Every four or five years, mariner takes his hajj to the Mecca of modern medical diagnostics: the MAYO Clinic in Rochester, Minnesota. He has now returned from his visit. It occurs to mariner that this is quite an unusual experience totally unrelated to normal doctor/hospital experiences. So here is an accounting of his recent trip to MAYO:

Imagine that the reader has a large room in their house where a nationally recognized physician from every medical discipline that exists is waiting. They are waiting for the reader to come into the room. Brain problems? Covered. Bone problems? Covered. Any internal organ problems? Covered. Runny nose? Covered. Back pain? Covered. Sore toe? Covered. Dementia? Covered. Depression? Covered . . . The reader gets the idea – name an irregularity, it’s covered.

But the reader’s room may not be large enough to hold the activity of MAYO. Does the reader have a room that can hold ten buildings, five of which have 18 floors and altogether cover eight square blocks? Does the reader’s room have a walking subway system that connects not only all the MAYO buildings with four separate elevator systems but nine hotels and parking, two shopping malls, US Post Office, and four national banks? Perhaps in the backyard does the reader have room for fourteen more adjacent buildings containing innumerable independent health corporations?

Within this small city, the reader first will meet a reception doctor who has a role similar to a primary care physician. The doctor will interview the reader at length based on at least six in-depth questionnaires completed before the reader actually visits MAYO. This doctor will establish and manage the reader’s itinerary. Unlike typical hospitals and clinics where the doctors are at the top of the pecking order and each sets their own schedule, at MAYO the reception doctor calls the shots so that as many tests and consultations as possible can fit into a typical three-day visit. This is how MAYO does its magic for more than 3,000 visitors per day.

Another unusual factor is the huge staffing ratio per physician. The reception doctor provides a chart of photographs showing each person that will have a role in managing the reader’s itinerary; mariner’s doctor had two additional physicians, three registered nurses, seven practical nurses, three administrative specialists, a personal representative for the patient, and a specialist in medical administration.

The on-line physicians had large professional staffs as well. As an example, mariner’s several ultrasound examinations utilized a total of ten young nurses who covered most of his body with ultrasound grease; it took four uniquely trained nurses to perform just one examination, each gathering a different set of data. Each examination goes the extra mile with duplication for accuracy and the use of every kind of examination machine that can be imagined.

In each medical department at the end of examination was a consultation with the lead doctor for that department. Finally, there is a meeting with the original reception doctor who discusses an overall evaluation of the visits, results and prescribed solutions. All in all, mariner had twelve examinations and associated consultations not counting the reception doctor, special trips for preparation, bloodletting and urinalysis.

Three days – done and done.

But all the financial investment, all the expertise, all the attentive, efficient specialists – are not what is remembered about MAYO.

Who is it that must scurry between ten buildings, five of which have 18 similarly numbered floors and four separate elevator systems and altogether cover eight square blocks? Who must navigate a walking subway system that connects not only all the MAYO buildings but nine hotels and parking? Who is it that starts each day in a waiting room by 6:30AM? Who is it that may sit in a waiting room for extended periods of time? Who is it that must find a restaurant for dinner? Who is it that must time bathroom breaks according to available times?

The reader, that’s who!

What the reader will remember is the fatigue, the confusion of which building? Which floor? Which elevator? What time? East or West? Desk number? North or South? Mariner’s itinerary was modified three times. The reader will remember being lost at the intersection of several tunnel options. The reader will remember the long one-third mile walk to the specimen department. The reader will feel the exasperation of driving into the MAYO neighborhood which is not only busy with MAYO traffic but downtown traffic as well and the overall urgency of finding and parking the car in the right garage associated with hotel reservations. Mariner strongly recommends reserving the first day back home as a day of rest and recovery – especially if it’s at the end of a six-hour drive.

There are good memories, though. Setting aside the overhead of being at MAYO, one remembers the hard-working, intelligent, caring staff. The depth of interest in one’s health is remembered and the quality prescriptions for the future are genuine. One can surmise whether trying to get it all done with back home medical support could ever be accomplished – let alone the obviously superior quality. Mariner makes sure that local doctors receive a copy of his full examination as a way of ensuring quality judgment at home.

The pace is steady and tasks require continuous focus by the staff. When mariner was receiving one of his greasings, the nurse at one point asked him to push in his abdomen “real hard like you were pushing a bowel movement”. A few seconds later she turned to look at her computer screen and mariner innocently asked, “What do I do with my bowel movement?” She broke out in great laughter; it was a break from her intense focus. It made mariner realize how hard these staffers work.

Ancient Mariner

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