Diagnostics

I can’t believe I’d ever hear these words coming out of my mouth, but Friday I had my annual mammogram and the experience took up entirely too little time.

(If you’re apprehensive of TMI, you may want to leave this post now.)

I got to the Valley Radiologists Imaging facility early, on account of having to fill out that poxy paperwork. And I wasn’t heartened by the fact that some of their magazines were five years old, or that there was one guy who spent about 15 minutes while I was there asking the reception staff when they’d have his paperwork so he could go. (Eventually, after he’d been there more than an hour, they got it to him; seems the delay was…because he was paying cash. Which seems counterintuitive; cash ought to be simpler and shorter than anything else.)


But five minutes before my actual appointment time, the mammographer called me and took me straight to the mammography room, hauled out one of those mini-gowns (you leave on the lower part of your clothes, so why have a gown that goes beyond your navel?), told me to put it on and left.

Now, for the Y-chromosome set out there who may not have heard about this, normally you’re sent to a dressing room to make this change, usually a cluster of them around some central waiting area, with magazines; because the procedure is for the tech to make the images and have them checked by a radiologist for clarity of image before sending you away. If there’s any question, you go back for more shots.

So I thought this rather odd. But it got stranger.

With hardly any adjusting at all, she took four shots and told me I was done. That was a total of ten minutes; I timed it.

Now—again, TMI alert—I have A History. Not of cancer, but of cysts, which typically set off all kinds of red flags and alarm bells. I’ve actually had surgery because of this. (There’s nothing like going into your junior year of college and having your doctor find A Lump and referring you to a surgeon. That kind of wakes you up in the whole exam area for the rest of your life.)

Indeed, my last three mammograms (two in Washington, one in Virginia) triggered not only more shots, but also ultrasound before the radiologist in each case diagnosed cysts & sent me on my way.

(BTW—every time I’ve gone through this, I have been sent away “clean”. But the past is only indicative, and every time you get that, “Uh, we need some more pictures” call, you think, “Is this the time it turns out to be Something?”)

And the imaging centers always allocated an hour just for the ordinary screening—what with messing you about on the instrument of torture, taking a few extra views because she can see that there’s something going on and then having you wait for the radiologist to scan the images. They don’t want you leaving the place until the radiologist has verified that they have pictures that can be interpreted. If the first round doesn’t do it, you need to rinse and repeat.

(Although in the Reston Hospital radiology center that factors in at least 35 minutes for waiting because they over-book patients, and then for being told that they can’t find your previous films and that you must have taken them the last time you were in. And turning out that they were done at a different facility since at that time they had no mammographer so they sent you to their Sterling site and had never bothered to send the films back to the main center.)

Longer if they want to squeeze you in, so to speak, the ultrasound schedule.

So, I’m somewhat concerned about this latest experience. Every woman who’s ever had a mammogram will tell you it’s akin to root canal (but without the anaesthesia): you do it because you have to; but when you have to, you want it to serve a purpose and be done right. I find it hard to believe that this facility’s equipment is so far superior to anything that’s ever been used on me that four quickly-placed shots will provide the physicians enough information to give me the clean bill of health I’ve always mostly had.

Which means that they’ll either be calling me back for the usual rigmarole, or they’re just going to pass it off and I’ll be wondering if this time there’s Something that they just can’t be bothered to find.


Actually, what I really wonder is whether they can only collect some limited amount from my insurance company and they want to put forward the minimum amount of effort because of that? Although adding in the ultrasound would enable another charge to Blue Cross, they probably get paid the same sum of money whether they take four or 14 mammogram films.

(Having taken a shot at our medical delivery and compensation system, let me add that it could be worse. When I first visited my GP in England—the physician at the surgery to which I was assigned by the National Health Service by virtue of my postal code—I said I wanted to get a mammogram. She asked why. “Because it’s been a year since my last one.” Blank look. “In Britain we only do them every five years, because of the cost and because only one woman in ten is at risk.” Didn’t matter that, with my history, I might be one of the ones, she wasn’t going to refer me to a lab. And you’ll notice that they’re okay with double-digit breast-cancer roulette. Even our insurance companies have figured out that it’s cheaper to detect and treat cancer earlier than later, even if they only care about the cost and not the lives.)