Clinical Trials

N A RECENT Saturday, I took myself to our local "Urgent Care" clinic—a place you go when you're not sick enough to warrant the emergency room, but too sick to wait until you see your own doctor at the next available appointment, which in my case is Thursday, March 16, 3026 at 10:40.

Things at Urgent Care were going as swimmingly as could be expected, considering I felt crappy and was naked but for undies and a johnny gown, waiting for the doctor on staff to complete her triage of a possible emergency.

Doctors and nurses love to say "triage" in front of patients. Maybe they're watching those perpetual reruns of M*A*S*H. However, triage is not strictly the domain of the medical community. Just the other day I performed one in my own kitchen. "What's for dinner?" I asked myself. "What will take the least amount of time to prepare without actually killing me?" I asked myself back. There were three choices: from the fridge, a bowl of 9-day-old leftover tuna fish in mayonnaise; a can of green curry from a far-flung nation possibly lacking our stringent canning regulations; and back in the fridge, a week-old piece of pepperoni-and-mushroom pizza. Not being a cold-pizza lover like so many of you, I triaged the slice to second place. Eying the curry, I pictured myself writhing on the kitchen floor, attempting to retrieve the can's label from the garbage as evidence for the medical examiner. I did the sniff test on the tuna fish and triaged it to primary position. There's a little doctor in all of us.

Back to Urgent Care, where my doctor had returned breathless from triaging. She had me say "ahhh," took a culture, told me I could get dressed, left for longer than it would take me to get dressed if I were dead, and then rejoined me to summarize our lovely visit.

"We should know as early as Wednesday, so just call back then for your results, hm?"

"Well, okay," I said, realizing it was useless to explain how patients are treated when they call a clinic. It's a Jekyll and Hyde thing, something the doctor will never experience. But still I tried to get around it.

"Can the clinic maybe call me when the results come in?" I meekly inquired.

"Just give us a call, and then if you need it we can start you right away on medication," she replied, ignorant of the thorny path.

Wednesday came, and still not feeling better, I bucked up and dialed the number for Urgent Care.

"Please listen carefully to the list of menu options, as they have recently changed."

I'd love to know where on the planet the list of menu options has not recently changed. There is a very busy office somewhere in India where a young fellow named Rajesh is, as I write, changing options such as "if you'd like to speak to an operator" from "press zero" to "press eight—teen."

But I listened very carefully, and when it said "If you'd like to speak to a nurse, press five," I made sure I pressed five. As I held, I rehearsed my little speech, so as not to get any further on the bad side that I could sense was waiting for me. Doctors don't know the unspoken rule, but we do: patients are not to call the clinic for any reason whatsoever except to make or cancel appointments.

"Urgent Care."

"Um, yes, I was a patient at Urgent Care over the weekend, and the doctor who examined me told me to call back today to find out my test results."

Never say that you want your results; always say "the doctor told me to call." It's your only hope, but as you'll see, a slim hope indeed.

"I don't know how your call got to me."

"Well, it said if I wanted to talk to a nurse, I should press five, so I pressed five."

"Are you sure you didn't press four?"

"No, I was very careful to press five. Should I have pressed four to get a nurse?"

"No, I just wondered if you pressed four by mistake. Did you press seven, maybe?"

"Uh, no, I pressed five, I'm sure of it. Should I have pressed seven?"

"What's your name?"

"Kate Heidel. H-E-I-D-as-in-David-E-L."

"Birth date?"

"Eleven, three, [redacted by the Department of Homeland Security]."

"Okay. Can you tell by the snippy tone in my voice that I'm really annoyed to be speaking with you?"

"Um, yes . . ."

"Can I help you?"

"Yes, well, as I said, the doctor who examined me said I could call back to find out my test results."

"Oh, did he."



"So—are there any test results?"

"What was your last name again?"


"Date of birth?"

"Eleven, three—"

"I don't see any results; when did you say you were here?"

"Just last Saturday, August sev—"

"You know we fax results to your primary doctor when we get them. You know that, don't you?"

"Well, no, actually I didn't know that, but—"

"Is this an emergency?"

"Well, no . . ."

"If this is a medical emergency, please hang up and dial 9-1-1."

"That's what they always say on the recording."

"You're still on the phone."

"Oh, I'm sorry, I guess you want me to call my clinic."

"Have a nice day."

So that was fun. As it turned out, I didn't have to make that harrowing call, because two days later an Urgent Care nurse phoned to give me my results. She was perfectly nice, not at all snippy. The key here is to hold out as long as you can and let them do the calling. It's a one-way street, and if you violate clinic traffic laws you'll be heavily fined by being made to feel like a stripper at a church bake sale.

We got to the end of the call, when the nurse signed off with, "Now, if the prescription we e-mail to your pharmacy doesn't seem to be making you feel better in a few days, just call your doctor." I swear I heard a little giggle.

"But, that means I'll have to call my clinic."

"Well, yes, it does." giggle "But just call them and tell them you need to speak to your doctor about trying a different medication."

I told her I would do that and hung up. But, you know, instead, I'll think I'll just wait until my next appointment.