Scheduling a Surgery: Almost as Fun as the Spanish Inquisition!

So, remember how helpful the Stanford Cancer Center folks were when I tried to book a second opinion consult with Dr. Dirbas? Well, that same commitment to complete incompetence delayed my surgery by a couple of weeks and nearly derailed the whole process. It went something like this:

> Thursday 27 Jul: I meet with Dr. Gurtner, agree that we are going to perform a DIEP flap, possibly bilateral--but will wait for genetic testing to come back to make final decision. I immediately follow up with Gurtner's surgery scheduler who'll get in touch with Dirba's scheduler to see if we can have the surgery the week of August 7. Oh, they have to find an OR for 10 hrs too.

> Friday 28 Jul - Wednesday 2 Aug: I call and leave many messages for Dr. Dirbas and Dr. Gurtner's scheduling staff. I finally get a call back from Dr. Dirbas' office; apparently the same woman with whom I had my little "second opinion" conversation is on the case. Really? Exasperation + Sigh... After multiple phone calls I manage to convince her that I am NOT having a TRAM FLAP and that most likely both breasts will be reconstructed. She finally confirms that the surgeons have been scheduled for Friday the 18th and it's just a matter of getting the OR. I may not know for sure until the day before the surgery. GREAT!

> Thursday 3 Aug - Monday 7 Aug: Still non-committal answers about the actual final schedule, but I am assured that surgeons are confirmed and an OR will be found. Mom, Allie and Raff take the plunge and buy airplane tickets. Still no final date though.

> Wednesday 9 Aug: Hmmm...funny how I don't have pre-op appointments with either surgeon and I'm supposed to be in the OR next week. Don't they have to run tests? Don't I have to sign consents? I get on the phone. Dirbas' scheduler, who still isn't sure what the procedure will be despite me having told her repeatedly: *B I L A T E R A L* *D I E P* *F L A P*, finally confesses that there might be a problem. WHAT?!?!? Tickets have been bought, plans have been made...are you serious?

I call Gurtner scheduler. Turns out Gurtner was NEVER actually scheduled for the surgery and he is going on vacation on Friday the 18th. Gurtner scheduler actually HANDLES the situation, figures out what's happening, and gets me in for pre-op appointments (which Dirbas' staff refused to do without a "solid" date). I guess they were waiting for the Cancer Fairy to materialize herself, schedule the plastic surgeon and find an OR.

> Thursday 10 Aug: Gurtner walks into the pre-op appointment and apologizes for the situation. He had been looking for me on the schedule and was so surprised my surgery date wasn't set, he figured I'd gone with another surgeon. Meanwhile --I tell him--I thought he already had me booked. "What?" Exactly. He is very gracious and confesses he is new to Stanford and now that he understand the system's limitation he's going to work on it. "That is fabulous," I say, and I mean it honestly; "but what do we do about MY surgery?" "Well," he replies, "we move all small, non-urgent cases from Wednesday to Friday, and we operate you on Wednesday the 16th. I already took care of it." WOW! The SURGEON fixed the schedule!!!! That's unheard of, and really awesome. Had it not been for his intervention, I'd have to find another surgeon or wait an extra 3 weeks. Meanwhile, the tumor is nearly 6 cm now and encroaching on the axila (that's the armpit for non-medical personnel). Dr. Gurtner is my hero :)

To be fair, Dr. Dirbas was also apologetic and very irritated with the situation. I tried to politely tell him how incredibly useless his staff is, but really, I had to be diplomatic. He did follow up with some specific questions, and I was as frank as I possibly could without telling him outright that the stethoscope he was holding is probably smarter and far more capable than his current scheduler. I also couldn't tell him that she doesn't actually understand spoken language, that she doesn't listen to patients and that she lied to me. But I *DID* share the second opinion conversation--in broad strokes--and warned that had it not been for my absolute resolve to have him as my surgeon, I wouldn't have been seen in his clinic, at all, EVER. I finally did mention that this reflected poorly on him professionally, and though I didn't hold him personally responsible, it was a major problem. He never got defensive, but looked a bit troubled.

The most important thing, however, is that the surgery is finally set: Wednesday 16 August, 7:30 am PST, Stanford Hospital. My mom is still working on changing her ticket to arrive before the surgery, Allie gets here on the 14th and Raff most likely on the 16th. Sigh... and on we march.