"Lack of care factor"

I accompanied my spouse to an Ear Nose Throat (ENT) appointment recently. They had received a letter saying to be there for a specific appointment time but were not called in for nearly an hour and a half. There was no apology or acknowledgement that they had been kept waiting. I had taken time away from work, and ended up spending much longer away from the office than planned.

During the appointment, the doctor seemed not very interested in my spouse's concerns about the deterioration in their hearing, which interferes with their work and social interactions significantly. While my spouse was asking the doctor about whether surgery (which has been suggested as a treatment option) to remove exostoses that are almost completely blocking one ear would improve their hearing, the doctor got up and started squirting something in their nose.

Only after the doctor had done the first nostril (my spouse is a very compliant patient!) did they bother to explain they was administering a local anaesthetic spray as they would be using a scope to look at the back of my spouse's throat.

Even though it is a procedure my spouse has experienced before, I felt angry that the doctor simply assumed they would consent. The doctor also then started playing with their phone when they sat down. Only after they had been staring at their screen for close to 2 minutes did they explain that they were Googling the private ENT clinic that my spouse had been recommended for the exostoses surgery to see if they knew any of the doctors and whether any of them routinely did that type of surgery. 

I feel so disappointed each time a doctor tells us that the combined chemotherapy and radiotherapy that my spouse has endured to treat throat cancer just accelerates a normal progression in hearing loss. I found myself wishing that all ENT registrars better understood the true impact of so-called 'normal age-related' hearing loss and how horribly uncomfortable investigative procedure the 'nose scope' is, which invariably makes my spouse choke and leaves their throat raw afterwards.

A nurse opened the door to the consultation room without knocking or excusing herself to us in the middle of the consult to ask the doctor a question. The doctor then walked out of the room to talk with a patient in the next room without explaining why they were leaving or when they would be back.

When the doctor finally got around to the nose scope part of the consult, they asked my spouse to sit in a special chair saying that they now wanted to get a look at their cancer.

I felt so furious at that point my heart started pounding. It is pounding now as I write this. My spouse endured treatment 18 months ago that has left them with irreversible side effects and permanently altered their quality of life in order to overcome throat cancer. It felt as if the doctor was treating 'a cancer' rather than the most important person in my life, and they couldn't even have the courtesy to acknowledge that my spouse's treatment was successful and they are 18 months into remission.

There is a discourse about patient-centred care, and goals of care as well as goals of treatment. I have seen glowing examples of it in action. This was not one of them.