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Tuesday, October 13, 2009

Radiation -- sticking up for myself

I started writing this post before the holidays, but then it got delayed...
I meant to post it right after radiation relationships

Now that I have praised the radiation department in several posts, I feel obligated to share one story that was particularly traumatic. This was a one-time incident, probably because I made sure it was not repeated. Leaving it out, would be white-washing the whole radiation experience.

In order to appreciate the magnitude of this incident, it is important to understand some of my limitations. I have very weak stomach muscles -- I have had 6 major abdominal surgeries (3 C/sections, 1 failed hernia repair, 2 abdominal surgeries for reconstruction including additional failed hernia repairs). My stomach muscles were not particularly strong before the surgeries, kal vahomer (even more so) after them!

So, sitting up from a prone (lying down on my back) position is difficult, even in the best of circumstances. I either have to hold on to my legs and rock or turn over on my stomach and rise from that position. Neither is particularly graceful, and I need room to maneuver, to make sure I don't fall.

I share these private details, so you will understand what happened and how humiliating it was for me and how important it is for a patient to stand up for his/her dignity.

During radiation, the patient lies down on a narrow platform.

The technicians help you lie down in the correct position, and do their best to make you comfortable. They lay a clean sheet for you (re-using "your" sheet, every time); they will place a cushion under your knees, to relieve stress on your back; and, of course, they make sure to line you up so that the radiation is aimed correctly.

As patients, we are primarily passive -- adjusting the way we lay down, according to how the technicians direct us; then holding still, while the machine does its work; then we get up and go.

It is really very simple.

Except, for me, I need a little help getting back up. Most days, this was not a problem. I asked the technician to give me a hand -- I just needed a little steady leverage to help me sit up.

Now, so we are clear, I did not need someone to pull me up. My stomach muscles work, they are just weak. I just needed someone to hold my hand and "spot" me as I pulled myself up. I did most of the work, they just supported me, helping me stay steady, so I did not lose my balance.

After the first few times I asked, the technicians knew to come right away to help. The whole thing took all of 15 seconds.

Then, sometime in the middle of my treatment, one of the technicians refused to help me up.

At first, I could not understand why he was not coming to help me. So, I asked again for his help.

“Get up yourself,” he told me.

I was a bit taken aback, but I explained again that I need a little help getting up.

“Get up, the way you get out of bed,” he instructed me again.

Now, just to remind you, this conversation is going on while I lie on my back, powerless to get up, feeling helpless and humiliated.

I did not feel like elaborating to this technician, who is insulting me, why I cannot get up the way I get up in my WIDE bed, with my American Twin Size Mattress, that has plenty of room for me to maneuver without any risk of falling off. (Have I mentioned recently that I am terrified of falling because of all the cancer in my bones and the high risk of breaking something?)

I repeat that I just need a hand to brace against while I pull myself up.

“If I help everyone, it will damage my back,” he said.

“So, please get someone else to help me,” I plead, wondering how long I will be stuck lying there, while this technician not only refuses to help me, but also refuses to ask someone else to come in and help me. I feel completely powerless.

Finally, one of the other technicians enters the room. She has no idea how long I have been lying there, but comes right away to help me sit up.

I go to the small dressing room to put on a scarf, over my already bald head. I gather my things and walk out. For the first time, I do not say "thank you" as I leave.

I am humiliated and want to cry.

On my way out, I see one of the other technicians, who has always been very friendly and helpful. I take a few deep breaths, then describe to her what happened and ask that I be helped by other technicians in the future. She understands and promises to take care of it.

For several days following this incident, I worried about a repeat scenario. I made sure to request that certain technicians come in afterwards to help me.

Thankfully, the situation did not repeat itself.

I was very shaken by the experience.

I had to remind myself that there is no reason to be embarrassed about needing help.

The shame is on the technician who made a patient (me) literally beg for assistance.

It was not easy for me to share the experience with the other technician, which meant revealing how dependent, and helpless, I found myself.

I am proud that I had the nerve to say something and make sure that I would not find myself again in such a helpless position.

I did what was necessary to protect myself in the future.

Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,


Anonymous said...

I can understand why you are still so upset about this situation. I do think that it would be worth writing a letter of complaint, even at this date, to the tech's line manager describing what happened. This would be especially worthwhile if you remember the offending tech's name and the assisting tech's names. The tech may have had a personal reason not to help you (eg bad back), but there was no excuse for not summoning assistance for you. I am really glad that you asserted yourself to prevent it happening to you again; a well-worded complaint may help prevent it happening to someone else. People who receive radiation are not in the best of health (understatement). Many of them might require assistance rising from a prone position on a narrow plinth.

Rahel Jaskow said...

RivkA, I applaud your level-headedness in the face of such a difficult and emotionally trying experience. I think that in your place I might have started screaming the walls down... which probably wouldn't have been very helpful, I admit.

Rahel Jaskow said...

(Wow. I just saw that I and the commenter above me left our comments at exactly the same time. How often does that happen, I wonder?)

Robin said...

What a horrible situation to be put into, shame on him. Shame on him indeed, and I am so proud of you for standing up for yourself and all the patients to come.

rutimizrachi said...

I want this guy's name and address, so I can go punch him in the nose. His holy neshama really wants the wake-up call. Believe me, I'll be doing him a favor.

[Pause. Take a deep breath.]

Okay, we don't do that. The pen is mightier than the sword, yada-yada. But today I think I'll let someone else give him the benefit of the doubt. Kol hakavod for not sugar-coating your otherwise excellent treatment experiences.

Anonymous said...

It's really terrible to be treated badly and to feel so powerless ... especially when you're already not 100%. Then again, I find that when someone treats me extra well, I feel super grateful.

rickismom said...

Patients tend to feel powerless. I am glad that you were not, and stood up for yourself.

Robert J. Avrech said...

I understand your humiliation completely. When our son Ariel Chaim ZT'l was undergoing treatments at Cedars Sinai here in LA, the nurses just adored him and treated him with respect and compassion. But there was one male nurse, Milton, who was inexplicably hostile. Ariel was literally afraid of him. Karen and I tried talking to Milton, but it was useless. His behavior continued and escalated. We told the doctors and all they could say was that Milton had a reputation as an excellent nurse. Finally, we wrote a letter to the head of the nursing dept. asking that Milton never be assigned to Ariel. After much nonsense with the nurses union, our request was honored. The point: move aggressively against cruel hospital staffers.

As always, we are davening for your refuah shlemah.

adena said...

When I was going thru radiation, I remember thinking that it was quite a balancing act to get myself up and off the table...I can only imagine how you felt...we spit on the man who decided it would be fun to humiliate someone living with cancer! Good for you for doing what you did!

Val said...

That technician is in the wrong field. There are plenty of prisons who need 'hard-asses' like him around. Not working around innocent and often helpless people.

Man, you were calmer than I would have been and in addition to talking to other technicians, I'd have made his supervisor aware, as well.
Who knows how many others he's put in the same situation as you were in.

Good for you sticking up for yourself. I wouldn't have expected anything else!

Karen said...

Rivka, your request was more than reasonable. Even if you DIDN'T have problems with your stomach muscles, and even if the table WERE as wide as a bed -- the radiation department treats people with CANCER. It's to be expected that some of them might have trouble getting up. The day that I went with you, some of the patients looked to be barely (or not) ambulatory. Someone who doesn't want to offer assistance, because they have a weak back or just because they are a jerk, shouldn't be a nurse in such a department (or in any department, IMHO). You really HAVE to make the supervisor aware of this. I understand that your treatment is over and that you hope to never go back there, and I don't want to say that you owe it to the other patients, because your main concern must be yourself. But look at it this way -- Ein Karem isn't that big and you might very well cross paths with this guy again if he isn't disciplined. Write a letter to his supervisor and cc it to the head of the nursing department, the head of patient relations, the head of the hospital, anyone that you can think of. There are some problems that are hard to fix. This is an easy one. I'll help you if you want.

Anonymous said...

As a technician in EK, I want to aplogise to you for the feelings of humiliation and desperation that you went through that day.
We often help patients get on/off the bed, and see it as part of our job description. We know that it is not comfortable in the least, and very now. You're right RivkA, platform is a better way of describing it than bed.
I can't imagine who would have spoken to you that way. There is one guy in our department who has serious back issues, however, even so, I have never seen him refuse to help a patient. Maximum he'll wait until there is more help so that all the weight of the patient isn't on his back. He is a very good technician, and I do think the person who said that someone with back issues maybe shouldn't work there is a little over the top.
Please realise that this profession generally attracts very warm people who really want to do the best by our patients, but we all have bad days. Also, wouldn't it be "wonderful" if as we technicians got older and physically weaker we would just be replaced? Things can happen from the job/on the job that do physically debilitate us. I don't think that that should necessarily disqualify us from doing our job.
I don't want to defend below-par behaviour, and maybe this is in a way a backhanded compliment, but RivkA b"H you look well, and strong, and what he was thinking, I'm sure, is that I can't help every "healthy" patient. (yes believe me, although we know all our patients are not well, RivkA looks great, her smile lights up the room, and the stereotype of a cancer patient with metastases is gone - that's one of the reasons I'm happy I found this blog).
The fact that he didn't help I don't think is the main issue, the insensitivity, though is appalling.
I am posting anonymously, but RivkA knows who I am. I wish everyone who has battled, or is battling cancer, as easy a ride as possible on the road to a full recovery.

rutimizrachi said...

To the anonymous EK technician: Thank you. As cathartic as it was to say I want to punch the fellow's nose to defend my friend's shamed feelings, I do like even better someone who can show me the way to see the situation differently. The guy behaved disgracefully; but that does not mean that he is evil. I hope somehow he figures out that his bad day hurt another human being, and that he will not let another bad day cause anyone else such humiliation. Come to think of it, I hope my bad days will stop hurting others -- especially the people I love the most, but who are often the handiest when I am grumpy. Good reminder.

Jameel @ The Muqata said...

My first thought was identical to that of Ruti.

EK Technician: As an MDA volunteer ambulance driver, its a cop out to say, "this might hurt my back." If a technician isn't willing to help, then he should change professions.

Why should anyone have to deal with this mental anguish, let alone radiation patients?

Perhaps you should mention this to your boss at EK, for them to remind technicians that the only justification for the hospital, is the patients.

We personally had a rather annoying instance with a doctor in Israel, who when asked to explain his diagnosis, simply said, "I got my Medical Degree at such and such a school..." No explanation of how he arrived at his diagnosis (which even turned out to be wrong).

I'm sure you and others are fantastic technicians at EK, yet even on rotten apple can ruin a whole bushel of wonderful fruit.

RivkA with a capital A said...

It would not have bothered me in the least had the technician said "I am unable to help you, but let me get someone else who can."

The technician, who might even have helped me previously, suddenly ignored my requests for help, and then refused to call someone else in, even after I asked him to (I would have had to scream for someone else to hear me).

Had another technician not walked in, I have no idea for how long I would have had to lie there.

I did figure that someone would eventually come in, since nobody else could receive treatment while I was still there....

Noa said...

RivkA - Hadassah has a policy that every letter of complaint or praise that comes in makes it to both the employees personal file and their direct bosses. The complaint letters also require a bit of a talking-to. Its worth writing up this letter - the tech needs to realize how his behavior affected you.

Having a bad back is a justifiable reason for not being the one to lend the helping hand, literally, but he should have brought someone to help you without making you feel bad. Back injuries are the most common injuries in nursing, and we do have to be careful.

Anonymous said...

EK tech again! To clarify myself, I agree wholeheartedly with RivkA, there is a way to deal with these issues. When I was pregnant or if someone looks very heavy I have asked patients to wait while I get help. The insensitivity displayed was outright disgusting (I still can't work out who in my department would speak so callously).
I disagree with the commenters saying he shouldn't be in the job. Lifting patients is not THE job description, but a part of the job. There is a difference. It is a VERY hard job, mainly made up of people who went into it with a genuine wanting to help. It holds no prestige, and no promise of great wealth. It is difficult physically, emotionally, on every level. This is not necessarily apparent when as a young person you are going into the profession (I did not realise the toll it would take on me and I am in the profession 10 years including study time). At the same time, there is huge satisfaction. I meet fascinating, inspiring, wonderful people every day (like RivkA), and that is the payoff. Most days I love what I do. We are people and do not always realise our impact. Until I read this blog I never really thought about getting off the treatment bed as being harder than a bed at home. Not that it doesn't make sense, I just never thought of it! And I like to try to be davka sensitive!
Israel is also a more abrasive environment than where probably most of us were born. We professionals need to be above that.
Last piece of advice, inform your caregivers! The number of times I have straightened a patient, only to have them yelp in pain because they had fallen/had an operation etc. ....it makes me feel terrible always!
Shavua tov and feel better RivkA! Hug

Batya said...

You should definitely report it. If the tech guy/gal isn't physically capable of assisting the ill being treated, then he/she should get another job.

Lurker said...

EK tech: I disagree with the commenters saying he shouldn't be in the job. Lifting patients is not THE job description, but a part of the job.

Sorry, but I'm afraid you're wrong: He should not be in this job. Not because he refused to personally provide assistance, but because he refused to provide assistance in any manner whatsoever -- even by asking someone else to come provide assistance, and even after he was explicitly requested to do so. This is why he should not be in this job.

I would also add that people like him give a bad name to professional and compassionate technicians like yourself. You, and others like you, deserve much better than that.

Cheryl@SomewhatCrunchy said...

That is unacceptable. Horrifying. Whether you could or could not get up is irrelevant, you asked for help and should have received it. What a heartless person. The techs are supposed to be there to support and assist the patients. I'm so sorry you had to experience that.