Bob's Blog 7-6-13: The Doctor Is In...Sort Of

Bob Here.

The other day, I was trying to mentally dissect my dislike of doctors.

The reason I was confused (no wisecracks please), is that I really don't despise ALL doctors.

Just the ones with a pulse.

No, I'm kidding. I've had a great relationship with several of the nephrologists that I've seen on a regular basis at the dialysis centers over the years. My real hatred seems centered on the docs that I see on an occasional basis, or at least less regularly than weekly.

I think it all began shortly after I had my transplant, many moons ago.

The technology wasn't as advanced back then, and when I had what looked like a rejection episode, I was told to get my butt back to the hospital where the surgery was performed.

Now, I didn't know any better at the time, but if the same thing were to happen now, I'd immediately sense danger.

Having to go in on a short-notice basis means there's no guaranteeing what doctor you're going to see.

Your regular physician may be in surgery, visiting another hospital, or ripping off 18 holes for all you know.

So, clueless me went barreling in to the hospital, and sure enough, I was sent to see a transplant doctor who I had seen before but never visited with. We'll refer to him as Dr. A. (Draw your own conclusions.)

I was wary of this guy right away; he seemed really harried and confused. I had to resist the urge to thrust my hand in front of his face and ask, "How many fingers am I holding up?"

My initial encounter with this guy read like a script to a sitcom.

A nice-looking nurse accompanied Dr. A into the examination room. She gave him the date of my transplant and some other important information.

Then she said, "Bob's been exhibiting some possible signs of rejection."

"So, what are we here for today?" asked Dr. A.

I just sat there looking at him. Then I looked at the nurse who was staring as well.

"Doctor," she started talking again, more slowly this time. "Bob has been exhibiting some possible signs of rejection." She was careful to annunciate each word clearly.

"Ah, okay," said Dr. A. "When was the transplant done?"

The nurse took a deep breath, since she had just told him when my transplant was done. Nonetheless, she repeated the date.

"May I see his chart please?"

"I gave it to you when we came in, doctor. You're holding it in your hand."

"Oh, hah hah. Silly me," said Dr. A.

At this point, I was going through options in my mind, bolting for the door chief among them.

Anyway, my brilliant physician was looking pensively at my chart, nodding his head slowly. I really couldn't tell whether he was taking anything in or about to fall asleep. I looked at the nurse again, but she was just standing there quietly, trying to avoid my questioning glare.

Dr. A started talking again, and I was relieved that I wouldn't have to shake him awake.

"You know what works good in cases like this?" he asked nobody in particular.

I had all kinds of wisecracks flowing through my head.

"A frontal lobotomy? For you that is."

"Running up and down the street clucking like a chicken?"

"Forty eight hours of serious drinking?"

"Pistols at 30 paces?"

But I just sat there saying nothing, since I knew he wasn't really expecting an answer.

After what seemed like an eternity, he said, "OKT3."

Then he looked at me as if he was waiting for me to break out in applause.

"O-K-T-huh?" I said.

"Non, no," he said. "O-K-T-Three, as in the number three."

I thought, forget sarcasm with this doorknob.

I said, "You've got me at a bit of a disadvantage here doc, you know, you having graduated from medical school and all."

I looked at the nurse. It was subtle, but I think she was trying to avoid laughing.

"You did graduate from medical school, didn't you doc?" And then I laughed. The nurse was puckering her lips.

The doctor was just looking at me. "Oh yes. Yes, of course, hah hah hah."

"So, what all is this O-K-T-Whatever?" I asked.

He hesitated, and I thought he was going to correct me again. "No, no. Three. O-K-T-THREE."

But he didn't. "It's the newest technology for treating a rejection episode," he said. "Some of my colleagues have used it successfully."

I felt like saying, "Can you get one of them in here?"

But I said, "So this is still experimental?"

He said, "Well, only in a sense that it's new and still in trial mode."

This caused me to ponder my shoes for a bit.

Finally, I said, "I don't know doc. Is there anything more tried and true?"

He thought about that for a minute then he said, "The only alternative is a heavy dose of steroids."

I had already been through the steroid routine, so after consulting with my regular nephrologist, who gave OKT3 his blessing, I agreed to give it a shot.

Now, the effect of this OKT3 is to severely reduce the strength of your immune system, which I know sounds like a really bad idea. But it can stop your body from attacking the transplanted organ, and essentially put an end to a rejection episode.

When they give you this treatment, they put you in an isolation room, all by your little lonesome. With your immune system so low, you’re doubly susceptible to infection. So they put you in one of these rooms that would make Alcatraz feel like a country inn. The treatment drug also has some nasty side effects, which I'll talk about in a moment.

The point being that undergoing this type of treatment is not a decision to be taken lightly.

But, I had agreed, so I dutifully reported back to the hospital the next day.

Now, some of you are going to think I'm making this next part up, but, honest, it really happened.

When I got to the hospital, they put me in the isolation room, and a while later, who prances in but good old Dr. A. The nurse whom I had seen previously was with him again.

"So, what are we here for today?" he asked.

Now, keep in mind, I'm splayed out on a hospital bed in an isolation room, wearing only one of those hospital gowns, which is little better than being buck nekkid.

I thought about saying, "Oh, I had a free afternoon..."

But, I didn't get the chance when the nurse interjected, "Bob is here for his OKT3 treatment, doctor."

This appeared to stump Dr. A in his tracks.

He looked at the nurse, rubbing his chin.

"OKT3?" he said.

She just nodded, but she looked like she wanted to slap him.

Then he looked off in the distance.

"OKT3...OKT3..."

I was just looking at the nurse, but I was thinking about calling 9-1-1.

Then he asked the nurse something that I will never forget as long as I live.

"What is OKT3 again?" he said.

For a second, I just sat in stunned silence.

Then, I got up off the bed and was ready to head out into the hall, bare butt and all.

The nurse put her hand up and looked at me pleadingly.

"You remember, doctor. OKT3? To treat Bob's rejection episode?" she said.

Dr. A thought for another minute, then the light bulb went on.

"Oh...of course...OKT3. I'm sorry. I've been really preoccupied all morning.

"Arranging for your patients' funerals?" I thought, but didn't say.

But instead I asked to call my regular neph again, and he assured me again that despite Dr. A's brain spasm, OKT3 was still a viable alternative.

My memory of this whole OKT3 episode is probably further sullied by the experience of the treatment itself.

When the effects of the drug first hit me, it sent me on a one-way trip to la-la land.

I vaguely remember my wife coming to visit. Later, after the treatment was over she told me that she walked by and peeked in the window on the door to the isolation room. I apparently looked over and waved goodbye to her.

She said, they let her in the room wearing a surgical gown. She came over to the bed and she told me that I said, "Thanks for coming by honey. Be careful going home..."

Knowing her, she probably said something like, "Why are you saying goodbye? I just got here, you nitwit."

Then she said I asked her if she just got out of surgery, looking at her gown.

Aside from being really out of it, I remember having a serious fever, no appetite, and muscle pain that could stop a bull elephant.

In other words, it didn't exactly make for a fun weekend.

Now, in the long run, everything worked out okay. But I definitely looked at doctors in a different light after that, and now I know better than to take their advice unequivocally.

My interactions with them normally include a healthy dose of skepticism and a lot of questions. Oh and maybe a few one-liners along the way.

Thanks for reading. Hope all your doctor's experiences are good ones.