There is one difference between a good provider and a... less good provider...

It's not what school they went to.

It's not how many letters they have after their name or how long they've been in the practice.

It's not how many associations they belong to.

It's how well they listen to their patients.

That's it.

I was recently in the hospital and I had to have a couple of different procedures. If you've been a patient for over 30 years, it's inevitable that some of your experiences will be less than positive. Even as a professional advocate, I have debilitating procedural anxiety as a result of these less than positive experiences. Even just the sterile scent of an OR sends my heart rate sky rocketing. I do my best to try to proactively put pieces in place to prevent this anxiety from taking control or getting in the way of the actual procedure, but as a patient, there's only so much I can do.

One of the procedures I had while I was in the hospital was the removal of my central line. For a bit of context... these lines are typically in for a few weeks or months at a time for treatment. Providers are not used to seeing patients who have had them in for years. In fact, one of the first things the doctor said was, "Must be a good day if you're getting your catheter out!" I didn't have enough time or breath or energy to explain why it, in fact, wasn't at all a good day. In the past, I have always had the removal and replacement happen in the same procedure, so I have almost always been sedated for this process. The one time I wasn't, it was removed in an office, had been in for three years, was only done with local anesthetic, included a lot of screaming and crying, and resulted in an abscess that took months to heal. Due to a miscommunication, I couldn't get anxiety medication in time, and because this was in the midst of COVID, there was some apprehension that we wouldn't be able to do both the removal and replacement at the same time due to scheduling, or something, so I agreed to it, thinking it would indeed be a simple procedure.

Because I made the mistake of assuming there would be some sort of sedation this time, based on the only other context I had, I didn't inquire about anxiety medication prior to this procedure. They wheeled me down to the cath lab and we were greeted by a room of scowling cross-armed doctors. The interventional radiologist began talking to me about the removal process. I didn't hear any of it. I said, "Am I going to get anything to like, calm me down?" The doctor, knowing this would be a quick and simple procedure, was very confused. Come to find out, there was someone there WITH anxiety meds in hand, but didn't administer them until the procedure was basically over for reasons I'm still unsure of. I very articulately said, "Okay, well... I'm probably going to freak out," and then my eyes immediately welled up with tears. I don't know if you've ever had an anxiety attack, but they are very inconvenient and very hard to come back from. It's not the same as a panic attack in that they usually happen as a result of a specific situational stressor, you know you're not going to die, but your frontal lobe checks out and logic is no longer helpful.

Despite the sobs I wasn't even trying to stifle, I was shuffled from my bed to the table where my gown was unsnapped, drapes were laid directly over my face, and everyone in the room continued to act as though nothing was happening. The same person who had the anxiety meds that I didn't receive until the procedure was basically over, whose name I never even learned, kept asking me curtly, "Why are you so worked up? What is wrong?" like I was just a huge inconvenience at that point. There was one person in the room who kept running over to check in on me and help try to calm me down. She spoke gently and kindly and held my hand and kept the drapes from falling directly into my eyes.

The procedure itself was quick and simple and painless and had anyone taken two seconds to explain to me what was going on, I might have been able to stay calm, but the whole thing was so unnecessarily chaotic, I was already gone. Then being scolded like I was a toddler in the midst of all of it, I was already scared, and then felt guilty and embarrassed for being scared. Like, trust me bro, if I could calm myself down, I would. I hate this even more than you. I finally got the anxiety meds AS THE PROCEDURE WAS ENDING, so as soon as I got back upstairs to my room, I fell asleep.

It didn't have to be that way.

A few days later, I found out I was going to have to have another line placed and was not going to be sedated for that either. This time, before it was even scheduled, I told my doctor, "I'm going to freak out." So she ordered anxiety meds to be administered before I even got to where I was going.

This time, I was wheeled into the room and was greeted by two smiling docs who were basically floating around the room, though that might've been the Ativan. They made sure I was comfortable and asked how I was feeling. I told them I was still absolutely terrified and they quickly ordered more meds to help me get more comfortable. They put on music and waited until I was properly spaced out to even begin setting up. The procedure itself went fine. I don't even remember it. But I know I was still really emotional; just the result of a long exhausting week. The response was so different though. They were compassionate, patient, and understanding. They didn't make me feel guilty or embarrassed, and they checked on me later in the week to see how I was doing.

I know hospitals are fast paced. I know our healthcare system stretches doctors and nurses to their limits and continues to ask them to do more with less. I know arriving 5 minutes late to a procedure throws off the whole day. I know doctors can't take the time to be best friends with every patient. I am not naive enough to ignore all of these truths, but I need providers to hear me. Every procedure you do could very well be the biggest scariest thing your patient will encounter that day, even if it's just a line removal. I understand that it is necessary for doctors to have emotional boundaries or they simply wouldn't be able to do their job, but the fact that one person in a room full of people even took the time to check in with me without making me feel like an idiot should not be acceptable in 2024. Not every doctor is going to be warm and fuzzy and that's okay. I mean, there's something to be said for bedside manner, but not everyone is going to have it, and I have long since come to terms with that. There's a difference between kindness and respect. I don't need you to be kind to me. I don't need to be coddled or babied, but at the very least, I need you to be respectful to me. I need you to communicate with me OR find someone who can. If you know that you have to see your patients as a giant slab of meat in order for you to do your job, you need to find someone who can treat me like a person. Patients are humans with feelings, and how you as a provider respond to those feelings will have a lifelong impact on that human. Be the one that checks in. Be the one that takes an extra second to explain what's happening. Be the one that makes the difference. Be the one that listens.