Meeting Expectations

After living in Wisconsin for 3 weeks or so, Mama strongly encouraged Jayme and I to find “something we enjoyed with our time which would allow us an opportunity to generate some independence until school started” (aka, a J-O-B).  It made sense. What good was it to be sitting around a house in a new city with your sister and no money? Sold. I interviewed and scored a position at Pier 1 Imports.

My time at Pier 1 was priceless. I made great money, put away a good furniture stash for later, and made some really good friends (shout out to Anj and Emmer). I always smelled good when I left there – I called it “eau de Pier 1.” The store had 2 walls of windows and exceptional lighting. Pier 1 stores are designed to showcase the products, and the products are known for a specific look, quality and price point. In essence, the job was easy because the brand and the product sold itself.  This is the most important part about working. You should believe in the product or service that you are “selling,” and believe that you are dispensable, because if the product or service is what it should be, it can sell itself.  And the brand behind it should be recognizable as a brand that produces that product.

I use this at work to explain customer service expectations. When a consumer pays for a product, they have a certain expectation of what that product is “worth.” It is our job as the face behind the brand to deliver a product that is consistent, worth paying for, and leaves the consumer wanting to return for a similar experience. In healthcare, our service is our product.  So our product ought to be what our patients expect it to be…and in most cases, more than what they expect it to be.

So when you are 32 years old and walking into the Main Surgery building to have your breasts removed, someone should greet you. They should tell you that they are not going to see you through to the end of your day, but that the people who do will take excellent care of you. And that should set the expectation for the 32 year old mother of two, as well as her husband and mother, who will sit for the next 10 hours in utmost anxiety. Instead, we heard that there was another patient having surgery with a similar last name – a young lady who we later saw with no hair coming out of an office – coincidently a breast cancer patient.  Mama looked at me and said, I’m not sure what that other girl is having done, but you remind everybody you come into contact with that you are TINA and you are having a double mastectomy.  I agreed that if I came out of surgery missing a different body part that I would be pretty miffed.

I was taken back to Pre-Op, where I met my temporary nurse. She was good, and she was funny. She prepped me for my sentinel node injection, gave me an IV, and then explained what was going to happen.  We laughed (however inappropriate) about the patient nervously chatting on the other side of my pre-op curtain. She was a hot mess. The Anesthesiologist came in and explained what was going to happen, and then he prescribed 10mg of Valium. Mama and Nathan were brought back to my Pre-Op room before I was given the Valium and whisked away to Radiology. When I entered Radiology, the Nuclear Medicine Technologist held my hand as the Radiologist injected a radioactive dye into the outside border of my right areola – the pain was about a seven out of ten, and that was after the numbing medicine was applied for 2 hours. But I was expecting an eight out of ten because Dr. Hatmaker set the expectation. The Nuc Med Tech squeezed my hand harder than I squeezed his. And then I was wheeled back to Pre-Op. It was at that point that I would have been considered “loopy.”

I sat in my stretcher, giggling uncontrollably at Nathan, whose head seemed larger than normal. It was like a scene out of Tim Burton’s Alice in Wonderland…this great big floating head looming over my stretcher. I spun my finger at it like a horizontal tornado and poked him in the nose. “Do you want some Valium, too? I bet they’d give you some if you asked!” And then I proceeded to poke him in the nose again, as I whispered loudly (as if no one could hear me except Nathan), “You should ask for some…really!”

Dr. Hatmaker came in and said that we could get started early if that was okay with Dr. Quintero.  She already had a page into him. He returned the call while she was standing there. He said that it was fine if we started early, but he wanted to see me first! This is why I chose him to reconstruct me – completely personal connection, beginning to end. I remember very little from that point, but I do remember Dr. Quintero making reference to some things in my blog (pancakes, Bess and Gretchen, etc.) while my giggles continued uninterrupted.

Anesthesia is funny. It takes very little time to set in, and when it is over the patient has no concept of how much time has passed. And yet, I found myself thinking when I woke up, “That was quick!” My Recovery experience was pretty good. I physically handle anesthesia well, so I was just trying to enjoy the experience. Here’s the thing about Recovery. Staff will talk about anything because they feel that the patients won’t remember the experience. And perhaps this is correct in most cases. Not so much in mine. My nurse was male, which I had no problem with whatsoever. He was really good. But he pointed out to the nurse across the Recovery room that she charted her whole patient’s experience under my medical record. Turns out, it’s hard to remind people that there are two people with similar last names having similar surgeries when you are on an operating table. I’m glad they caught it, but it shouldn’t have happened. And I shouldn’t know about it. They reminded me over and over again in recovery that I said, “Roll Tide!” when I found out that my lymph nodes were clear. This reminded me that my lymph nodes were clear, and that made my time there easy.

My expectations as an Inpatient were easy: Your pain is going to be controlled; We are going to take good, safe care of you; We are going to be nice. I had heard in health care seminars that this is what patients expect – in that order, and it is true. And for the most part, my expectation was met. Maybe someday I’ll tell the exception story.

I was discharged on Saturday evening. Dr. Quintero came in, told me what to expect over the next few days, and explained that my skin was now the biggest concern. If my skin has good blood supply and survives recovery, he has more to work with. He pulled two of my four drains. I leaned over the bed, looked at his shoes, and said, “You look like you got into a fight with a highlighter!” I’m glad he found my comment about his fluorescent tennis shoes funny!


Dr. Hatmaker called me early this week to let me know that my final pathology was back. As expected, the left breast was clear of any disease. I had clear margins of 5mm to the skin on the tumor, so this is GREAT news. She is leaving the decision for radiation up to the Oncologist, but that is not expected. I have a call into him. I was staged after chemo as a Stage Ia - this is the BEST stage possible for my cancer.

Now I am home. I have ample skin to work with, and I apparently had good blood supply. I have 2 drains that should come out next week, and I am taking less pain medication than I was a week ago. Recovery is going as expected, with no complications that I am aware of. I am meeting expectations.  If the desired outcome is a consumer who is satisfied with a product, then Hatmaker and Quintero are selling consistent, quality work. But I wouldn’t say that their work is the product because that would make the surgeons dispensable. My surgeons are the products that sell themselves. There aren't enough windows or exceptional lighting in the world to showcase that, but even Pier 1 would be proud.

Bean