Money for jam.

The receptionist can set the tone of the practice she works for. 

Last Thursday, at the endocrinology centre I attend, there was an angular, grey, fifty-five plus supercilious tone, with a brusque Hawthorn - refined, possibly British-Australian - accent.  The eyes, peering down through half-cut reading glasses, remained fixed on the computer screen.

Having announced my arrival, took a seat and waited.

It's my third visit with this particular endocrinologist.  She's tall, slim and fair.  Today she's wearing a black, back-zipped, flared pant teamed with a sleeve-less bolero style top over a black camisole.  There's plenty of time to observe all this as she leads me into the room, indicates that I should take a seat, sits and smiles at me.  White, long, somewhat prominent, good teeth.

She continues to smile, like she's really happy to see me, or she's not sure what should happen next.  I've encountered this before here and I'd already determined that I was not going to 'lead' the discussion.  Nor blather on to fill a somewhat awkward, albeit congenial silence.  (Don't you love these little mind games?)

I smile back, shrug, look beyond her narrow shoulders at the moody sky and rain spattered window, wondering if I'll get caught in the rain on my way home.

I tell her I haven't brought in any blood glucose data because I couldn't find the appropriate dongle.  (What's with that word anyway?)  Instead, I hand over my blood glucose meter and she busies herself backtracking through a few recent readings. Uh-hmm.  Silence.  No feedback.

"Which pump would you recommend?'  I interject, knowing the four year warranty on my Animas 2020 will expire soon.

"Medtronic," she says unequivocally, smiling and nodding.

"Any reason?" 

"I find it's easier to access the patient's data."  Still smiling.

"So it's about you rather than me," I say.  Because after four years I'm quite adept at interpreting my own data and I'm the one who has to live with it day by day.

"Oh, I think you'll also find they have the best after-sales support."  Smile.  Teeth.  Medtronic have really nobbled the consultants, I think.  Must be superior marketing.

"But Animas has been amazing.  I couldn't possibly have had better support."  I'm thinking of helpline calls I've made that have been 'life-saving' when I'm melting down; long chats with the young girl in Sydney,. herself on a pump; loan pumps when I'm overseas and a brand new pump, no questions asked, when mine failed.  Being Type 1 D and on a pump is practically part of the job description at Animas.

"Well, of course, it's up to you."  Still radiant smiles and then silence, which I'm determined not to fill.  We look at each other.  I can't stand it any longer.

"So, what was my last A1c?"  Which is really the only reason I'm here.  I can get scripts written at my local bulk-billing - that is, no payment - clinic.

"7.7."

The previous result was 7.8.

"Oh well, I'm heading in the right direction."  Given the stress and sickness I've endured for the past three months I'm thinking that's not too bad.

Quiet again.  I wait.  Bit awkward.  White walls, desk, bench, cupboard, scales, sink.

"Do you want to test my blood pressure?" I ask.  I know the drill.  She wraps the cuff around my arm, presses a button, but doesn't tell me the result, and I don't ask.  "My weight's been pretty stable," I add, which prompts her to suggest I get on the scales.  We both peer down at my feet before she returns to her seat and writes a note.  I already knew what I weighed. Apart from a few extra grams for clothes, my weight hadn't changed since that morning.  What am I doing here?

"Do you need any scripts?" she asks.  Hurrah.  She hands them over along with a pathology form for my next visit.

"Could you write me a medical certificate?  Had to take a day off work today."  Despite only working three days a week, I had to take the day off because she only consults privately one morning a week.  Fair enough.

"Okay, see you next time."

"Thanks!"

Back out into the ice-cold reception area and I'm not talking about the aircon.  I've been with the endo for ten minutes, tops.

"That's a hundred dollars for today, thanks," says Mrs Personality, lifting her eyebrows in my general direction and reaching for my credit card.  "Cheque, credit or savings?"

Think it's time to review my diabetes management options.  Any suggestions?