My day had began early that Friday. My spouse, Joanne, and I arrived at 7 a.m. for my 10-year observe up colonoscopy with Dr. Smith. Though I had referred quite a few 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, the whole lot went properly,” Dr. Smith informed me. “I eliminated one massive polyp and some smaller ones, however none of them concern me. My workplace will let the ends in a couple of days.”
I thanked him and supplied finest needs on his retirement, considering that I might by no means see him once more. I used to be relieved ― no indicators of most cancers.
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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 widespread 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 stated out loud.
I informed Joanne what was occurring, 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 only some miles away. I referred to as the doctor’s workplace with an replace whereas we had been on our manner.
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 believed. I took a deep breath of reduction as Joanne and I walked by means of the door and had been led to my room. The nurse did the standard check-in duties, related me to the monitor monitoring my coronary heart price and blood strain, put an IV in my arm, and drew blood for testing.
“No operating 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 rapidly handed a number of pints of blood, which almost stuffed 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, stated sarcastically as he walked in. Nice! Right here we go, I believed. “Yup, that’s me,” I replied, attempting to scale back the stress. I identified the blood within the commode, however Dr. Woods didn’t appear impressed.
Whereas taking my medical historical past and doing a short examination, he was continually wanting up on the monitor, which confirmed a coronary heart price of 62 and a standard blood strain. (Usually, an individual’s coronary heart price goes as much as compensate for blood loss.) He commented on the low coronary heart price as a sign that I used to be steady. I used to be puzzled. “Dr. Woods, I’m on a excessive dose of a beta blocker for my blood strain,” I informed him. “My coronary heart price 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 operating IV fluids and order blood transfusions. “You look fairly steady,” he answered. “I believe we will 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 might have referred to 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 severe since my coronary heart price was low. He was operating the present and damned if he was going to take heed to me.
I continued to cross a considerable amount of blood each 20-Half-hour. For the reason that 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 grew to become 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 degree 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 issues. 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 stated, “You already know, 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 believe 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 arms of a physician I didn’t know or belief, and he refused to take heed to my issues.
It was round 5:30 p.m. at this level. Then, to my shock, Dr. Smith entered my room. He requested a couple 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 straight, “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 if you happen to’re nonetheless bleeding. I’ll admit you to the hospitalist service.”
I knew from my very own experiences that physicians at all times need to weigh the professionals and cons of doing one other process versus shut statement. He needed to know {that a} GI bleed is extra severe 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 doubtlessly lifesaving process ― one of many main causes of great antagonistic occasions. I couldn’t assist however suppose that the night retirement social gathering influenced his choice.
Round 7 p.m., one of many hospitalists on obligation visited me. He was thorough and, in contrast to 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 verify in on me. Joanne and I had been anxious to get out of the emergency room and off the arms 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 degree 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 monitor of time. I saved asking, “The place’s the blood?” The nurse saved 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 continually. 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 come back over me ― it was an acceptance that I would die peacefully in mattress. So that is what it feels prefer to die, I believed. I used to be not afraid. “I’m going to die,” I stated in a whisper. I can’t think about how Joanne felt. My nurse obtained startled briefly, however she was skilled with critically unwell sufferers and referred to as in her staff.
Inside seconds extra nurses arrived, and so they took management for the reason that hospitalist was nowhere to be discovered. Two further IV catheters had been positioned for fast infusion of fluids and blood as a way to maintain me alive. My nurse phoned Dr. James, the on-call GI specialist and one in all my associates. She gave him an replace after which handed me the cellphone. “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 had been delivered quickly after, and inside minutes it appeared the interior bleeding was slowing for the reason that cramping and urgency had lessened. At 1:30 a.m., the nurses wheeled me right 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 positioning 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 checks domestically 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 training drugs and my every day life, and I used to be suggested by my PCP to cease working and pursue incapacity.
It was very tough to just accept this suggestion, and I used to be very indignant. I liked my work. I had simply moved right into a newly transformed workplace and, as a result of I used to be so unwell, I didn’t have six months to barter the sale of my apply ― I needed to shut my enterprise. I attempted to get a malpractice lawyer to symbolize 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 remedy plans? What’s extra, why do too lots of them not take heed to their sufferers ― essentially the most fundamental factor that needs to be a basic a part of their apply?
Dr. Woods didn’t actually need to contemplate my issues, however he and Dr. Smith additionally did not 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 price, or being distracted by a retirement social gathering. They each had loads of time for my analysis and may have thoughtfully weighed my worries.
Sadly, my expertise is widespread since adverse events occur in a reported 25% of hospital admissions. If you end up in one in all these antagonistic 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 might make issues worse.
2. In case you are 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 difficulty. 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. Should you’re very unwell and at a small neighborhood hospital, it is best to contemplate pushing for a switch to a bigger hospital and, if vital, contact the hospital’s high quality, threat administration, or medical director’s workplace. This nearly at all times ensures motion since no hospital needs to be sued.
4. Outpatient medical apply may be very totally different from hospital-based care. The previous is now quantity pushed and likewise rife with missed diagnoses, delays in remedy and unsatisfactory workplace visits. Nurse practitioners (NP) and doctor assistants (PA) have comparable outcomes as physicians, typically have extra time to spend with their sufferers and have excessive satisfaction rankings. Nevertheless, ask to schedule a go to with the doctor if you happen to’re dissatisfied with the care of the NP or PA.
5. Enhancing communication along 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 are actually commonplace in most examination rooms, a supplier might solely spend 8-10 minutes nose to nose with you throughout a 20-minute appointment. Put together on your go to by studying about your downside. For instance, the Cleveland Clinic’s web site has an amazing graphic depicting which organs could also be inflicting belly ache. Sort an inventory of your issues however maintain it centered, as, sadly, most physicians don’t have time to completely handle a protracted record of points. Evaluation your record with the medical assistant and ask them to scan it into your data.
7. Major care suppliers might not contemplate a analysis they don’t typically see. Requesting an ultrasound if the ache is extreme or not enhancing might save your life. If the supplier says that you just don’t want it, you will get a self-funded ultrasound for lower than $200 in lots of states. Take your issues to the workplace supervisor or a director overseeing the apply.
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 rapidly change the system, however it’s not going to occur. Drugs has morphed into huge enterprise with trillions of {dollars} spent every year. Discovering an amazing 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 very best. Opinions of physicians on hospital web sites usually are not useful in my expertise, so take a look at unbiased websites when attainable.
9. View your first couple of visits with a brand new apply as an interview and transfer on if it’s not a match. Bear in mind, you possibly can at all times finish a long-standing relationship with a apply. Should you resolve to divorce your supplier, ship an authorized letter to the administrator of the apply explaining why you’re 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 very best and brightest medical college students typically pursue extremely paid specialty positions. Physicians are overbooked, overwhelmed, drained and burned out. Computerized medical data have made it worse. The top result’s typically poor affected person outcomes. Since you possibly can’t change the system, you need to discover ways to navigate by means of its waves utilizing a number of the recommendations that I’ve made.
After my expertise, I used to be sure that I wouldn’t survive a 12 months however it’s now been over 5 years. My kidney perform and anemia have improved. I’m nonetheless dealing every day with my coronary heart failure, proscribing salt, resting for hours at a time and decreasing my actions. I used to be capable of resume {golfing}. By means 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 an excellent high quality of life. In the long run, I survived, however I got here too near demise that ought to have been simply prevented.
Observe: 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 revealed in April 2023 and is operating once more now as a part of HuffPost Private’s “Greatest Of” collection.
Lawrence Mieczkowski, M.D., aka Dr. Mitch, practiced drugs from 1982 till he closed the enterprise in 2018. His e book, ”The Room on the Proper: A Memoir of Despair, Hope and Reckoning within the Face of Abuse, Trauma, and PTSD,” was revealed on June 3, 2025. He had additionally revealed quite a few articles in scientific journals, a collection of op-ed items within the Dayton Day by day Information selling healthcare reform, and a current article on Doximity about PTSD. You may learn extra about him on his web site, LawrenceMieczkowski.com.
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