MAKING A DOCTOR’S APPOINTMENT AT UMASS MEMORIAL

MORNING QUARTET

I was having a dream about how I hadn’t yet managed to see a doctor about whatever it was that happened to me a few weeks ago. Two weeks? Three?

For the past few weeks, they’ve been researching my Pacemaker. Apparently my telling them that I can’t have an MRI because it would suck the Pacemaker out of my chest leaving me bleeding and quite probably, dead as the proverbial door nail.

What make door nails deader than other things? Has anyone done any research on this issue? No? Well, isn’t it about time?

The Front Door at UMass Memorial where they said I didn’t have an appointment

Meanwhile, back at the doctor and hospital, apparently a mere patient with the implant can’t say “No, don’t do that, it will kill me.” There are all these privacy laws in place, so mere information from the original source — me — is inadequate to stop the progress of grinding towards this very expensive test that I don’t merely not need, but which would end my life.

It took almost a week of research by the doctor’s nurse to track down my device and note that it cannot be allowed anywhere near those big magnets. She called the manufacturer, but privacy laws forbade them from saying anything about it. That I had the information was apparently irrelevant. Calling my cardiologist — again — was a no go. Privacy laws.

Meanwhile, I got a call from the MRI people to schedule an appointment. I had already had this same discussion with the nurse and said “No, no, no MRI no, not ever” but UMass Memorial does not give up easily.

So I said “I can’t have an MRI. I have a Pacemaker. A metal one. NO MRI. Never ever.”

“When did you get the Pacemaker?”

“Four years ago,” I replied.

“Oh,” she said.

That was the end of that call. Next I heard from the nurse who said she was really sorry about that call from the MRI group, but she had explained it, really she had and I said I believed her, really I did.

Yesterday I got a bundle of papers from Blue Cross to announce that they were happy to pay the gazillion dollars it would cost for the MRI that I can’t have because — y’know — it would kill me.

Valet parking at UMass Memorial — where they said I didn’t have an appointment

I sighed. Put the papers on the kitchen counter and went on with my day, pretending nothing had happened. It was too stupid and I just couldn’t deal with more stupidity. Especially medical stupidity.

But all night, I dreamed that I was trying to just talk to a doctor to see if anything even needed to be done for this “issue,” whatever it is. I think it’s related to my migraines  — a complicated, advanced version of the aura you get before a migraine. If you get migraines — with auras — you know what I mean. It affects your sight and makes you dizzy, sometimes nauseated … and occasionally gives every evidence of your having a stroke. But it isn’t a stroke. It just looks like one.

Another view of UMass Memorial — where they still said I didn’t have an appointment

It goes away without a trace and no amount of testing or tracking will find any evidence that it happened. Moreover, there are a dozen other things it could also be, all of which leave nothing in their wake. They happen, they scare the pants off you and yours — and vanish.

And may — or may not — ever occur again.

More parking lots at (you guessed it) UMass Memorial

This has happened a few times through my 71 years. For a while, after  one or another surgery when I was terribly thin — emaciated — it happened fairly often. Good thing I weighed so little since strong men had to haul my butt upstairs until I came to. Since the cancer and heart surgery, the worst part has been occasional dizziness, but none of those screaming seizures.

I had one, though, a few weeks ago for no apparent reason. Although I don’t think it was important and still don’t think it was medically significant, my doctor thinks I should at least have a chat with a neurologist. I agreed to the chat because how big a deal should it be to see a doctor and talk a bit?

After last night’s dream, I took a deep breath and called the nurse at my doctor’s office who assured me that they shouldn’t be sending me paperwork agreeing to the MRI I can’t have and she would call the hospital and make sure a doctor — or nurse, but anyone someone medical — would call me. Soon.

I hung up. That was the second call.

The phone rang. It was the MRI group trying to set up another appointment. I said “NO MRI I HAVE A METAL PACEMAKER” and she said “Then how about an EEG?” I breathed again. Deeply. Slowly. Counting.

More views of the excessive amount of snow on the grounds of UMass Memorial

The next thing she did was ask me why I didn’t show up at my March 15th appointment. That was the one I went to where they sent us home because they said there was no appointment or maybe the nurse had screwed up the paperwork, but one way or the other, we went home.

I said “We were there. We were told there WAS no appointment and they sent us home.”

“That’s impossible,” she said.

“Would you like to see the photographs I took of the hospital? And the receipt for the parking? Would you like signed papers from my husband and I attesting to having been there and being turned away as not having an appointment?”

She said that couldn’t be because things like that don’t happen at UMass Memorial. Breathe, Marilyn. Breathe.

“I would like to talk to a doctor before I make any other arrangements. Let’s see if I even need testing.” So she connected me to the Neurology Department. They asked me my name. “Marilyn Armstrong,” I said.

She said “You don’t have to be hostile!”

The trip home from that missing appointment

I said I wasn’t being hostile. That was my name. She asked me for my last name again and I said “Armstrong.” Silence. “I still need your last name,” she said and I said (louder) “Armstrong,” so she hung up. Still breathing slowly I called again. Asked for neurology. Gave my name. Was questioned (again) about how come I never showed up for my March 15th appointment. Said I had but was told there was no appointment. Was assured that couldn’t have happened. Whatever.

“Be that as it may,” said I, “I would like to talk to a doctor. Or a nurse. Or a nurse practitioner. Or even a receptionist.” She asked me where I’d like to be seen and I said Worcester, so she connected me to the Bolton office which is 50 miles northwest of here and nowhere near Worcester.

I hung up and called back. Determination is my middle name. The remnants of the blizzard from two days before March 15 when I didn’t have an appointment

I told her — this time — that a doctor was supposed to call me this morning, but instead I heard from the testing department about setting up an MRI or some other test, but before we set up tests, can I — pause, pause, breathe in, breathe out — please talk to a medical person. So we can decide if I need testing.

She said a doctor would call and I said “Well, I’m off to the Oncologist today, so if no one calls soon, it will have to be tomorrow . I repeated my phone number, name, date of birth and reminded her that this was the ONLY telephone number I have and it is NOT a cell phone. Try to deal with the concept of it not being a cell phone. In other words, please don’t text me.

After which I hung up and couldn’t find my new blue jeans. I gave up on that and wore the blue pants I bought months ago and forgot I owned. Went to get coffee and an English muffin with raspberry jelly.

And then I wrote this post.

How many calls was that? I’m pretty sure it was four, a basic quartet, but it gets difficult to count what with the transfers, hang ups, and calling back.

Lovely view of beautiful glass building at UMass Memorial.

Garry thought I sounded cranky so I explained and he said “Oh,” and offered to refill my cup. I still have to go to the oncologist and hope I still don’t have cancer.

It’s noon. So many more things could yet happen today. Maybe I should call off the doctor and go back to bed.

Nah. Let’s get it done already. Deferring the event will just make it even more complicated.



Categories: #Health, Customer Service, Medical

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47 replies

  1. Reblogged this on KCJones and commented:
    Same stuff WorldWide!!

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  2. hi marilyn!
    1-yes i get migraines with an aura(since 1970)
    2-do have medic alert bracelets that say “NO MRI” or something? i think you can order them.
    3-i let my primary care physician coordinate all my tests the office is great.
    4-unless i am , or feel like i am, on the verge of death, have a compound fracture or am bleeding profusely-i will not go near a hospital. those people will kill you. and i got C-diff there last year when i was really sick already.

    always confirm appointments. dont let the bastards get you down. and they CANT MAKE YOU GO THERE.
    is there not an independent lab/ testing place near you? they’re great with testing.
    i think there is a HIPA release you can sign relative to any problem so practitioners can share info.
    FEEL BETTER!!!-SENDING LOVE HUGS AND UM-ICE CREAM???

    Jane

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    • Thank you for the reminders. I should have called. I don’t what possessed me to assume they really had the appointment, even though they called me the day before to remind me of the appointment I didn’t have.

      I DID let my doctor’s office make the appointment. the problem isn’t MY doctor. It’s UMass. They have been calling me daily to check in on my health. After treating me like a demented old far for 18 years.

      Liked by 1 person

      • wow- must be the hospital. sounds really bad!! is there no place else you can go? also a thought: is there someone who could make the phone calls FOR you? ( not gary) someone badass who is not emotionally involved?? like a
        “producer of health care”
        ?

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        • I can go to any hospital. There’s a good little one in Worcester. Otherwise, it’s Boston, which is a bit of a haul and inconvenient, but at least I’ll feel safe. I have gone to Boston for all my serious surgery. That’s where the good places are.

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  3. Poor soul; I probably would have imploded…. Or rather, I guess, my pacemaker would have!
    As for not getting your name: I live with it on a daily basis. We are Swiss with a Swiss name and nobody in France can spell it – so I listen to quite a variety of pronounciations…. The woman who was insulted probably understood something beginning with ‘ass’? 😉
    I wish you only good news from now on and congratulate you to keeping your temper at bay. Maybe you should get a golden needle for your lapel for being so patient. BTW, do you know that patient means ‘being patient’ in French…. But stop, you couldn’t put that golden needle on your clothes with a metal pacemaker, what a well-meant but crap idea 🙂

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    • Your pacemaker KEEPS YOU FROM IMPLODING. It keeps your heart beating neatly and nicely. Also, I have two replaced valves, so I’m a masterpiece of rebuilt humanity. Breathe, breathe, breathe.

      Liked by 1 person

  4. Unbelievable! Why did they object to your last name being Armstrong? This whole story is just teeth-grindingly infuriating!! Worse evern–much worse–than my flying from Mexico to Wyoming for an annual checkup that they scheduled for after I had a battery of tests that took two weeks and then when I arrived for the results and the physical the day before i was supposed to fly back to Mexico, I was told no appointment had been made! So I got all the test results without ever seeing a doctor.It happens. The surprising thing is they would not acknowledge that it could be their fault.. as though I would spend the money for a plane ticket from Guadalajara to Sheridan, Wyoming without having an appointment. Oy vey. I hope your problems are resolved before they CAUSE a heart attack, Marilyn. All my sympathies…

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    • I actually have no idea. Maybe she thought I was saying something else, though what I have not the slightest idea. I actually had a long talk with the guy who runs the place. Sometimes, if we are lucky, Garry’s name — and reading my writing — combine to get someone’s attention. He knows they have a problem. But can they solve it? That would require that they deal with making receptionists actually care about the people they talk to — and not lying to patients. Apparently, I DID have an appointment, but they told me I didn’t. All the lying and bullshit. At least it convinced me that NO way is Garry having surgery in that hospital

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      • I hope he apologized. After this, be sure to get the names of all the receptionists you deal with so at least someone can be called on the carpet for it. Doesn’t help you but would make me feel better about it!!!

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  5. It’s amazing how things can get f(*#ed up. Like when I went to the surgeon in Salida who 1) couldn’t read my X-rays and 2) told me one leg is shorter than the other. It blows me away that someone had to pay for that appointment. And like the prosthesis in my right leg. There are angles to which I canNOT turn my foot (pigeontoed) without risking dislocation. Get an X-ray, “Go pigeon toed. MORE.” No. NO way in hell am I doing that.

    I don’t know… There’s a happy medium between a huge, fancy teaching hospital like UMASS and the five bed rural thing in Del Norte where you get a LOT of personal attention and people do talk to each other. I wish you didn’t have to go through all this. ❤

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    • There are big hospitals in Boston that are very well run. Where the medical staff talks to patients and you feel as if “they’ve got you.” Beth Israel was like that. It’s big. Huge, actually, though not as big as UMass — but that’s just because UMass is a medical school as well as a hospital.

      Big doesn’t have to mean badly run. Big doesn’t have to mean rude receptionists. Big doesn’t have to mean that one department doesn’t talk to the others. The badly run part is particular to UMass which has had this problem as long as I can remember, especially the rude receptionists and the inability of one department to pass information to another. Or to ever get a message straight. How many times does the MRI department need to be told that they cannot give me an MRI without killing me? How many people have to call them with the same information?

      Today I talked to the guy who HEADS the hospital. Maybe that will help. Because if it doesn’t, I’ll get myself geared up and go to Boston where they know how to run a hospital.

      Liked by 1 person

        • It’s also one of my worries about Garry’s possible surgery. Is THIS the place to do it? Do they know what they are doing? Do the nurses know what they are doing? Will they take care of him? Whatever is wrong with me is not a big deal … but what they are discussing doing to Garry is a very big deal.

          Liked by 1 person

          • Yeah. I understand those kinds of doubts very well. I also think trusting the doc, trusting the hospital and being confident that (at the very least) they will do the best that’s humanly possible — well, that’s all the insurance that’s possible, I think, regarding a good outcome. If you can’t relax in those things, don’t go there.

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            • I think by the end of this day, Garry’s doubts had firmed up into real fear. No matter what they promise, NO hospital is any better than their receptionists and the nurse’s aids … because THEY are the people you are going to interact with most of the time.

              Liked by 1 person

  6. Oh my gosh, Marilyn. You don’t need to say a word because I am speechless. Holy crap. Totally speechless.

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    • I’m exhausted. I’ve actually done about as much as I am willing to do. I know I could push it along and make it a “thing” — but I’m tired. I’ve served my time, doing the right things. Now, I just want to take care of me and mine.

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  7. I truly feel your pain! Although my PC Doc KNOWS I can not take steroids – it is in my file – that was prescribed for me and that is what put me in the hospital this last time with a sugar of 800. It turned out to be a happy accident since that is how they found the heart blockage… but that was after 3 days in and out of consciousness while they fought to get my sugar under control. I nearly died – no joke. The last weekend I was in, the cardiologist on call told me I could go home and come back for the heart cath and stint. Ok, sounds wonderful to me, I obviously wasn’t very sick so, I turned into a hysterical woman wanting to go home and see my dogs. The cardiologist on call had failed to mention just how sick my heart was. When Dr. Ali, the internal med doc, told me I could brush my hair too vigorously and drop dead, I calmed down and thanked Dr. Ali profusely for saving my life. I had determined I was going home even if Dr. Ali would not release me! Needless to say, I have put off my follow up with my PC…I’m still too angry. I see my Cardiologist next month and he and I are going to have a talk about his assistant – I am hoping I will be less angry, but I ain’t promising nothing. lol

    I have migraines too; have since a young child. I see the auras, loose vision, etc. While these do not hurt, they can give you some weird symptoms. The painful ones have gotten less and less frequent the older I have gotten. Hope you get some good advice on them – (there is medicine you can take for them now), and that your appt. with oncology turns out all clear. I just got the all clear from mine, all scans were negative…whew!

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    • I have no symptoms that would alert my oncologist. It’s 8 years, so I’m probably safe from at least THAT cancer.

      I also went through a long level of hell with my heart — diagnoses that if I had followed them, I would be dead. Garry said I needed to write to the hospital. I couldn’t find a contact on their website, so I did what Garry would have done — I contacted the head of the hospital and his top PR agent and told them my husband — the guy they used to watch on TV — was going to hook me up to his contacts on Boston media because I’d had enough. I asked if there was a law that me it illegal for me to see a doctor BEFORE they order tests? I don’t mind tests, but I’d like to know there’s some point to them. If there’s no information they can get from them, why spend the money and time?

      Nice conversation. It’s good that this didn’t turn out to be something really dangerous because I’d be dead by now. And they persist in trying to make me get a (terminal) MRI. They make me so MAD. It’s just stupidity and bad communications. I’m pretty sure they’ve got doctors. What they don’t have are people who know how to talk to patients.

      It has been a very long day and I’m dead on my feet. At least as far as anyone can tell, I don’t have new cancer or any symptoms pointing towards cancer. My cardiologist is pretty happy with my heart, too. Maybe someday I’ll even get to see a neurologist! You never know. It COULD happen.

      Liked by 1 person

      • My Cardiologist is Dr. Stamper and he is one of the best in the nation…why he is in Memphis is beyond me. lol I am going to suggest you contact the national registry and get a recommendation for your area. These usually have references from people who have been patients and that can tell you a lot.

        We have 3 major hospitals here and I have been in all 3. I wouldn’t send my dog back to Methodist, but the other 2 are great. I have no idea if hospitals have sites that rate them or not, but check. The one you are using doesn’t seem to be nearly as wonderful as they think they are, so try to find another if you can.

        I was lucky with Dr. Ali, who went out of his way to explain my condition when the other doc dropped the ball. I am half in love with him…he would come to my room and just talk to me about life, his daughters, etc. Oh to have been 10 years younger…I’d be stalking him. He was also very handsome…hubba, hubba. lol

        We all make the mistake of trusting doctors and hospitals just because they are the professionals….which can leave us dead. My mother, a RN, could find the biggest quack within a 100 miles…and that’s who she used. Have no idea why. She had a radical mastectomy because the doctor she was seeing kept telling her the lump in her breast wasn’t anything to worry about. As a nurse, she KNEW better, but because he was the doctor she waited 2 years before being forced to see a different doctor (she had moved) who immediately admitted her for surgery.

        I have a neurologist that I haven’t seen in a couple of years…since my last little stroke. But I do see his partner on a regular basis for BP and kidney care.

        Don’t you hate having to see a different doctor for every single thing? I do.

        I am so glad you are cancer free! Us old ladies have enough to worry about. My friend Phil, lived almost 8 years after being diagnosed with bone cancer. I lost him just 6 months ago. He went to the Cancer Treatment Center then to Duke University. 8 years survival for bone cancer was unheard of just 10 years ago, so they are doing great things now with treatments. My cancer was in my kidney, but in a good location so I still have a functioning kidney left after surgery, which was important since I am diabetic. Do I do run-on sentences much? LOL

        I seem to get very long winded…sorry. Feel better! G

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        • I do my research. I was hoping that since all I needed was a sit down with a neurologist that this ONCE it wasn’t going to turn into a major big deal. Apparently, when you deal with UMass, there’s nothing simple. Ever.

          I was very careful about my heart surgery. I have been the victim of bad doctors who I went to because they were convenient. It turns out not having a long drive and bad parking is not as important as having a doctor who can save your life.

          Liked by 1 person

          • Yea! Internet is now fixed! LOL

            Too right! We tend to learn the hard way. lol It has taken me several years to get a good team in place that I comfortable with, but the years before hand were tough! lol I hope you find better, inconvenient or not.

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  8. A Catch 22 if ever there was one – what a nightmare for you. I hope all turns out okay with all your tests.

    Liked by 1 person

    • Garry says I should complain. I suppose. I just don’t think it’ll make any difference. They have been totally screwed up since we moved here. And aren’t showing any sign of improvement.

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  9. That is a nightmare compounded by 4. Holy crap! I thought you handled it admirably considering. I hate that MY body and my KNOWING my body and what it can and cannot do having lived in it for 63 years goes under the heading of unqualified knowledge. Don’t care what “others” have to say, I know how it responds and when it’s not working right. J H C. already!

    Liked by 1 person

    • Yeah, well, not being willing to believe me when I say I can’t have an MRI goes beyond the usual level of stupid into a kind of idiocy. But I’m just back from the oncologist, so I need some unstructured brain time before I think about them again. Sheesh.

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  10. What a nightmare Marilyn. I would have had a hard time staying civil over this.
    Leslie

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  11. My sincerest sympathy. I truly hate it when healthcare practices (including big wonking hospitals) become so BIG that nobody knows what anyone else is doing. Information ceases to be shared. Common sense is murdered. Quietly and without fuss and until the determined patient comes along, nobody notices either. I’ve met a relative of your huffy phone woman who was insistent that you were being hostile by saying your name. I usually breath, get THEIR name (which they are required to give you) and hang up on them. Call back. If they answer again, I ask for their supervisor. Stay determined. It’s your body, you deserve the best care they can offer. Which, I admit, ain’t sayin’ much. The best care is gone sadly.

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    • I have been in a lot of hospitals, but this one takes the prize for idiotic failure to manage anything. And it really IS the biggest hospital in the state AND our primary medical teaching facility. Yikes. So they are a big deal, but they don’t have a clue about anything … and the idea of having anything serious done at their facility makes me more than a little nervous. What ELSE don’t they know about? If they make me ANY crazier, I’ll haul myself into Boston where the hospitals actually know what they are doing.

      Liked by 1 person

      • This is really, really scary.., kinda makes you wish for the return of the General Practitioner of old. The doctor who made house calls and knew your whole history. Today’s tendency towards “disconnected” specialist is dangerous and I’m amazed that more, serious, mistakes haven’t been made…, Ooooor have they?

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        • They make a LOT of mistakes. They don’t read the directions — and a lot of the help in hospitals can’t really read English, so the instruction never get to their brains. I actually had a nice chat with the guy who run the hospital. I was SO pissed off and this isn’t the first time. I really have been patient, but this has been going on for weeks and I’ve just HAD it.

          Yeah, they make a lot of medical errors, most of which get buried by the hospitals — Jeffrey was an accident. A dead accident.

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      • You hope! It could be spreading you know. How you didn’t explode with the rage of it all, I don’t know, I nearly did, just reading about it….

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  12. And I thought that sort of thing only happened in England with their National Health Service. My dad had a pacemaker. He was then in palliative care, age 100 years and 6 months. They decided his pacemaker should be checked needing an hours journey by ambulance across London, or they told me I could do it myself with a car (and a plane from Swizterland?) So they checked his pacemaker and it was OK. If it hadn’t been OK, what would they have done – fitted him a new one? I was livid that they did all this with him, a dying man which he was at the time. He was old and weary. but no, he had to go through this odyssy and two days later he was no more, but not because of the pacemaker, that was in perfect working order, my dad’s time had come.

    Liked by 1 person

    • What to me is MOST baffling is why MY telling them they CANNOT do an MRI because of the pacemaker isn’t enough information. What would happen if I had a car crash and was unconscious? Would Garry have to throw himself physically over my body screaming NO NO NO until someone listened?

      Most hospitals aren’t this bad, but this one is really terrible. It is, unfortunately, the ONLY major hospital in this county. If I don’t go here, we have to haul ourselves into Boston. But one more round of this and I will just give up. Whatever is wrong with me will remain wrong with me. If I actually thought there was something dangerous going on, it would be different, but I’m quite sure it’s nothing, really. And UMass Memorial is really AWFUL.

      Liked by 4 people

    • PAT & Marilyn; and I thought this could only happen here in F!
      I didn’t go to a doctor 3 days before Christmas after a heavy fall on my shoulder, arm with damaged tissue and more because after having made some 8 calls with waiting times each around 5’ and then finally be disconnected – simply because it was IMPOSSIBLE…. Had no xrays either as I had no doctor’s paper.
      HH went to his dental appointment – came back – said he didn’t have an appointment (but he got another one 3 days later) – I showed him the original handwritten card I took with me from said dentist….
      3 days ago I had to call again 3 times x 5-8’ each to receive an appointment with my doctor. Told him that I could easily die if I had an emergency for failing to get an actual human being to interrupt either Vivaldi’s spring or a super-annoying announcement for ‘calls will be registered to improve the quality and thank you really very much for waiting another 24hrs before we might be able to answer your call’….. Said doctor sighed and said ‘I know but having our own secretary is just simply too expensive’…. That’s OK then – and that after waiting still 80’ after the time I was called up for.

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      • It’s bad. NOT all big hospitals are bad, though. Beth Israel, in Boston, is superb and I don’t say that lightly. I felt safe there. They “had me.” If you pressed a button a nurse would be at your side in under two minutes. They didn’t use underpaid non-English speaking nurse’s aides. They had actual NURSES. Of course not ever nurse was a gem, but at least they had some fundamental understanding of the human condition and if they didn’t know an answer, they found someone who did know.

        Meanwhile, UMass is atrocious. Worse maybe because it’s supposedly the primary hospital for a county in the middle of the state — a state renowned for high quality medical treatment. Which IS available — in Boston. My nurse (at my doctor’s office — and they are WONDERFUL) told me I should probably try the much smaller hospital in Worcester — St. Vincent’s — because they really ARE much better. The problem is that UMass has all the top-quality latest equipment, so for a lot of things, you have to go there or travel to Boston — a long drive through heavy traffic with expensive parking. We are luckier than people who live in places like Maine because a lot of them have to travel to Boston because their facilities don’t have the equipment for complicated surgery.

        For this issue, St. Vincent would be fine for me, but Garry’s cochlear implant? More and more, I distrust putting him at the hands of these losers.

        This is a state-owned hospital. It’s our major medical school (there’s also Tufts and Harvard, but you need some big, big money to go to either of them) and one of our primary research facilities. Yet somehow, all the good research seems to come out of the Boston Hospitals — The Baptist, Beth Israel, Brigham and Womens’s, Harvard — and it SHOULD be coming out of UMass.

        UMass has extensions everywhere in Mass. The biggest chunk is near us in Worcester, but there’s a hunk of it in Amherst (where all the universities are), in Boston and Fitchberg and other places I can’t quite remember at the moment. Medical expertise is a big deal in Massachusetts, so to have it’s only state owned major facility be so awful … well … it’s really wrong. Garry is now writing to friends at the other TV stations. They’ve run pieces about this before, mind you. Everyone nods and says yes, we have to do something — but they don’t do ANYTHING.

        Add that to the railroads that have been falling apart for more than 40 years.

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