Med Note:
Against Innovation
10 May 2018

¶ This afternoon, I went to the Hospital for Special Surgery for a Remicade infusion, having had the first infusion a little over fourteen years ago, in April 2004. For some reason, the fact that that year ended in “4” has made the fourteenth anniversary unusually notable. 

Over the years, the basics have remained the same — the two-hour duration, the blood-pressure monitoring, the chemotherapy easy chairs, the attentiveness of the staff — but superficial details have changed many times. The infusion therapy unit has been expanded and remodeled, and only one nurse from that first visit remains on staff. But for bewildering alteration, change for its own sake, nothing can compare with the scheduling protocols and admission processes.

While scheduling has become a lot easier lately than it was for a long time — or perhaps as if to compensate for that improvement — the hospital has introduced a new check-in wrinkle. I learned of this with trepidation, because it seemed to provide an opportunity for last-minute bureaucratic interference: your papers are not in order. From now on (until the next new wrinkle), infusion patients are to present themselves at the Admitting office, off the ground-floor lobby. I can’t say that this makes no sense. But I also can’t see how it changed anything from the hospital’s point of view. 

Hitherto, I would go straight to the elevator and proceed to the seventh floor. That’s where my rheumatologist’s office is, as well as the infusion therapy unit. I would check in, whether for a doctor’s appointment or an infusion, with the clerks at the waiting room desk, and then take a seat until called. Anxiously, I wondered how the Admitting office would enhance or otherwise complicate the business of showing up on time. 

I was directed to Desk 5, where a woman smiled (somewhat goofily, I thought), and asked me to spell my name. Then she wanted to know when I was last at the hospital. The answer was out of my mouth before I could think — for you must know that my rheumatologist was on the advisory staff that oversaw the hospital’s recent massive IT overhaul, a distraction that took up much of his time for several years; we discussed it from time to time in a joking manner, but not entirely without my learning a thing or two: “You can see for yourself on the computer,” I said, pointing to the back of her monitor. 

Then I apologized, saying that, if I seemed short, I’d been coming to the hospital for fourteen years, and discovered that new procedures were not my cup of tea. 

The next thing I new, the woman was printing a bracelet. Standing up and leaning forward, she asked me if the names and birthdate were correct. When I said that they were, she fastened the bracelet around my right wrist and said “Seventh floor.” 

I had to ask. “Do I go straight to the infusion therapy unit or to the waiting room first?”

Her eyebrows shot up in surprise. “Do they have a waiting room up there? I’ve never been.” 

My advice to the young: forget about the AARP. Read Kafka. 

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