My Mammogram Ordeal: One Tale of a Troubled Civilization

Prologue

In September of 2020, I went for my annual mammogram during the height of COVID-19. I wrote this piece soon after to document my experience (as writers do), check my sanity, and vent my incredulity and anger. I decided not to publish it, because during the early months of the pandemic I didn’t think the world needed more rants about how crazy and hard everything was.

But three years later, this story still rings true as ordeals like mine are increasingly common. So I offer it now, in the hope it provides knowing chuckles, needed validation, and important insight into our current human predicament.

My Mammogram Ordeal: Act 1

Last week I went for my annual mammogram. That fact is unremarkable for a 40+-year-old woman in 2020’s America. However, this year’s experience was unnecessarily difficult, comical, and enraging. My story shines light not only on the insanity of our crumbling healthcare system, but also on the real-life effects of my country’s failure to invest in our collective thriving. It also illuminates the symptoms, drivers, and outcomes of the metacrisis — our civilization’s eroding ability to meet people’s needs and its inevitable unraveling.

Last month, I enjoyed a surprisingly delightful visit with my doctor. Upon leaving, I stopped at the discharge desk to receive the necessary paperwork to obtain my annual labwork and mammogram. The clerk handed me the sheets politely yet unceremoniously. I noticed she took longer than usual to get them together, and that the phone number on the mammogram order was whited-out, with a new number written in pen. I paid this no mind, figuring she made an error and folks have the right to make mistakes.

The next day, I called the handwritten number, which appeared just below the familiar name of the facility (which I’ll call “City Hospital”) where I’ve gotten my “mammo” for the previous three years. To my surprise, no one answered, and the recording sounded different than before. I paid this no mind, figuring their systems changed. The recording suggested callers visit “RadNet” online to schedule their appointment, so after I left a voice message, I went online to RadNet.

It was very not rad. It also looked different than before— denser and not user-friendly. I figured out how to find my location (even though neither my city nor my hospital was listed) and entered my information to request an appointment.

After several days I’d received no response to either my voice mail or my website appointment request. I called again, not wanting this to drop off my radar because I’m committed to my wellness. I got a polite but tired woman on the line I’ll call Natasha. After some keyboard tapping, she said she didn’t find me in “the system”. (Odd given I’d been going there for years, but OK, computers sometimes suck.) She asked me a dozen questions, which I also found odd given my history with that clinic. I stopped her and asked whether she was located at City Hospital. She said yes. I said I was confused, since I’d been there three times for a mammogram. Why all the questions? She mumbled something vague about “intake procedure”.

After scheduling the mammogram, Natasha told me to bring my “priors” to the appointment. (Huh? What the hell are “priors”? I’m not a felon!) She said they needed copies of my previous mammograms to compare them to my new one. (Wait, what? Why do I have to do that? How do I do that?) I asked, again — am I not speaking to the Mammogram Department at City Hospital where I’ve already had three mammograms? She said yes. (WTF? I needed to get my records from Natasha’s department … to bring them to Natasha’s department?) I told her something wasn’t right, and I needed to call my doctor.

I called my doctor’s office and after being passed to a second person I got (another) polite yet tired-sounding young woman. I explained my dilemma. After a quick check, this angel I’ll call Linda explained that I was now going to a NEW LOCATION for my mammo because my NEW INSURANCE didn’t cover the old location! (The choir sang: Haaaaaalelujahhhh! But wait <record scratch>, New Location is still part of City Hospital. Why was I not in their system, and why didn’t they have my records?)

WTF? I needed to get my “priors” from her department … to bring them to her department?!?! I told her something wasn’t right, and I needed to call my doctor.

I swallowed my questions and called the handwritten number (again) to reach the Mammo Department (again). This time I got a less-tired person on the line — a man I’ll call Santos. Even though we were starting at zero, he asked far fewer questions than Natasha. However, he failed to mention I’d need to bring my “priors”. Luckily for me, I already knew this, and had gotten a phone number from Natasha to request these (by quickly thinking through what I needed and asking her for help). So, when I hung up with Santos, new appointment in hand, I called it.

I spoke to a cheerful lady I’ll call Marguerite who said she could easily create a CD with my “priors” for me to pick up. All my sphincters tightened. I need to GO TO THE HOSPITAL to pick up my “priors” TO TAKE TO THE HOSPITAL? Egads! Stress from the parking situation alone might give me breast cancer! When I asked for other delivery options, she said mailing me the CD was only possible if I sent her a release form, a copy of my driver’s license, blahdy blahdy blahhh. (Why not an encrypted email for Chrissake? A file dropped in a secure cloud location like my accountant uses for my taxes?) I relented and said I would go pick it up the next day.

I drove over to City Hospital with instructions to go to the “west tower, then basement, then diagnostic imaging.” I found the West Tower and the closest parking structure, thanks to helpful street signage (yay!). I parked, located the elevator, and got in.

Inside, there were two signs that appeared one on top of the other:

What fresh hell is this bullshit?!?! I knew I was on parking structure level 3, because it was painted blue. But where the fuck is the basement, according to the top sign? According to the second sign, it looked like it was on the same floor as level 3 (the blue one, where I was) and the Emergency Department! So, I exited the elevator and wandered around the corner to the Emergency Department. However, it was clearly ABOVE GROUND and not the basement.

I returned to the elevator, took it all the way up, then all the way down, now lost out of my mind… and losing my mind. I got off and found a woman in scrubs who spoke enough English to tell me I needed to go ALL THE WAY UP TO LEVEL 5 to take a WALKWAY over to the West Tower, THEN GO DOWN TO THEIR BASEMENT!

I’m sweating bullets at this point, wondering how the hell anyone who can’t read, doesn’t speak English well, doesn’t have a genius IQ, is too shy to talk to strangers or ask for help, or never worked in a hospital (me, for seven years) would be able to figure any of this shit out. I check all those boxes and wanted to tell my mammogram and everyone at City Hospital to fuck right off, then go home to drink heavily.

[Customer service request: Please do not force people to rely on their psychic and social skills — when they’re already sick and/or unable to move well and/or stressed out — to find their destination in a fucking hospital.]

I go across the walkway, find the new set of elevators, ride down to the basement, and spot signs (hallelujah!) pointing to “Diagnostic & Imaging”. I figured that was the same as “diagnostic imaging”, and found Marguerite! She remembered my call and had my CD ready (glooooory glorrryyy!). I was too relieved and grateful to slap her for giving shitty directions. (To be fair, her “west tower, basement, diagnostic imaging” directions were technically correct but missing some verbs, nouns, adjectives, and warnings that would have aged me far less.)

Bidding Marguerite farewell, I made the whole trek in reverse and drove home with “my priors” and a sweaty shirt with stinky pits.

Act 2

The day of my mammogram arrived. I’d had a shitty morning, but still got into my car with ample time to drive over, park, walk to the clinic, and check in. However, when I clicked on the appointment address in my calendar, the navigation app on my phone plotted a course taking me nowhere near City Hospital! For a moment, I thought I’d finally gone completely insane. But I HAD put the address in correctly — I remembered being careful about that. I HAD checked where the location was because I’d noticed the address was unfamiliar, and it WAS at the hospital.

Right…?

I checked the address on my written order. Indeed, I had the correct one. Heading out, I put on my headset and call the phone number on one of the clinic’s several confirmation texts. A human answers (yay!), identifies herself as Lupe (let’s say) and asks how she can help me. I explain that I’m on the way to my appointment, and I’m concerned because my phone is sending me south, instead of east to City Hospital. I tell her where I am, and ask if I’m going in the right direction, because I’m heading nowhere near the hospital north of the 134 (freeway).

She pauses and asks for my name. (Why do I need to give my name to get directions? Do they give different directions to different callers?) She cheerfully confirms that yes, I do indeed have a mammogram at 12:45.

I reply that I know I have a 12:45 appointment, and I’m on my way to [address], but I’m concerned because I’m headed south instead of east, where City Hospital is located. Are they indeed located near Forest Lawn and not north of the 134? She says “no” and repeats the address, saying they are at “the hospital”. My blood starts simmering. I feel like I’m waking up on Groundhog Day in the Bizarro Universe.

My blood starts simmering. I feel like I’m waking up on Groundhog Day in the Bizarro Universe.

I pull into the Big 5 Sporting Goods parking lot. Lupe says they’re “near San Fernando”. I consider screaming “WHERE THE FUCK AM I GOING FOR MY ANNUAL TITTY SMASH FOR THE LOVE OF ALL THAT IS HOLY!?” but instead I look again at my phone. I see that navigation is, in fact, sending me “near San Fernando”, but Lupe said they are NOT near Forest Lawn. Which is a HUGE fucking cemetery. By San Fernando. Which is a long-ass street in northern Los Angeles that sometimes goes north-south and sometimes goes east-west.

Guessing based on her name and speech patterns, I ask Lupe if she speaks Spanish, and she says yes. I explain my dilemma again, in Spanish, tell her which direction I’m going, and ask if they are near “the big cemetery.” “Oh SÍ, el FOREST LAWN!” she affirms. (Palm to face, then palm to head, then fist through windshield while screaming.) Then she sweetly provides very detailed instructions, in Spanish, on which street to turn onto “because it can be confusing due to construction”.

Jesus Fucking Christ!!!! It turns out I’ve been going in the correct direction this entire time AND THAT THERE IS ANOTHER LOCATION OF CITY HOSPITAL. Guess where? NEAR FOREST LAWN!

[Customer service request: Ensure that EVERYONE interacting with the public on the phone (a) knows cardinal directions, (b) is aware that there is MORE THAN ONE LOCATION OF YOUR HOSPITAL in the same city — surely I’m the 1,000th person this year who got confused — and (c) can fully understand and communicate in English.]

I turn on the non-construction street as Lupe advised and pull up to the parking ticket machine. I pull a ticket and ask the tired elderly Filipino gent manning the gate arm where I park for [address]. He mutters and limply gestures about turning right and walking. I thank him and pull forward. I quickly realize he had given me INSTRUCTIONS ON HOW TO GET TO THE BUILDING, NOT WHERE TO PARK.

I figure out where to park by following the signs (thank you, Jesus) and walk to the building. I enter the clinic doors feeling like a marathon runner staggering into the “finish line” tape, completely spent and just wanting some carbs.

I enter the clinic doors feeling like a marathon runner staggering into the “finish line” tape, completely spent and just wanting some carbs.

Act 3

Aside from the mammographer mispronouncing my name; not responding when I cheerfully correct her; and making me pretzel my torso, neck and head into shapes I’ve NEVER done before — including holding my own titty — it was a minimally traumatic visit, as mammos go. (Thank you, Divine Mother, for once again warding off fires and active shooters while I’m trapped in a booby vice.)

And aside from having to park in the “no parking” zone to pay for my parking at the ONE self-serve machine (because there were no signs telling me to pay the machine before exiting, and that there was ONLY ONE machine ONLY on the ground floor) I managed to flee the premises without stabbing anyone in the neck.

I drove home pondering my ordeal. Holy fuckbuckets was that unnecessarily hard! What on God’s Green Earth would someone else in my position have done if they (a) didn’t speak English well, (b) didn’t have a certain level of assertiveness, (c) didn’t have lots of time or energy to figure shit out, or (d) didn’t understand how important a mammogram is?

They just wouldn’t have gone to their appointment, that’s what. Or they would have been late, or gone to the wrong location, or shown up without their “priors”. All of this drains and frustrates not only patients, but every employee who interacts with them, as well as the larger system. The result? Rampant stress and anxiety, vast amounts of wasted time, and tons of lost revenue.

I drove home ranting in my head about how my experience was just one tiny parable about the big picture of our current human predicament. These sorts of insane shenanigans are one reason we’re so mentally and physically unwell. Why we’re chronically exhausted and angry. When I hear people scorn others’ anger (“Geez, why are they so angry?”), I want to say, “Really? Have you tried to get a mammogram lately? Or called any customer service line? Driven anywhere in a major city? Tried to solve a problem that required the intervention of any organization or official? How are you not angry? Are you high? Or have you normalized the rampant insane fuckery and numbed out?”

“Really? Have you tried to get a mammogram lately? Or called any customer service line? Driven anywhere in a major city? Tried to solve a problem that required the intervention of any organization or official?

How are you not angry? Are you high? Or have you normalized the rampant insane fuckery and numbed out?”

Yes, most of us have normalized it. We’ve numbed out, self-medicated, and turned the rage inward where it metastasizes into depression. These are all adaptive coping strategies created by our genius nervous systems under threat, but they debilitate us to the point of chronic passivity, immobility, and apathy in the face of incompetence and injustice.

We’ve also coped by creating stories like “this is the way life is”, or “this is how it’s always been.” These stories are lies. We’ve also made up stories about a secret global cabal out to control us, manipulate us, and exploit us. These conspiracy theories are bullshit. First, we’re already being controlled, manipulated, and exploited — including by those who promote conspiracy theories (duh). Second, the level of competence and coordination required to pull off something like global domination simply doesn’t exist. There isn’t even enough competence and coordination in the system to allow a relatively privileged middle-aged woman in one of the largest cities in the world to get a fucking mammogram! Exhibit A.

Exhibit B is my many years of experience as a trainer and consultant to some of the largest, most powerful organizations in the world, including their leaders. The truth is that it’s chaos out there. No one — NO ONE — fully knows what they’re doing. Everyone is hanging by a thread. Egos, narrow points of view, and the latest “crisis” are driving knee jerk decisions from the top down. But we’d rather believe that the rich and powerful are eating babies and consorting with lizard aliens as they plot their global takeover, than believe the more terrifying truth: it’s all chaos and it’s falling apart.

We’ve also coped by creating stories like “this is the way life is”, or “this is how it’s always been.” These stories are lies.

We’ve also made up stories about a secret global cabal out to control us, manipulate us, and exploit us. But we’d rather believe insane conspiracy theories than face the more terrifying truth: it’s all chaos, and it’s falling apart.

My mind went many places on that drive home from my mammo. When I arrived at my building, I opened my mailbox and found an envelope from City Hospital. Huh! Interesting! I wonder what’s in here?

Behold:

I. cannot. make. this. shit. up.

No words. No more thoughts. Time for a lemon drop martini and a baking reality show to numb the pain and flush the dumb from my day. Maybe those non-angry people are onto something.

Epilogue

Here are the 19 points of failure that led to this tragic comedy of errors. A tragicomedy that unfolded while attempting to accomplish a relatively small, but important, positive life task.

1. Change in insurance disrupting my ability to receive care from the same organization as before, in a reasonably efficient, effective manner.

2. Clerk at my doctor’s discharge desk failing to alert me I needed to go to a new location for my appointment because my insurance had changed. Also failing to tell me where that location was located.

3. Voice mail recording at the Mammo Department telling callers to schedule their appointment via RadNet. This assumes callers have (a) computer, (b) internet, (c) the ability to navigate a complicated, non-intuitive website, and (d) knowledge of geography.

4. No response to voice mail.

5. No action resulting from booking the appointment online via RadNet. (Possible causes: Lack of effective technology and/or enough staff with enough bandwidth to respond.)

6. Lack of seamless systems to maintain records on ongoing/past patients within the same organization. Therefore, needing me to bring records of previous appointments in the same organization.

7. Staff (Natasha) inability to listen to my concern and understand my confusion. Inability to clarify or explain. Use of medical jargon (“priors”). Lack of explanation for why records were needed given previous history, nor how to obtain those from the same organization. Burden of system failures placed on the patient.

8. One person (Linda) having to pick up the slack for two other people’s failures to communicate completely and effectively.

9. Lack of built-in technological or human process to explain or alert me to the impact of the insurance change (before or after).

10. One person (Linda) having to bear the burden of ineffective (financial, policy, human, and tech) systems where everything changed when my insurance did.

11. Two locations in one organization (three miles apart) not connected by communication or records systems.

12. Lack of reasonably consistent process and “customer” experience. The quality of my experience completely depended on the mood, skills, and knowledge of the person who happened to respond to my call. While some variation is normal and helpful, such a vast range is not. Santos and Natasha worked for the same department yet handled our conversations very differently in content and approach, and both missed important pieces.

13. Bizarrely outdated, non-user-friendly tech. I could only pick up a CD, and there was no electronic option that was quicker and more accessible, despite such options being widely available in other settings for equally sensitive information (like taxes).

14. Only verbal directions to the facility were given, no text or picture options.

15. Insane signage at the hospital.

16. Person answering the phone at the clinic (Lupe) not knowing cardinal directions, or fully understanding English. I only got the information I needed when I switched to another language we both happened to speak.

17. The person operating the entrance gate not understanding a question, and giving wrong instructions.

18. Lack of instructions and signage about where and how to pay for parking, and no alert to pay before leaving. Only one machine on one floor.

19. The stupid-ass letter telling me to schedule my mammo, which arrived the day of my mammo. Which had been scheduled for weeks.

My mammogram ordeal is neither an isolated incident, nor uncommon. It describes our daily lives now, interacting not only with the U.S. healthcare system, but with all institutions. It illuminates the reasons we’re unwell, unhappy, and uneasy. It reveals why we’ve grown to hate and mistrust institutions — and each other. It presents the inevitable outcomes of our long-misguided collective priorities, skewed values, immaturity, and short-sighted vision.

It’s going to continue. It’s going to get worse. This is the metacrisis — a liminal space between worlds, and the culmination of centuries of human history. The old is falling away, while the new has yet to emerge.

Just hold on, buckle your seatbelt, and know you’re not crazy. You’re not imagining it, and you’re not wrong for wanting something different. It’s coming. But the road to get there won’t be pretty, nor completely in our control.

I may not live to see it. But I hope you get your mammograms despite the ordeal, so that maybe you do.