CW: mentions of self-harm, suicidal ideation, eating disorders, and symptoms of PTSD
Labor Day, 2021. I text my acting supervisor that I can’t come in the next day. Unprofessional, sure, but I was having difficulty speaking and didn’t want to explain the why of it. I was having auditory hallucinations, flashbacks, and hypervigilance. I was in the middle of a crisis; binging and purging food for control. Edibles helped take the edge off the weekend, but it didn’t stop my incessant crying. Whatever I was feeling was bottlenecked in my throat, I couldn’t articulate it accurately.
Nearly everyone in the world was going through a rough couple of years already, which made it easier to dismiss my own experiences. I still needed to get help; I was falling apart. Thankfully, my acting supervisor allowed me to take an extra day. I tried to spend that time centering myself; instead I was ruminating. Chewing over the last call I made at work Friday. Rescheduling a patient for diagnostic testing.
I had been working at this private hospital for about nine months when I broke. I scheduled patients for diagnostic testing. I would receive orders from providers throughout the area and scrutinize them for “medical necessity.” If the orders meet medical necessity, I can schedule the patient. Sometimes patients are scheduled outside the order’s date range, sometimes the diagnostic code is wrong, or the orders went to the incorrect hospital. I was a very weak link on a disintegrating chain. The next link was the pre-registration department. They call insurance companies and get the pre-billing process started on all scheduled appointments. Any rejections get sent back to us to either get updated orders, reschedule, or cancel the patient’s appointment. If the orders were corrected or updated in time, then patients didn’t need to be rescheduled.
I joined a team of five schedulers in late 2020. The COVID-19 vaccine was almost ready for rollout. The hospital intended on opening for more elective procedures, including the tests we scheduled. The first few months had a lot of downtime, which helped me become acquainted with all the steps I needed to take for different appointments. By the time I was comfortable working there people started leaving with no replacements. Then more orders came in as the hospital opened to more treatments. Some clinics had closed, others received more patients.
We started to backlog during the late spring, when we got down to three people, just before losing one more. My mental health paid a heavy toll from having to schedule as many patients as possible within 40 hours a week. The hospital won’t cover overtime, every administrative department is hurting for personnel. The hospital offered a few free counseling sessions to personnel, appreciation weeks, prizes just for sticking it out. I got a pair of socks that said I was awesome and to keep up the good work. I was losing it.
I had started having auditory hallucinations, loud noises like alarms caused me to shake, and I was plagued by the idea that I’m more of a placeholder than an actual human being. I was a weak link on a disintegrating chain.
Summer of 2021, two of us, training a third. I am on a lunch break looking at the news. The US was evacuating Afghanistan. Most of us have seen the footage, I will not be discussing that event in detail. I was a teenager with righteous vengeance on my mind after 9/11, now I understand more and feel otherwise.
I went to my manager’s office and cried—I was allowed to leave work early. I was a zombie the next day, asking the manager if I could leave early once again because I was not okay. She gently let me know that I am only allowed to miss so many hours a week before I lose my full-time status. I decided to stay the whole day, a zombie.
By September of 2021 I was using all my energy just for work. I was having night terrors, flashbacks, and excessive hypervigilance. I had a mental health appointment late in the month, but I needed help now. I had called the crisis line. I was given some options, including hospitalization. I made an appointment for counseling for the next week and planned to go to the ER if I felt like acting on my intrusive thoughts. I was close to a three day weekend and was praying the extra day would give me some mental stability. We were finally three and training a fourth! My manager had accepted a new job and left. The acting manager didn’t expect we would be able to hire new workers for some time.
It is Friday, and the person I am training is listening in on my calls. I am anxious to leave, with just half an hour left in the day. I must reschedule a patient. Their previous specialists were shut down during the pandemic, the clinic that gave us the orders was receiving an influx of patients. The orders were out of date by a week. We were behind on getting orders fixed. Clinics were behind on amending orders. The insurance company would refuse to pay because of an administrative error. An overburdened bureaucracy getting in the way of a patient getting a diagnostic test? When I called the patient, they were, understandably, frustrated.
We failed this patient, and I was holding the bag on behalf of the hospital. They had every right to be as angry as they were. But being left holding the bag broke me. I was having flashbacks during and after that call. I left work after collecting myself emotionally, at least enough to drive home.
The following Tuesday I was driven to the VA for a voluntary hospitalization. I was suicidal and was not in a great state of mind. I texted my acting supervisor and said I will not be available. They said I was in their prayers and to take the time I needed to get better. By the end of the day I was in a pair of grippy socks, ready for vacation. ~