:
“There are actually five
tiny stones in the kidney,” he said in that same Muzak-y neutral
hum, adding that they were in the “collection area” and were
“not obstructing” the kidney. The large one in the ureter, he
added, had only about a 20 percent chance of passing on its own.
He said it could be broken up with a laser, and the small ones
“grabbed.”
“It’s like
spelunking,”
said Dr. Dude jauntily, adding that the stent implanted for a
week after the surgery, from kidney to bladder, is “not very
pleasant.”
Shudder.
I asked if this was
doctor-speak for “extremely painful,” and he repeated the
words “not” and “pleasant.” The only people harder to pry loose
from their euphemisms are generals. I cringed over this, but
even more at his use of the term, “spelunking.” I mean, I’m glad
he might enjoy his job, but my kidneys are not a playground.
In conclusion, said Dr.
Dude, “I recommend that you have surgery in order to avoid
long-term damage to your kidney.”
I asked how soon the
surgery could take place, and he instructed me to call his
office in the morning to book it. “I can get you in,” he said
with what I thought was a touch of boastfulness, “within 48
hours.”
I must explain here that
I do not like doctors. I have been mistreated, abused,
misdiagnosed, ignored, administered tests that were unnecessary,
given drugs that I didn’t need (which sometimes turned out to
cause dry-mouth-headache-diarrhea- strokes-and-even-death),
and so on. My body has healed itself from a number of maladies,
including three years of Chronic Fatigue Syndrome, with no help
from western doctors. (Chinese Medicine doctors, notably the
wonderful Dr. Ji-Ling Hu, have been very
helpful.)
And if I had a chance to
avoid general anesthesia, doctor/nurse error, the risk of
pneumonia, drug-resistant staph infection, etc. incurred during
kidney stone surgery, I figured on taking it. So what I heard is
this: the kidney was not obstructed, after all, and the stone in
the ureter had a slim chance of making a break for it. Still, I
was very nervous about the whole affair, so I followed through
and phoned Dr. Dude’s office the next morning to book the
surgery, just to preserve that option. I wanted to confer with
wife and a couple of friends first.
Dr. Dude’s office aide
phoned me back late that afternoon to say this:
“I’m afraid we can’t book
your surgery. The hospital is moving.”
Yes. Really.
The
hospital is moving. My dog ate it. Huh? Hospitals
move? Which hospital was this, I wondered. St. Alphonso’s
Pancake Breakfast General? Dr. Dude works in a very big and
reputable facility full of very big and reputable doctors right
next to a very big and reputable hospital. The hospital is
moving? Huh?
“It’s moving? Oh. Um. .
.”
“Well, wait a minute. We
might be able to get you into this clinic that we sometimes use.
. .hold on. . .”
This clinic that we
sometimes use? What, the MRSA H1N1 Clinic?
“Oh, never mind. I guess
we can’t do that. Is your situation urgent?”
I swear to Florence Nightingale
she asked me this. Is your situation urgent.
“Well, gee. I don’t think
I am qualified to make that determination. I think that such an
evaluation is up to the doctor, don’t you?”
“Okay, I’ll have him call
you.”
Which he did.
The next afternoon.
Right around the time that he
had told me he could “get me in” for surgery. And these were his
exact opening words, delivered again in that dispassionate,
almost disinterested vocal blur:
“You wanted to speak to
me?”
Seriously. He really said
that. I should have responded, “Right. I wanted to hear you
blather on self-importantly about Rupert Murdoch and your pal,
Bob Hilburn, you jackass.” You wanted to speak to me. .
.No, actually, there was no one in the world I wanted to speak
to less, with the possible exception of Tavis Smiley. Still, I
played it straight. Dr. Dude instructed me to tell his office
manager that my situation was “urgent,” and that had I done that
in the first place, she would have booked the surgery.
My fault, apparently!
I didn’t ask Dr. D. why
in the kidney stones he did not tell the goddamn woman to book
the goddamn surgery herself, if it was so goddamn urgent. I
goddamn suddenly had about as much goddamn interest in
proceeding with goddamn Dr.
Spelunking Dude as I have in sitting on the goddamn 405 at
goddamn 5 p.m. This was not very pleasant.
“Well,” I said, “I’ve had
a lot of pain in the past year (calcific rotator cuff tendonitis
landed me in the ER, where they doped me up with Dilaudid), both
physical and emotional, and frankly, I think I’d rather take my
chances on passing this thing.”
Because he is a doctor,
whose sworn priorities have something remotely to do with
healing people, I knew he would explain further why the surgery
was necessary, “urgent,” or even vital. But no, I’m all mixed up
in my understanding of doctors, you see. Dude just repeated that
it was “urgent,” but not an emergency, and that the situation
would not start to become more serious for several weeks. His
parting remark:
“I understand your
reasons. I’ve given you my recommendation.” (Or something very
close to this.)
That.
Was.
It!
In the next month, my
symptoms stabilized and the pain subsided. No more attacks.
I went on a program of tinctures, herbs, and liquids aimed at
promoting the passage of kidney stones. I took hot baths and
popped Flomax and slept with a heating pad. Crazy people offered
to heal me by long distance, and I told them to go ahead.
But because I am not totally insane, I got a second opinion.
“Your kidney is blocked,” said
Dr. No. 2, Gerhard Fuchs of the
Cedars-Sinai
Minimally Invasive Urology Center.
You will be surprised to
learn that Dr. Fuchs never once brought up Rupert Murdoch or
“Bob” Hilburn. All he wanted to talk about was my health. Over
three weeks had passed, and he was viewing the same CT
scan that Dr. Dude had.
“Blocked?”
“Oh, yes, it’s blocked.
The stone in the ureter is blocking the kidney.”
Ah, the stone in the
ureter was blocking the kidney. . .
“So the kidney. . .isn’t
working?”
“That’s correct. It has
shut down. The lack of pain is actually a bad sign.”
I realize that DC-3’s can
fly on one engine, Marty Feldman saw with one eye, and people
can pee on one kidney---and that perfectly health humans donate
kidneys to help ailing friends, even strangers---but you know, I
kind of like the idea of having a back-up. It was then that I
fearfully realized that the puffiness and dark circles under my
eyes were probably a symptom of kidney failure.
I booked the surgery
faster than
The Roadrunner disappears after sticking out his tongue. At
Cedars-Sinai, which did not appear to be moving.
And then I phoned Dr.
Dude.
“Hi,” I said. “I just
wanted to clarify a couple of things here. “Is my kidney
blocked?”
His voice was, as usual,
as indifferent as math.
“Oh, yeah, the kidney is
blocked,” he said, probably filing his cuticles. “You’re now
doing moderate to serious damage to the kidney.”
Really. This is what
he said. Blithely. Like he was giving instructions on how to
water a lawn. Yawning. He had told me that the kidney was not
obstructed by the five stones in the kidney “collection
area,” so I had concluded that the kidney was fine. He never
said that the stone in the ureter had actually shut down
the kidney. This had never occurred to me, especially since he
said there was a chance of passing the thing. And he had allowed
me to walk away. He had allowed weeks to pass without following
up with further information or recommendations. Three weeks when
I was doing “moderate to serious damage” to the kidney. Why?
Because he was not
required to.
He had spoken the legally
required “I recommend you have surgery so as to avoid long-term
serious damage” speech, which sounded like, “Brush your teeth so
don’t get cavities” to me---especially in view of the fact that
he told me the kidney was not obstructed, and that he had
also given me a sample of the evil drug, Flomax, to promote
passage of the stone. Exclamation point.
Again, he had done only what
was legally required. He did not care beyond that. I repeat the
key words in the preceding sentence: he did not care.
I responded:
“Well, that’s
comforting!”
This set Dr. Dude off.
Mind you, his voice remained mild, marshmallowy, but the
inflection was unmistakable. Scolding.
“I told you,” he
said. “I told you that I recommended you have this
surgery so as to avoid long-term damage to the kidney---“
“Yes, I know you said
that---“
“I told you. I can
read the exact quote to you because I wrote it down.”
And he read it.
“Yes, yes, I know you
said that.”
Do you get the picture
here? Dr. Dude didn’t give a rat’s ass about my health. All
he cared about was covering his own. He had written down the
quote as a precautionary measure to protect himself in the event
of a lawsuit. And now this overgrown spoiled, rich kid, a
one-time graduate of a very monied high school, had the audacity
to crow at me, a guy with one functioning kidney, “I told
you. . .”
No, Dr. Dude. You didn’t tell
me. Had you told me, I would have booked the surgery faster than
a fly blinks. Here’s what you should have told me:
“The stone in the ureter has
blocked the kidney, and the kidney has stopped functioning. If
this goes on, you will very soon experience moderate to serious
damage to the kidney. You need to have the surgery as soon as
possible and I will book it for you within the next 48 hours.”
You goddamn dumbass.
Instead, Dude had
indifferently recited, “I’ve given you my recommendation. . .”
and hung up. After all, he’s a very busy guy packing in as many
of those profitable spelunking expeditions as he can.
The upshot: Dude never
phoned back, of course. If I was doing damage to my kidney, what
concern of it was his? I had surgery promptly with the
excellent, highly professional Dr. Fuchs (who still has not
brought up Murdoch or Hilburn), all went extremely well, and the
kidney is expected to recover over time.
Which is more than I can
say for Dr. Dude’s communications skill, and humanity.
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