My Letter to SuperDoc

Here is the letter that I am sending to SuperDoc in the morning. Many thanks to Barren for proofreading, editing and review. You can blame her for not making me cut out more. She made me cut out about 4 sentences. Maybe five. The rest, she said, was too perfect to cut. Who can argue with perfection? Anyway, the letter doesn't say anything you don't already know - so you don't have to feel obligated to read it.


Dear SuperDoc;
As you know, I have been a patient of Ye Olde Fertility Clinic's since 2005, first under Dr. Awesome, and later as your patient until I conceived my triplets through my sixth IUI in February of 2007. I returned to your office in January 2009 for the purposes of pursuing IVF with eSET in hopes of adding a single child to our family. You and I both agreed that this would be the most prudent course of action for both family and medical reasons.

To date, I have been seen by YOFC for initial consults and testing, an HSG, six IUI treatments, OB ultrasounds subsequent to a pregnancy after my fourth IUI and subsequent to a triplet pregnancy following my sixth IUI, follow up consults with several doctors, countless monitoring appointments for bloodwork and ultrasounds, two cancelled IVF cycles, two IVF retrieval procedures, and two IVF embryo transfer procedures. I have even participated in multiple media interviews promoting eSET and YOFC's stellar program.

Until recently, my interactions with each and every one of the YOFC staff, from the receptionists, to the nurses, to the doctors, to the marketing staff have exceeded all expectations. I have been impressed at every step with the level of care, personal attention, professional manner, and attention to detail that each member of the YOFC team has provided to me as a patient. Though I was initially concerned that seeking care from such a large team of providers would mean sacrificing personalized care, I have found the opposite to be true: I am anything but a number.

Not only have I felt that my medical needs have been appropriately addressed, but the office has continually gone above and beyond all reasonable expectations to ensure that my non-medical needs have been met. As an Orthodox Jew, I was initially concerned that I would not be able to pursue treatment because of restrictions related to the Sabbath, but in my very first consult with Dr. Awesome she said, “Don’t worry, we work with Orthodox patients all of the time – while I can’t guarantee you will never have a procedure on a Saturday, we have ways of working with you so that you can sign consents ahead of time, etc. This should be the least of your concerns.” I have always found this to be true – indeed, my first IVF retrieval was on a Saturday and the process was seamless.

It is because of this exemplary care that I have continued to refer countless patients to Ye Olde Fertility Clinic. I believe that there is no better care available in the greater [insert metropolitan city] area for infertility treatment.

I think that this is why it was so surprising to me that I had such an unpleasant experience at my recent embryo transfer on Saturday, June 6, 2009. Dr. I-Hate-Him was the physician performing the procedures that day. As you know, because it was a Saturday, I had to make special arrangements to be there on a Saturday, including a driver, etc. I had made clear ahead of time that I would not be able to physically sign any consents on the day of the transfer and I had been told this would not be a problem.

When Dr. Hate came into the room, he explained which of my embryos was to be used for transfer, and why, and then handed me the consent for transfer. I asked him if it was absolutely necessary that I personally sign the consent and explained that I am an Orthodox Jew and am restricted against writing on Saturdays due to my faith. His response was two-fold: First, he stated “Yes, it is absolutely necessary that you sign this consent. If you do not sign it, I cannot perform the transfer.” Second, he told me (with regard to my religion restricting my ability to write), “There are exceptions, and this is one of them.”

With all due respect to Dr. Hate, while I am quite certain that he is an extraordinary and well-qualified reproductive endocrinologist, I have doubts that he is a well-qualified Orthodox halachic authority. Therefore, his assertion that “there are exceptions” was both condescending and inappropriate.

Furthermore, his first statement was even more troubling. He had made an implicit threat: if I didn’t sign that paper, he wouldn’t do the transfer, and I would have wasted an entire cycle by not signing. As a vulnerable, half-naked patient sitting on an exam table, knowing how much money, time, effort, emotional investment, and hope would be wasted, the imbalance of power in that negotiation was palpable.

“There simply must be another way,” I asserted. “I know I am not the only patient that has had this issue.”

Finally, Dr. Hate left the room to “ask someone else” and returned with two witnesses who witnessed my verbal authorization for him to sign in my place. A resolution was reached. Peace was restored in the transfer room.

I wish I could say this was the end of my unpleasant encounter with Dr. Hate, and I did try to simply put this behind me. We resumed cheerful conversation as he got set up for the transfer. I joked that hopefully this single embryo would not split into identical triplets and he said, “That can’t happen; there’s no such thing as identical triplets.” I told him that, in fact, I know several sets of identical triplets. “No,” he corrected, “You don’t know any identical triplets; just because they look alike doesn’t mean they are identical.”

Though I respect Dr. Hate's knowledge of reproductive endocrinology, it concerns me that he doesn’t know that there is such a thing as monozygotic triplets, and it further concerned me that he felt the need to continue to respond in an argumentative, condescending manner. This may seem like a small matter, and had it not been for the adversarial way in which I had been approached regarding the Sabbath issues earlier, I may never have been concerned about this. But I daresay, it did not inspire confidence in my medical care that day.

Thank heavens for the nurse who provided me with my discharge instructions that day, and the technicians who were in the room during the transfer. Had it not been for their professional, pleasant and wonderful attitudes, I would have left the office that day without any positive feelings about the visit at all.

Ultimately, I am relieved to know that the experience that day will not have any effect on the outcome of this cycle. I know that the quality of care that I have always received at YOFC will remain intact and I will remain your loyal patient and friend, regardless of the outcome. I am, simply, saddened that I now have this experience to reflect on at the end of this particular cycle. Hopefully, it will be overshadowed with better news to come.

Thank you for your time, your patience, and, as always, your outstanding medical care.

Respectfully,


Ms. Perky
Patient # 5903487