The Cortisol Free Urine test is also called the Urine Free Cortisol test, thereby suggesting that either way you go—urine or cortisol—they’re both free. (We wouldn’t want to have any bound urine or cortisol, now would we?) The normal range for this test is less than 45 ug/24hr. What is an Ug is not specified, but in twenty-four hours you don’t want to have more than 45 Ugs. I’ve got 62 or 153, all depending.
Specifically, what it depends on is which test results you believe, since the endocrinologist—a nasty piece of work if I ever met one—has sent me two results for the same test. I find this to be rather quaint—giving me the choice of either being kind of sick or terribly sick—but I would like to know which is which, so I call the Nasty Piece of Work’s office and talk to her person, the woman who answers the phone.
All medical offices have a Woman Who Answers the Phone. The person rarely has a name, does fulfill the primary function of answering the phone, and is always female. Actually, her primary function is to answer the phone and then tell you why you’re not going to get what you want—an appointment, a prescription, a chat with the doctor—it doesn’t matter what you want. She’s there to help you not get it.
This particular woman’s name is Shawn. I know this because now I have learned to always ask. Get the woman’s name. Say it a lot. In the beginning, say it nicely and pleasantly so that she feels good about herself, feels like a real person, not just a voice on the phone. In the end, say it clearly and sharply, as in “I know your name, and I know where to find you if you screw with me one more time.”
The Cortisol Free Urine test results are from the Laboratory Alliance, which is a large clump of laboratories that monopolize all activity in Central New York. The Laboratory Alliance report says that Specialty Laboratories in California performed the test. (So many specimens of my bodily fluids have been sent to California for testing that I would like to propose a package deal: For every thirteen specimens, I get one free trip to deliver the fluids in vitro.)
Shawn and the Nasty Piece of Work have sent me pages 10 and 11 of 12 from Specialty Labs, so I call Shawn and say, “Could you please send me the rest of the pages?”
“No,” she says, performing her primary function. We chat a little. She confides that she has sent me everything in my chart, everything the lab sent them.
“Oh,” I say. “D’you suppose it would be all right if I called the lab for the missing pages?” This is pro forma because I’m going to call the lab if Shawn says anything other than, “I’ll be right over with the missing pages.” (I would, of course, require personal delivery since when they sent the test results, they arrived postage due.) I am just asking Shawn’s permission because this makes her feel important—having this illusion that she has some kind of power over something. She doesn’t. Neither do I. We both live by illusion—but I may be dying by reality, and I plan to check it out.
Shawn hesitantly mumbles that she guesses I can call, so I terminate with her and pull out the phone book. LabAll has six numbers listed, none at the address on the lab report, so I pick one at random and get a recording saying it’s not a working number. When it gives me the working number, I call that and get Kelly in Customer Service. I write her name down in the notes I’m taking, not realizing that Kelly and I are about to become very close friends. In fact, we chat for the next half hour, go out for tea, get our hair done, and raise the kids while we talk.
Kelly, of course, wants to start with numbers. She never asks my name, just what numbers I want to talk about. I pick a number at random off the offending sheets and give it to her. She goes to work, fingering her computer keyboard and telling me what I already suspected: SpecLab did not send a 12-page report about me; it sent a 12-page report to LabAll with everybody’s test results for that day.
I explain to Kelly that we have two different results for the same test, and this constitutes a problem. W49772 says 62, and F20454 says 153. While Kelly is fingering her keyboard some more, she notes that W test codes are Wednesday, and F ones are Friday, thereby comforting me with the thought that there actually is a reasonable and straightforward explanation for some things in the bureaucracy of medicine.
W49772 comes up on Kelly’s screen, but F20454 does not. She tries several ways to pull it up then says, “Something rings a bad bell, like I already investigated this.” Bad bells make my stomach queasy and give me a headache; Bad Bells is fast becoming a diagnostic code, billable to Medicare. (To be continued)