I’d been sitting in the sunshine, next to a pristine lake for 8 days - swimming, sunning, swimming some more, reading, drawing, chatting with friends. I finally said to one of my friends, ”I have this really weird pain in my abdomen, and it’s been getting worse. I thought I was constipated, but that’s not it.”

I’d had the slowly increasing pain for 4 days. Both of us being nurses, my friend said, “Ah ha! Eight days in a wet bathing suit. I bet you have a urinary tract infection!” “Maybe,” I replied. 

I waited one more day — on vacation, hoping this mystery pain would just go away. I left the beloved sunshine and good company only long enough that day to get a gallon of cranberry juice. By the end of the next day, I could hardly move. Another friend took me from our lovely beach spot to a local ER.

After 1/2 hour of waiting inside the ER, this friend, who had an important position in a prestigious college, told me they had kept us waiting long enough and that she would take care of matters. She demanded, in a loud and commanding voice, that I be seen immediately.

She put up such a fuss, the staff merely became angry with her, and by extension, me too. They did not move any more quickly or see me any sooner. I, being a nurse, felt I had a lot of making up to do. The situation was all the more embarrassing. 

So I decided to be the ultimate good patient. Everything they did was “fine.” I felt “fine.” Except, that is, for the excruciating pain in my gut.

They did the gamut of tests on me, even admitted me overnight. The night nurse came to see me. “How is your pain?” she asked. “Well, it’s about a 7-8/10 but still, I’m fine,” I replied. In the morning, a new doctor came in and sat down in front of me, chuckling as he said, “You’re constipated!”

I wanted to rip his head off and scream, “I know what constipation feels like! I am not constipated!” But instead I said, “That is fine. I’ll go home now.” ”How is your pain?” the doctor asked. ”It is still pretty bad,” I replied. “Can you get a wheelchair for me to leave in?” “Oh sure we can,” he answered. “You’re fine though.”

When I came home, the doctors still couldn’t seem to find the source of my pain. My own primary MD was skeptical. Being a nurse, I was so eager to please. I did not want to disagree with my doctor. I just kept telling her how much pain I was in: Unrelenting, unremitting abdominal pain. She did not believe me.

I was so angry at her for not believing me and at so angry at myself for holding this deferential thing (“I promise I’ll be good”) between us, even at my own expense. My doctor even admitted I was previously someone she “never heard from” and suddenly I was turning into a “nervous wreck.” I’d say I was pretty calm for someone in as much pain as I.

It was the mid 1990s, and in those days it was fairly common for clinics and emergency rooms to run one preliminary test and let it go if it was negative, so as to save money. And so my clinic did what was called a urine dip test. Not finding a positive result, they discarded the remaining urine sample and didn’t go to the next step. 

The abdominal pain became so horrific and debilitating over the next six weeks that I could neither work nor sleep properly. It was not long before I was back at the doctor’s office, crying in pain again.

I remember describing the pain to my dad. I told him that I felt as if there were a jack hammer inside me everyday, all day, going on and on. I was losing weight; my white blood cell count was elevated; and I began having fevers. But they still didn’t think I was sick. A few of the providers I saw asked me if I was seeing a therapist.

Then one weekend, again in intolerable pain, I went to the doctor’s office, and this nurse practitioner was working. She said she wanted to review my record, to see if they could possibly have missed anything. She then saw the glaring problem: They had apparently tested me for urinary tract infections (UTIs) through the use of ultrasounds, a CAT Scan, intravenous pyelogram (IVP), and many blood tests, but they had failed to do a culture and sensitivity test.

The nurse put me on antibiotics, presuming I had a bad UTI. She sent me home and ran the culture and sensitivity test. Two days later, the test came back positive with fulminant multiple bacteria. The nurse called me on the phone with  the “good” news. She kept apologizing, but to me it was wonderful news.

“I didn’t know you could grow three bacteria at a time in the bladder,” she said, “As a matter of fact, there is one bacteria I have never, even seen in urine. I called an Infectious Disease doctor, who said it is very unusual, but understandable, given how long you have had this infection. You have been suffering so long with this. I can’t believe all you have been through!” 

I asked the nurse how it was possible that nobody before her had found it. That’s when she explained to me the money-saving policy when it came to the tests. All those weeks I had been asking repeatedly, “Was the culture and sensitivity test negative?”

As it turned out, the doctors simply were not performing the tests that would have found the infection. They must have saved about $200.00. But the cost became far greater in the end, for them as well as form me, when they had to progress to prohibitive testing.

So in foregoing this far simpler, less expensive test, through which the doctors could have found the problem much sooner and saved us all a lot of heart ache and misery, the HMO didn’t save a penny. I was so angry with the HMO policy and my doctor.  I called administration. I wrote letters.

I got one letter of apology, but not one human being (beside the nurse who found the reason for my pain) ever apologized to me. Not even my primary MD. She insisted that the UTI was something that was a recent development.  

I tried changing doctors within the HMO. When I went in for my first appointment with the new doctor, I was in-between seeing my own patients as a Visiting Nurse. I decided that I might as well get some work done while waiting. I had brought a stack of my patients’ records — about 1.5 feet high – and got busy.

As I was led to the exam room, I noticed my old doctor in the hallway, talking to my new doctor. The new doctor then came into the room, stopped at the doorway, and laughed snidely. “I see you have brought all your medical records with you,” she said. ”Well, no, these are my patient records, I’m a visiting nurse. While I was waiting I…” 

“Yeah, right,” she answered. “So what are you here for today?” It went downhill from there. and I changed my insurance plan within the next month.

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