From: T. A. FartMan
Sent: Saturday, July 02, 2011 7:59 PM
To: Benedict A. Brain-Must
Cc: M______
Subject: Cappy Was Bilious!
Dear Dr. Brain-Must,
A couple (2) of things:
One (1):
My “hepatic subcapsular fluid collection,” also known as "Cappy," was successfully aspirated by Dr. K_____ at the L____ S____ Interventional Radiology Department on Thursday. You might remember that when we talked on the phone a couple (2) of weeks ago, I had asked what that fluid might be. You said you were pretty sure the fluid was lymph fluid. When I had asked if it might be bile you insisted, "no way it’s bile."
Turns out, the goop they sucked outta my liver capsule was indeed a fascinating grass green color. Nothing official yet as to whether that grass green fluid actually was bile, but based on the color, that seems like a pretty good guess.
Yup, sloshing around inside my liver capsule were two hundred and ninety (290) cc of grass green slush, about a coke can’s worth, which for the last several months had felt like a piece of stiff leather luggage poking me under the edge of my ribs and making me mix my metaphors every time I moved my upper body or tried to sit upright for more than a few minutes. I don’t know whether it’s necessarily a bad thing to have the surface of the liver marinated in a digestive fluid like bile juice for several months on end, but can tell you that in addition to the pain going away immediately after Cappy was drained, for the last two (2) days I’ve felt about a thousand (1,000) percent better than I have in the last four (4) or five (5) months. The everyday fatigue that I’d been telling you about for so long now seems to be gone. I feel so much more energetic with that yucky green stuff outta my liver capsule.
Hopefully, Cappy the "subcapsular fluid collection" will not come back, although it seems possible, if not likely, that some bile duct plumbing might still be leaking. It would probably be a good idea to have a follow-up ultrasound or some such diagnostic procedure done in two (2) or three (3) weeks to see whether there is something still leaking in there and whether the fluid collection is reappearing. I’ll be in touch with Dr. J_____’s office about that, but thought you might want to know these details since you are still officially my onc (but not my uncle). They are going to do cytology and infection tests on the fluid, so I’ll let you know if anything interesting comes from those tests. Even though you won’t be my onc much longer (and never were my uncle, thank heavens!), perhaps all this info might be useful for you to know and have in mind when caring for other patients who might have symptoms like mine.
And I do need very much to get my port flushed in the next couple (2) weeks, so I hope that can still be taken care of there at the MBC Clinic.
Two (2):
Regarding the letter you sent informing me you would be terminating our doctor-patient relationship, it’s way beyond hilarious that, here I am the one (1) who’s s'posed to be the fussy attorney, but it’s you who’s sent out the certifried letter, return receipt requested, full of inane lawyer talk. Probably MBC's lawyers composed the letter for you, because only someone (some1) as silly as a lawyer could believe it to be a necessary redundancy to put a number in parentheses after spelling out the whole word, the way your letter does, like this: “Effective thirty (30) days from the receipt of this letter . . . , ” as if, without the number 30 in parentheses, a reader might get confused about what the word “thirty” actually means. How embarrassing for you, a physician, to be made to put your signature on such lawyer nonsense!
And the line in your eloquent form letter expressing your sincere “concern” about my “continued good health” was a hoot, too, since no emotionally sentient human being would speak to someone (some1) who was ten (10) months into fighting Stage IV (4) cancer as being in a state of “continued good health.” Again, only a dense lawyer at a big overpriced law firm (speaking of redundancies) would have the training to remain oblivious to the ridiculousness of that phrase applied to my circumstances. When I have been in indisputably bad health for the last ten (10) months, for you to be so inattentive as to express concern for my continued good health would suggest that you don't give a spit about my continued health, whether it be good, bad, or indifferent. However, since one (1) knows that the disingenuous language was penned by some anonymous lawyer (at great expense to MBC, no doubt), you are not to be blamed for it.
Yes, your certifried letter, return receipt requested, was good for several big belly laughs and numberless (∞) chuckles--comic relief for which one (1) is always thankful.
But really, Dr. Brain-Must, a certifried lawyer letter officially announcing the end of our doctor-patient relationship was quite unnecessary. I promise once again that, although I’m a Certifried Half-Wild (1/2-Wild) Native American Injun Lawyer, y’all can stop circling your wagons because I would never sue you or anyone (any1) else on my own behalf. That’s not my style or my morals. (However, you could expect, deservedly, to be teased about your latest screw-up for an appropriate period of time, or until you gathered the nerve to ‘fess up to it.)
Rather than wasting your limited attention span sending out legalese letters, if you had been as carefully attentive to the important medical details of my care, maybe you would not have forgotten about the reduced dexamethasone dose we had settled on that time, would not have forgotten that other time to change your written orders when we had agreed to discontinue the Avastin after I developed a blood clot, and most recently would have given prompt and proper attention to the fluid collection reported on my CT scan result, instead of overlooking what that report said about Cappy and telling me just to make an appointment to see you in August. (If these are facts you dispute, I invite you to contest them in any suitable non-legal forum, perhaps before some sort of medical review board there at MBC Clinic.)
So, yes, you are right that a certain lack of trust has developed in our relationship, but that lack of trust, at least on my side, concerns the “human” aspect of your doctoring more than it does your purely medical errors. If you had expressed the least slight regret about initially overlooking my fluid collection problem, I would have accepted any half-hearted (1/2-hearted) apology and been thrilled to have you continue as my doctor.
But because you reacted to my complaint by treating me shabbily, you are certainly right that you cannot be my doctor for long: Sometimes a doctor needs to be able look his patient in the eye.
I’ll let your assistant, M______, know as soon as I find a new oncologist.
T. A. FartMan
P.S. I have just this very moment learned from my deep sources that you, Dr. Brain-Must, were serving as Cappy's secret alter ego identity right up until his recent demise.
What a shocker! Dr. Brain-Must, my very own oncologist, was Cappy's alter ego all this time!
Lord knows, I hated having to appoint Cappy as my Super Hero Sidekick, but had no real choice in the matter, since he was right there kicking me in my side. So one can hardly imagine the confused self-loathing that must have tormented your surreptitious life as the alter ego of a bilious subcapsular fluid collection like Cappy. It almost makes me feel sorry for you. Nonetheless, your intimate personal, financial, and professional relationship with Cappy clearly constituted a conflict of interest, which you should have disclosed the moment you learned that Cappy's pernicious influence had somehow leaked into my life. Your undisclosed conflict of interest does explain why you were so hesitant to acknowledge Cappy's existence in the first place and then refused to help me find a particular person competent to get rid of him.
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