To scan or not to scan.

It’s Friday and I feel a sense of relief. I can’t help it. If I’m going to keep this journal I need to be honest and keep it real.

I don’t know if it’s just this hospital or if it’s like this everywhere but there is a degree of humiliation one must endure. I appreciate it depends on who you encounter and how you hold your own but nonetheless I am experiencing it. It might just be first week initiation.

Take for example the daily post ward round pilgrimage to radiology carrying the carefully written imaging requests as asked for by the consultant on the ward round. Our  hospital has two worlds – the old and the new and they are connected by a rather long corridor. The radiology department lives in the new world. It takes about 13 min to walk there at a brisk pace.

On the ward round, it makes sense that one of the patients needs an urgent CT abdomen – I won’t go into details. I carry the form with the patients details, the questions that we are asking of the scan and why the patient requires it.

Standing in the radiology queue comes with it’s own legendary reputation. All FY1s from every corner of the hospital gather here at a certain time of day – post ward round time – with their requests tightly in their hands.  The ease with which you will get the stamp of approval depends on who is on that day – both in terms of secretaries and radiologists.

You watch as each one steps forward to justify the request. It’s in full view of everyone and as one after another is interrogated about the reasons for scanning we quickly add more and more justifications to our forms with their small boxes, over-filled with reasons.

It’s important to not over-scan unnecessarily and to not also waste important resources and slots. So this screening process is important. But the process of filtering is painful.  Especially when your own consultant has explained quite clearly the reasoning behind the request. You carry this with you, feeling confident.

I am called forward. It’s passed from the secretary to the radiologist. He steps up to the counter and I smile confidently. He looks at the form and declares that it’s not warranted based on the information. I try to verbally portray the indication as identified by my consultant. I am told I am not a courier carrying paper requests.

I turn away to head back to the ward feeling a failure. I have not managed to secure a CT today and it’s a weekend so the patient won’t get it until next week. I walk back to the ward and try to contact my consultant who is in clinic. When I do get a call back to explain, I hear a sigh down the phone. Half an hour later I get another call, as I am busily trying to catch up with the jobs that have piled up since my trip to radiology.

The CT abdomen has been cleared and would I please take the form back to radiology. Nothing is changed on the request form.

I make the second trip down the very long corridor, leaving more jobs behind me. I hand over the form to the secretary and it’s given the required stamp.

I feel every inch like a courier.