"I haven't had a mammogram all my life", the patient looked at me and smiled with pride. "I am 70 years old now, frankly speaking I shouldn't be here today. If it didn't bother me all these years, why should I bother about it now?"
The woman said she was forcibly brought in by her daughter and sister for her baseline mammogram. She was very co-operative throughout the exam. She said it didn't bother her a bit as I compressed her. She found it amusing that her breasts were sandwiched between two plates. She kept looking at them and laughing about how they looked like pancakes under compression. She joked about how she did not have a need to touch them or feel them after her husband died 20 years before. I enjoyed her company while I did her exam. Rarely we get patients that are so jovial and easy going in the mammogram department. She kept calling me "little girl." She kept telling me, "Now, if I was your age", or "At your age I was..."
It turned out that her new caregiver found a lump under her left breast while dressing her for bed time and told the family members about it. And unfortunately I had to be the one to find out what that lump was. Technologists are the first people to examine patient mammography films after the exam. And more often than not it is the most difficult part of the whole process. We happen to find out any abnormality in the images even before the films go to the radiologists for the reading. Patients often ask us questions regarding the images and if we see anything wrong. They fail to realize that even though we are the ones who took their images, we are not authorized to reveal these results to the patients. So we see and we feel the sorrow seeping through our hearts imagining what is in store for that particular patient in the near future. In a matter of minutes we become emotionally attached to our patients. More often than not patients either think we are their saviors or we are their enemies. Either they want us to be the doctors or they want to get away from us.
Very rarely patients who come into a mammography department are free of anxiety. Fear of compression is the major player in these anxiety episodes. There are several ways to deal with patients who are nervous and do not want to be there for any number of reasons. These are some of the ways:
1. Smile - Most patients enter the mammography centers timidly as they do not know what their future holds as far the exam results and processes are concerned. In these situations a small smile and a warm greeting by the staff including the front desk personnel helps them to relax and feel comfortable.
2. Ambience- Most of the mammography centers are furnished in pinks and pastels as to provide an appealing scenery and pleasant feeling when patients enter the place. Pinks and pastels are favorite amongst most women, as well as vases filled with flowers like tulips or roses. Mammography places select pink for their gowns too in order to make a patient feel comfortable in a color that may be familiar like something from home.
3. Soft music- Soft music that's instrumental causes a soothing effect on anyone, most importantly on a patient who came to get a critical exam like a mammogram. Most technologists do pick their favorite exam rooms where they feel comfortable with machines and the orientation of the room. Generally there is a tape recorder or an am/fm stereo that is placed in the room. Some technologists like myself prefer to play soft music and some rock or pop or live broadcasts. Magazines are provided to patients in the waiting rooms as well as in examination rooms to read while awaiting their turns.
4. I am one of those people who use a bathroom at least half a dozen times before my doctor's appointments because of anxiety. Many female patients do prefer to use the bathroom before and after the mammogram. Restrooms in mammography centers are designed to provide maximum comfort for patients via decorations, floral arrangements, sanitary items, and soft fragrances.
5. Each and every patient deserves some special attention because of their emotional status when they come for the exam. Some centers provide coffee, tea or cookies and candies for patients to make them feel at home as they wait for their turn. Almost all places do provide cold water to drink. Sometimes a more considerate staff member even provides them with baked goods such as homemade cakes or cookies or store bought doughnuts.
6. In most centers technologists prefer to wear almost casual clothes with different colors. Some wear special, fashion scrubs that are ordered separately through catalogs and some wear clothes that are almost like day wear. This particular privilege is only given to mammography technologists only in order to make patients feel comfortable with them. Wearing casuals or colored scrubs makes a patient feel like she is dealing with another woman rather than a hospital employee.
7. There are patients who came to me year after year for their exams. They preferred to wait for schedules so they could have me as their mammographer. This kind of preference comes only when a technologist builds a rapport with the patient in the course of time. That includes communication skills, patience, gentleness as far as the positioning is concerned, and always a smile of course. Most of all, being willing to listen and take time with a patient gives a sense of trust and confidence in any particular technologist. Technologists usually make their patients feel like they are speaking to someone equal to them or outside the hospital.
8. Most important off all, when a technologist performs an exam she should exude confidence her skills, show that she is compatible and knowledgeable in her subject. This kind of sense comes to the patients only by asking pertinent questions regarding their history and answering any questions or addressing concerns they might have.
Overall, a mammography center should make an effort to make a patient feel at home away from home. Mammography is a very sensitive subject. It involves emotions on both sides of the spectrum. Showing concern and compassion are much needed during the exam to make it as pleasant as possible. Because of this, when the results are conveyed they are taken in with much more perspective. Precise information, skills, along with compassion on behalf of a centers' staff and technologists makes a lot of difference in a patient's life when difficult situations arise. As far as my patient from the beginning of this article was concerned, her diagnosis was a category-3, which involves further evaluation and procedures to determine the seriousness. I am glad I could make her feel as comfortable as possible while I was in charge of her case because, OUR LIFE MATTERS.