Confounding Health Care

by Robert A. Duke

Artwork by Hilary Cole


Man goes into Doctor’s office.

“Doc, I have pain in my right shoulder.”

Doc consults, examines and orders ultrasound and X-rays.

Man gives X-ray order to imaging Reception and follows Tech to X-ray machine.

“Why are you here?” Tech asks.

“Doc ordered an X-ray,” Man says.

“For what? An accident?” Tech asks.

“You’ll have to look at the order,” Man says.

“I don’t have it. Reception has it,” Tech says.

“Then call Doc,” Man says.

“I’m not allowed to do that,” Tech says.

“Why does it matter?” Man asks.

“Need to know so I can tell Radiologist to help her read the X-ray,” Tech says.

Man wonders: Is Tech saying Radiologist doesn’t know what she’s looking for from Doc’s notes or X-ray order?

“Where’s Radiologist, I’ll talk to her,” Man says. “Or she can read the order or call Doc.”

Exasperated, Tech asks, “Are your fingers numb?”

“No,” Man replies.

Tech, seemingly satisfied, proceeds to take five X-rays and asks no more questions.

Next, Man heads to ultrasound.

Man tells ultrasound Reception he is there to make an appointment for his right shoulder.

“You can’t make an appointment here,” Reception says, as she pushes a telephone toward Man. “You have to call this number,” Reception says, pointing to the ultrasound order.

“I could do that from home,” Man says. But as he turns to leave, Reception says, “I can make a copy of your order.”

“Is this where I come for the ultrasound?” Man asks.

“Yes,” Reception says.

“But I can’t make an appointment here,” Man says.

“No,” Reception replies.

Man goes home and phones for an ultrasound appointment.

“Why are you calling for an ultrasound appointment?” phone Voice asks.

“Doc ordered it,” Man answers.

Voice asks, “What is the appointment for?”

“My right shoulder,” Man answers.

“What’s wrong with your right shoulder?” Voice asks.

“I don’t know, but my Doc ordered it,” Man says.

Voice says she has to know what the problem is.

Man thinks: I’m having X-rays and ultrasound to discover what’s wrong with it.

Exasperated, Man says to Voice, “For privacy purposes, patients are advised not to give personal health information over the phone. And, since I don’t know who you are, I shouldn’t tell you any more. I just want the appointment Doc ordered. I gave ultrasound Reception a copy of the order and you can look at it if you’re authorized.”

Voice says she can’t do that because she isn’t at that office, but she is authorized to ask these questions because she is a nurse with the imaging company.

More exasperated, Man says, when he asks for medical information over the phone, nurses challenge him to answer security questions. “What’s your name?” he challenges her.

Voice ignores this and says she cannot make an appointment unless Man explains to her what it is about.

Man says, “I don’t feel qualified to explain my symptoms to you accurately. You should call Doc’s office.”

After a long silence, Voice asks, “Is it painful?” Man says, “Yes.”

With a hint of delight, Voice says, “That’s all I needed to know to make the appointment.”

Sounding pleased and in control again, Voice offers: “We need information so Techs can configure equipment for examining you.”

Man slumps forward staring at phone in his lap, no longer listening.

Robert A. Duke is author of “Waking Up Dying: Caregiving When There Is No Tomorrow,” and lives in Bellingham. His email:

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