Friday, October 12, 2007

Fear of the Known

One of the more educational pieces of my job consists of entering and configuring provider notes into our electronic medical record. I learn a lot about the various specialties and how these doctors work through this exercise.

Thankfully, I am not particularly squeamish. This is why I get the projects from the "fun" departments (Colo-Rectal Surgery, Urology, Gynecology, Emergency Medicine....)

Pictures of colonoscopies and endoscopies, ER docs sharing movies of their favorite "accidents"...I guess that means they like me.....

I finally found a circumstance where the reality is even scarier than the note.

One of our new Urology docs is heading up a new Pelvic Floor clinic. As part of that practice, she performs a procedure calls Fluouoscopic Urodynamics. This particular procedure is performed in a special chair. The procedure sounds scary enough:

A 7Fr triple lumen urodynamic catheter is placed into the urethra and advanced to the bladder. Additionally, a 7Fr rectal subtraction catheter is placed into the rectum. The catheters are zeroed to atmosphere prior to placement. The urodynamic catheter is infused with Cysto-Conray at a rate to 60cc/min.

The civilian interpretation - they sit you in a special chair, stick straws in unmentionable places, pump air and other stuff into those places and make you pee....


I figured that it couldn't be nearly as bad as it sounds on paper.

The nice thing about working at an academic medical institution (especially one whose first priority is TEACHING not research) is that many of the doctors are teachers at heart. Ask a question about what they do and they are more than happy to answer...usually providing more information than you really wanted to know.

So - I figured I HAD to go see this new chair. I know the Urology doc was REALLY excited about it when it came in. This should have set off alarms in my head. It is never a good sign when a doctor is excited about something. It usually means something bad is afoot. But curiosity got the better of me....

The chair is even scarier in real life - this picture doesn't do it justice (and I can't take pictures in our clinic - imagine lots of tools and a catch basin for the inevitable plus 3 computer screens.). Lots of computers and beeping things surround this chair in a large white room.

Even the new RN they hired for this clinic is creeped out by the thing (and she's old school and has seen darn near everything).

I still can't believe people strap themselves into this voluntarily!

Change management seems to focus on mitigating the fear of the unknown, but what do you do to mitigate the fear of the KNOWN?!??!

Meanwhile...I hope I NEVER have to be strapped into that scary chair......

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