My day had began early that Friday. My spouse, Joanne, and I arrived at 7 a.m. for my 10-year comply with up colonoscopy with Dr. Smith. Though I had referred quite a lot of my sufferers to his group, I hadn’t labored a lot with him and even met him. Because the nurse was going by means of her guidelines of duties, she casually talked about that he was retiring that day and a celebration was scheduled that night.
I used to be taken into the process room on time and Half-hour later I wakened within the restoration room.
“Dr. Mieczkowski, all the things went properly,” Dr. Smith informed me. “I eliminated one giant polyp and some smaller ones, however none of them concern me. My workplace will let you already know the leads to a number of days.”
I thanked him and supplied finest needs on his retirement, considering that I’d by no means see him once more. I used to be relieved ― no indicators of most cancers.
Joanne and I went dwelling to eat lunch. Since I felt properly, we drove to the workplace to do some paperwork. Round 2:45 p.m., I had an pressing want to make use of the lavatory and handed streaks of blood. I knew this was frequent after a colonoscopy, so I didn’t inform Joanne or name the physician’s workplace. Fifteen minutes later, I felt extra urgency and made one other hurried journey to the lavatory. There was extra blood ― much more blood.
“Oh shit! Rattling it,” I mentioned out loud.
I informed Joanne what was happening, and she or he requested, “Would you like me to name the EMTs? Are you feeling faint?” We determined to drive ourselves to a hospital just a few miles away. I known as the doctor’s workplace with an replace whereas we have been on our means.
Upon arrival, I used to be relieved to see that the ready room was empty. I checked in on the desk and some minutes later, a nurse opened the door. “Dr. Mieczkowski? Come on again,” she informed me.
I made it. I’m going to be all proper, I assumed. I took a deep breath of aid as Joanne and I walked by means of the door and have been led to my room. The nurse did the same old check-in duties, linked me to the monitor monitoring my coronary heart fee and blood stress, put an IV in my arm, and drew blood for testing.
“No working fluids?” I questioned. “That’ll be as much as the physician after he sees you,” she replied. As she completed, I felt an pressing want to maneuver my bowels and requested a bedside commode. I shortly handed a number of pints of blood, which almost crammed the container. I had simply misplaced almost 20% of my blood quantity. I used to be shocked and knew that I used to be in bother.
“So, you’re Dr. Mieczkowski,” Dr. Woods, the ER physician, mentioned sarcastically as he walked in. Nice! Right here we go, I assumed. “Yup, that’s me,” I replied, making an attempt to cut back the strain. I identified the blood within the commode, however Dr. Woods didn’t appear impressed.
Whereas taking my medical historical past and doing a quick examination, he was always wanting up on the monitor, which confirmed a coronary heart fee of 62 and a standard blood stress. (Usually, an individual’s coronary heart fee goes as much as compensate for blood loss.) He commented on the low coronary heart fee as a sign that I used to be secure. I used to be puzzled. “Dr. Woods, I’m on a excessive dose of a beta blocker for my blood stress,” I informed him. “My coronary heart fee is at all times round 50 and by no means will get above 80.” It didn’t alter his considering. I requested whether or not he was going to begin working IV fluids and order blood transfusions. “You look fairly secure,” he answered. “I feel we are able to maintain off for now till the labs come again. We’ll see the way it goes.”
I used to be dumbfounded. I had 40 years of expertise. If I noticed that quantity of blood loss in a 62-year-old male with coronary heart illness on aspirin ― a potent blood thinner ― I’d have known as for a right away GI (gastrointestinal) seek the advice of, began IV fluids, and ordered blood to be prepared for transfusion. Sadly, he jumped to a conclusion that my bleeding couldn’t be critical since my coronary heart fee was low. He was working the present and damned if he was going to take heed to me.
I continued to move a considerable amount of blood each 20-Half-hour. Because the blood-filled commode had not been emptied, I used the lavatory throughout the corridor. I used to be not considering clearly at this level and failed to notice the blood loss was not being measured. I at all times ordered nurses to watch a affected person’s blood loss and urine output. I turned weaker and paler with every episode, and I started to fret that I used to be going to bleed out. I held again on sharing my fears with Joanne.
Courtesy of Lawrence Mieczkowski
My situation deteriorated because the hours handed within the ER. The lab outcomes documented the drop in my blood quantity. My nervousness stage grew ― one other signal of worsening shock. I buzzed the nurse’s station and requested to have Dr. Woods come again. When he arrived, I went by means of my record of considerations. I requested once more about getting blood and platelet transfusions.
“The place’s the GI seek the advice of for a repeat colonoscopy?” I requested. Dr. Woods had had sufficient of my questions. He interrupted me and mentioned, “, Dr. Mieczkowski, you could have extra gray hair in your beard than me, however this isn’t my first rodeo.” My spouse and I checked out one another shocked! He went on, “I feel you’re overreacting, and I’m positive you’re anxious. Why don’t I provide you with some lorazepam to calm you down.” I used to be within the palms of a physician I didn’t know or belief, and he refused to take heed to my considerations.
It was round 5:30 p.m. at this level. Then, to my shock, Dr. Smith entered my room. He requested a number of questions, peeked into the bedside commode, listened to my coronary heart and stomach and poked round a bit. I reiterated my worries and requested immediately, “Are you going to do a repeat colonoscopy now?” He paused for a protracted whereas earlier than lastly answering, “Why don’t we wait this out and do a repeat colonoscopy tomorrow morning for those who’re nonetheless bleeding. I’ll admit you to the hospitalist service.”
I knew from my very own experiences that physicians at all times should weigh the professionals and cons of doing one other process versus shut commentary. He needed to know {that a} GI bleed is extra critical in an older affected person with coronary heart illness on a blood thinner. What was I purported to do now? We clearly disagreed in regards to the subsequent steps, however I couldn’t plead my case any additional. He was delaying a probably lifesaving process ― one of many main causes of great adversarial occasions. I couldn’t assist however suppose that the night retirement get together influenced his determination.
Round 7 p.m., one of many hospitalists on responsibility visited me. He was thorough and, not like Dr. Woods, he was respectful of my expertise. He gave orders for blood and platelet transfusions, began IV fluids and admitted me to a medical unit upstairs. Since he was ending his shift, he assured me the evening shift hospitalist would test in on me. Joanne and I have been anxious to get out of the emergency room and off the palms of Dr. Woods. I used to be relieved.
Sadly, my bleeding continued in my new room. I famous that my nurse positioned a basin in the bathroom to measure my blood loss. When she noticed the quantity, she was startled and requested if I had been experiencing that stage of blood loss all day. “Sure, and so they by no means measured the blood loss,” Joanne informed her.
The hours handed, and I misplaced observe of time. I stored asking, “The place’s the blood?” The nurse stored replying, “It’s been ordered. We’re nonetheless ready.” I used to be getting colder and fewer conscious of my environment. I drifted out and in of sleep however felt my spouse’s hand on me always. I knew she was scared. I used to be bleeding out, albeit extra slowly than an individual with a gunshot wound of their stomach.
It was round 11:30 p.m. when a way of calm began to return over me ― it was an acceptance that I’d die peacefully in mattress. So that is what it feels wish to die, I assumed. I used to be now not afraid. “I’m going to die,” I mentioned in a whisper. I can’t think about how Joanne felt. My nurse obtained startled briefly, however she was skilled with critically sick sufferers and known as in her group.
Inside seconds extra nurses arrived, and so they took management for the reason that hospitalist was nowhere to be discovered. Two extra IV catheters have been positioned for fast infusion of fluids and blood in an effort to preserve me alive. My nurse phoned Dr. James, the on-call GI specialist and considered one of my associates. She gave him an replace after which handed me the telephone. “Larry, we have to do the colonoscopy now,” he informed me. “I’ll be there inside the hour.”
Courtesy of Lawrence Mieczkowski
The blood and platelets have been delivered quickly after, and inside minutes it appeared the inner bleeding was slowing for the reason that cramping and urgency had lessened. At 1:30 a.m., the nurses wheeled me all the way down to the endoscopy suite. Dr. James arrived, and I used to be asleep inside seconds of getting the anesthetic. He used 4 titanium clips to clamp an artery bleeding from the location of the place the massive polyp had been eliminated. Lab testing confirmed that I had misplaced almost 50% of my blood quantity.
I used to be discharged later that Saturday morning. Sadly, the shock and blood loss had broken my coronary heart, kidneys, and affected my considering and reminiscence. My situation worsened and after present process exams regionally and on the Mayo Clinic, I used to be recognized with congestive coronary heart failure, stage III kidney failure and continual anemia. Regardless of adjustment in medicines, I nonetheless couldn’t deal with the rigorous necessities of practising medication and my day by day life, and I used to be suggested by my PCP to cease working and pursue incapacity.
It was very tough to simply accept this suggestion, and I used to be very indignant. I cherished my work. I had simply moved right into a newly transformed workplace and, as a result of I used to be so sick, I didn’t have six months to barter the sale of my observe ― I needed to shut my enterprise. I attempted to get a malpractice lawyer to signify me however after six rejections I used to be completed. Fortuitously, I had good incapacity insurance coverage.
Why do physicians miss a analysis or screw up on therapy plans? What’s extra, why do too a lot of them not take heed to their sufferers ― essentially the most primary factor that ought to be a basic a part of their observe?
Dr. Woods didn’t actually wish to take into account my considerations, however he and Dr. Smith additionally didn’t put all of the items of the puzzle collectively, whether or not it was due to ego, placing an excessive amount of significance on my low coronary heart fee, or being distracted by a retirement get together. They each had loads of time for my analysis and will have thoughtfully weighed my worries.
Sadly, my expertise is frequent since adverse events occur in a reported 25% of hospital admissions. If you end up in considered one of these adversarial occasions like I did, right here is a few recommendation which may be helpful:
1. Resist yelling on the nurse or doctor. It doesn’t assist, and you could get labeled as “a tough affected person,” which may make issues worse.
2. If you’re not being heard, get the unit’s cost nurse or supervisor concerned early within the battle since any delay could also be a life-or-death concern. As a result of sufferers are randomly assigned to a hospital-based doctor, these nurses can prepare a switch to a different doctor’s care or get different specialists concerned.
3. In the event you’re very sick and at a small group hospital, it is best to take into account pushing for a switch to a bigger hospital and, if needed, contact the hospital’s high quality, danger administration, or medical director’s workplace. This nearly at all times ensures motion since no hospital needs to be sued.
4. Outpatient medical observe could be very completely different from hospital-based care. The previous is now quantity pushed and in addition rife with missed diagnoses, delays in therapy and unsatisfactory workplace visits. Nurse practitioners (NP) and doctor assistants (PA) have related outcomes as physicians, usually have extra time to spend with their sufferers and have excessive satisfaction rankings. Nevertheless, ask to schedule a go to with the doctor for those who’re dissatisfied with the care of the NP or PA.
5. Bettering communication together with your supplier could also be aided by bringing one other individual with you to your appointment and having them function an advocate.
Courtesy of Lawrence Mieczkowski
6. Since computer systems at the moment are normal in most examination rooms, a supplier could solely spend 8-10 minutes head to head with you throughout a 20-minute appointment. Put together in your go to by studying about your downside. For instance, the Cleveland Clinic’s web site has an excellent graphic depicting which organs could also be inflicting belly ache. Kind an inventory of your considerations however preserve it targeted, as, sadly, most physicians don’t have time to completely tackle a protracted record of points. Assessment your record with the medical assistant and ask them to scan it into your information.
7. Main care suppliers could not take into account a analysis they don’t usually see. Requesting an ultrasound if the ache is extreme or not enhancing could save your life. If the supplier says that you just don’t want it, you may get a self-funded ultrasound for lower than $200 in lots of states. Take your considerations to the workplace supervisor or a director overseeing the observe.
8. Sadly, I don’t see a return to the occasions when medical doctors spent Half-hour with a affected person. Paying PCPs extra for his or her time would shortly change the system, but it surely’s not going to occur. Drugs has morphed into massive enterprise with trillions of {dollars} spent every year. Discovering an excellent supplier could also be a problem however there are well-trained medical doctors, NPs and PAs on the market who will take heed to you. Phrase of mouth referrals are sometimes the perfect. Evaluations of physicians on hospital web sites are usually not useful in my expertise, so take a look at impartial websites when attainable.
9. View your first couple of visits with a brand new observe as an interview and transfer on if it’s not a match. Keep in mind, you may at all times finish a long-standing relationship with a observe. In the event you determine to divorce your supplier, ship an authorized letter to the administrator of the observe explaining why you might be leaving.
We physicians know the healthcare system is damaged. Hospital executives are overpaid. Since PCPs are paid on common $180,000 versus the $500,000 an orthopedic surgeon makes, the perfect and brightest medical college students usually pursue extremely paid specialty positions. Physicians are overbooked, overwhelmed, drained and burned out. Computerized medical information have made it worse. The top result’s usually poor affected person outcomes. Since you may’t change the system, it’s important to learn to navigate by means of its waves utilizing a number of the options that I’ve made.
After my expertise, I used to be sure that I wouldn’t survive a 12 months but it surely’s now been over 5 years. My kidney perform and anemia have improved. I’m nonetheless dealing day by day with my coronary heart failure, proscribing salt, resting for hours at a time and lowering my actions. I used to be capable of resume {golfing}. By way of my physicians’ help and the love and tender care of my spouse and others, I’ve accepted what occurred to me. It’s not what I had envisioned a decade in the past, however I’ve a superb high quality of life. In the long run, I survived, however I got here too near demise that ought to have been simply prevented.
Be aware: Names and a few figuring out particulars have been modified to guard the privateness of people talked about on this essay.
This piece was initially printed in April 2023 and is working once more now as a part of HuffPost Private’s “Finest Of” sequence.
Lawrence Mieczkowski, M.D., aka Dr. Mitch, practiced medication from 1982 till he closed the enterprise in 2018. His guide, ”The Room on the Proper: A Memoir of Despair, Hope and Reckoning within the Face of Abuse, Trauma, and PTSD,” was printed on June 3, 2025. He had additionally printed quite a lot of articles in scientific journals, a sequence of op-ed items within the Dayton Day by day Information selling healthcare reform, and a latest article on Doximity about PTSD. You may learn extra about him on his web site, LawrenceMieczkowski.com.
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