Let me start this post by saying that the front office staff in just about every one of my physicians' offices are unusually accommodating to my crazy scheduling requests. I will only under the rarest of circumstances come upon a schedule request that they cannot meet. With my rheumatologist, I know if I am not one of his first three appointments of the day, I will spend hours in the waiting room. With my PCP I know that if I book an appointment any time between 8AM until about 9:30AM I should have a minimal time between checking in and getting called into the exam room. I am not impatient if I am kept waiting. I don't constantly check the time or question the receptionist if the doctor knows that I am there. It is just that I cannot relax in any waiting room. All I can focus on is the germs that surround me. If the seats are covered in fabric, you know that they haven't been wiped down with any disinfectant. Who sat in the chair last? Were they sneezing or coughing into their hands and then did they put their hands back on the chair?
I swear I was never this paranoid about germs and diseases. Then I started recognizing patterns. Take a child to the pediatrician for a well visit and they are sure to have a cold within days. First I banned my children from playing with any of the toys at the pediatrician's office. We brought our own from home. Then I adopted a game plan; the first appointment in the morning or the first one after lunch as the times I would take them in. It wasn't until the pattern started happening to me that I went from being very easy to book an appointment for to making special requests. I would go in for a well visit or to get my yearly flu shot, and I would subsequently have bronchitis, a stomach bug or whatever the germ of the day was. Whether proven or not, I am of the firm belief that the less time I spend in the waiting room, and in the doctor's office in general, the better off I am. Yes, I know that the handles of the carts at the grocery store are covered in germs as are door handles and the tabletop at your favorite casual eatery where they swipe a couple of crumbs off the table before you sit down.
My germaphobia would make for a strong debate but perhaps in another post. When I was being scheduled for my monthly visit with my PCP for this past April, it happened to fall during Passover week. He was not working at the beginning of the week but would be working in the afternoon of that Friday; Good Friday. The only appointment time they had available was 2:40PM. I had no other option so I agreed to be there at that time on that day. On the day of the appointment, I was feeling a bit congested so all signs seemed to point forward.
I arrived, checked in and found a seat in the crowded room. I hadn't remembered to bring my Kindle so I just sat there waiting for my name to be called. Without something to read I started people watching. I looked around at the collective audience in the waiting room. There was the son, standing at attention behind his mother’s wheelchair. She was wearing a nasal canula attached to her portable oxygen tank. Her edemenous legs pushing her pants outward and her bedroom slippers barely encasing her equally swollen feet. She kept inspecting her hands over and over looking for something barely perceptible to others but every once in a while she would find something that she would brush away. Her son, started to talk to me, a stranger, explaining that when he went through this with his father it was much worse because the doctor network he was in was so unreliable. He said that this network was much more easy to work with. We made the kind of polite small talk that strangers make while sitting hostage to an overbooked patient schedule. He was clean but dressed in worn, out of style clothes and sneakers that looked as if they no longer had a tread left.
Fellow patients, and their family members, mostly kept to themselves. There was a young woman there with her parents. Her mother dressed in well tailored jeans, heels with their trademark red soles and a handbag that cost as much as a car payment, if not a mortgage payment. Her husband speaking loudly on his cell phone despite sign after sign asking people to not use their cell phones in the waiting room. I have been guilty of using my cell phone in that same waiting room, usually just to check in with the boys or to assure them that I will be home soon. When the daughter was called in to be seen by the doctor, the nurse tells the mother that she was welcome to come with them. The young woman was not even consulted and she certainly looked to be over 18 to me, perhaps even as old as her young to mid 20s. I felt the girl’s conflict as she followed the nurse but kept a wary eye on the mother that was following behind.
There is a WIC office right off of the waiting room. A mother leaves that office with an abundance of powdered formula. As she is strapping her very little bundle of a baby into the carriage she looks directly at a woman who had been staring at her and felt the need to apologize for the formula. The cries and noises from the baby indicated to me that this was a newborn. There is a very distinct difference in the sound of a newborn to older infants. The mother looks directly at the woman and said “I tried to nurse, but it didn’t work”. I felt sorry that she felt obligated to need to explain such a personal decision with a stranger.
The loud speaking dad takes a new call. His end of the conversation gave the waiting room more details about his family. “Yes, we are at the doctor’s now”. “No, she is not going back. We are going to buy her a house near us”. His wife returns to the waiting room and says to him “Shhhh, she doesn’t know that yet. Who are you telling?” He says some name with his hand over the microphone. His wife tells him to stop the conversation because their daughter will be coming out soon.
There was the filthy man sitting in a corner, speaking to himself while rocking back and forth. His words either did not make sense or were not clear enough to hear. There was the man in work out clothes and very clean, white sneakers tapping his foot and checking his watch with impatience. There was a woman there with a huge handbag from which I witness the appearance of a water bottle, a notebook and a bag of chips.
The receptionists talk of their weekend plans and then start to speak of televisions programs they had seen the previous week and those they were looking forward to seeing in the week to come.
Eventually my own name is called and I go through the basics of the pre-physician appearance. My vital signs are recorded in my on-line record. My time with my physician is short. He confirms a sinus infections, prints out prescriptions for that and others for my regular medications. My visit took a few minutes, at most. What should have been just that - a short visit - had taken three hours on this Friday afternoon.