#BuckFifty – Day 11 – Mistakes


I work for a medical transcription company.  It’s a national company and the accounts I work on are all across the country and even in Canada.  It’s nearly all hospital work, acute care, and I’ve been working at this company since October 2012.  I’ve been in my current position of shift lead, i.e., supervisor, since December 2013.  I’ve survived downsizing, the shutdown of one operating platform and the move to another, involving having to fit in to an entirely different team and different ways of doing the same job, a major system/security hack that nearly shut the whole thing down in 2017 and various other industry related ups and downs.

I work with people’s protected health information in numerous states and two different countries.  I have a more than passing familiarity with a myriad of drugs, medications, cancer treatment protocols, etc.  Tell me your medications and I can tell you what’s wrong with you.  Usually by the time the doctor has dictated a couple of paragraphs, I’ll know what’s wrong with the patient and what they’re going to do to treat them.  I’ve transcribed enough C-section reports that I could probably do one myself in a pinch.

In this line of work, the accuracy standard is 98% and above.  A decimal point or a zero off in a medication can easily be fatal.  Confusing similar sounding medication names can be dangerous, Xanax and Xalatan, for instance.  Confusing left and right can be disastrous (and doctors do it ALL the time – be afraid).  The list goes on.  I keep track of all of that and manage the staffing and quality of the other medical transcriptionists (MTs) that I supervise.  I have to make sure they’re all working according to schedule, maintaining their production quality and quantity, keep up with new medical information, make sure all the MTs HAVE the new medical and account information, and about 9000 other things–ALL from my desk, long distance, via e-mail mostly and occasional phone calls.  I’ve never met anyone I currently work with and never spoken to most of them.

Additionally, on the weekends, after a certain point, I work all alone until my daytime counterpart comes on.  That is, there are MTs working on certain accounts, but no other supervisory/editor type folks, so *I* am responsible for everything other than the active production of typing jobs for all accounts, and, in fact, I have to do that, too, on the accounts where no one is scheduled at night.  Granted, some of these are usually not very busy, but you never know when folks are going to show up to the ER or there’s a flurry of operations or whatever.

Given all this, you know I’m going to make mistakes.  We all do.  I am not a machine.  I get frustrated, confused, distracted, sleepy.  But, for the last seven years, with only a few slips, I have maintained the 98% and above accuracy that is required.

So, imagine my surprise (well, actually, not really), when I got an e-mail from my boss that I had made so grievous a mistake that if I am to do it again, I will be terminated.

What did I do, you ask?

I left a time-stamp (which is how you mark where a blank is) in a medical report.  It would look something like this:  “The patient is on Seroquel, Ativan, _____ 3:35, and lisinopril at home.”  This is a completely made-up statement not taken from any real medical record, if anyone is worried about a HIPAA violation.  It just means that at three minutes and thirty-five seconds into the hypothetical recording, there was mention of a medication that I did not recognize with enough certainty to be above 98% accuracy to put it in the document.

For this particular client, on only certain types of jobs and on certain days, are the time stamps to be taken out before sending the job through.  On EVERY OTHER job type and on every other day, all time stamps MUST be left IN.  Not confusing at all, is it?

So, probably sometime in the wee hours of either Saturday morning or yesterday morning, I let a job slip through with a time stamp.  And now, I’m being threatened with losing my job.

I could go into my job politics, the problems we’ve had with this client, the fact that a TIME STAMP in no way affects patient care or safety, but I won’t.  For me, this is just a microcosm of where we are as a society today.  I’m not a power-wielding billionaire, so one tiny mistake puts me at the whim of a capricious boss who probably got yelled at 15 minutes before threating to fire me via e-mail.

I love my job.

A Moment

Today I was working at my second job.  On Tuesdays, I work at a local quilt shop, general duties, helping people pick out fabric, cutting, ringing up, all the usual things one does in a small retail shop.  I like the job for lots of reasons but one of the biggest is that the customers, other quilters, are almost invariably pleasant, creative, interesting people.   Today was a little unusual because we have a sale this week.  My boss isn’t big on sales as a business model because she says people will just wait till you have a sale to come into the shop and stay away otherwise.  But, we have a LOT of inventory on the shelves and more coming and we need to make some room, so a sale for the next three days is in effect.  It’s 20% off all fabric, but if you buy the end of a bolt, then it’s 25%.  That’s to encourage people to just snap up those small amounts left on bolts to put in their stash.

Around mid-morning a lady came in and wandered around for a while and finally settled on a bolt of red that she wanted to pair up with a blue.  I showed her where things were and she found a blue fabric she liked and pulled that out.  Turns out, she was going for the ends of bolts on both, and there were about 4-5 yards of fabric left on each bolt, so a pretty good purchase, even with a discount.

As I was unfurling the fabric to measure exactly how much there was, we were chatting about it and what her plans were for it, etc.  Being red and blue, of course, I was thinking something patriotic for Fourth of July and mentioned that.

“Yes,” she said, “I make a patriotic quilt every year and donate it to the Friends of the NRA so they can raffle it off to raise money.”

“Oh,” I said, pretty much at a loss for words.

“Yes,” she said again.  “The one I donated last year ended up going for $750!”

I suddenly wanted to grab that fabric out of her hands and tell her to just get the hell out of the store because I was NOT going to sell her anything that could be used to benefit that crazy terrorist organization.  It was really all I could do not to.  My hands nearly cramped up with the effort.

But I didn’t.  First of all, the woman was probably close to 80 years old and second, my boss, who owns the shop, also own guns, although I’m pretty sure she’s not a fan of the NRA, as I know lots of gun owners are not.   So I just smiled and nodded and sold her the fabric and was very happy when she walked out of the store.

“Friends of the NRA.”  Damn, who knew?


Sometimes, my thought convolutions and trails of memory surprise me. This morning, in the wee hours, to get a brief break from work, I read an online essay at Lucky Peach, a great food, cooking and culture magazine. In it, the author talked about keeping a food diary for none of the reasons that people are often urged to do this, i.e., track your food so you’ll know if you eat “too much” and then you can eat less and lose weight. This woman keeps a food diary as an aid to memory. Even writing this takes me down another mind corridor, to a conversation I had years ago with a college friend and her husband in New Orleans about our parents and their various quirks. Her mother invariably remembered events and occasions by what was eaten: “Oh, remember when we went there? We went to X Restaurant and you had that dish, and your father ate that?” while her husband’s father always seemed to remember event by how much things cost: “Oh, remember when we went there? We went to X Restaurant and the bill was X dollars, and you had that steak that cost X!” And so it goes.

Working nights is weird. I get hungry at odd times. I mean, really hungry. I don’t know if it’s the brain power I’m expending at times when my mind would normally be resting or if it’s just my body trying to tell me to sleep, but instead it just gives up and says, “Well, I know you’re not going to sleep, but I’m really tired, so why don’t you eat something instead?”

Either way, tonight/this morning there was a perfect combination of circumstances that threw me down memory lane big time. I decided I wanted some cheese toast. Toast has become a real treat for me lately because over the past few months, I discovered that either wheat or gluten or some combination of the two was the major culprit in all my miserable itching. I did two somewhat controlled experiments where I quit eating bread, baked goods, wheat flour products, etc. for a couple of weeks, then ate the same and wow…the itching had calmed down a lot and after I ate the things (2 donuts the first time, 1 corn muffin from a restaurant the second time) and had immediate and severe skin reactions, I thought, well, I can do without bread, etc. if it means not scratching myself till I bleed.

I did well the first 6 weeks or so. I’m not a really big bread eater, although I like it. Crackers are more my downfall, and I found some gluten free ones that I liked, so all was well. But, every now and then I want a sandwich. Or a piece of toast. So, after nearly 3 months of no bread, wheat flour, etc., I found a loaf of Udi’s gluten-free bread on sale and thought I would try it. I got the millet-chia variety and it is really good. My first piece of toast in 3 months was incredibly delicious…buttered under the broiler, with peanut butter and cherry preserves. Yeah, THAT’S a memory.

Which brings me back to tonight/this morning. I wanted cheese toast with tomatoes. And wanting cheese toast with tomatoes, I thought of Leo.

Leo was my boss at Six Flags Over Georgia in the Crystal Pistol for four years. The first year I worked there, I worked in the general wardrobe, where I took in the dirty uniforms for all the park workers and handed out the clean ones for the next day. I worked with a high school friend and her mom along with the rest of the crew, in a huge warehouse type place full of long racks of brightly colored uniforms for the different rides. There was a guys’ side and a girls’ side because every day after shift, the workers came in, went upstairs to the locker rooms, changed into their street clothes and brought their uniforms to us, got replacements and then went back upstairs to put them in their lockers for the next day. Over time, I learned people by their clothing size. I learned to look at a guy and think, “Oh, 32 x 32” instead of “Cute butt.” I learned to look at a girl and think, “Flume Large” or “Sky carts medium” which had absolutely no bearing on whatever size she might wear in the real world. But that’s a whole other post. The wardrobe was my world for the first year I worked as SFOG. I worked weekends and nights after school when the season overlapped and nights during the summer. It was my first experience with night shifts. SFOG was where I learned to drink coffee.

I liked working there, but even then my introverted self did not want to be out in the park mingling with the tourists. So, the second year when spring time rolled around, I put in an application again and started following up. My mom called, I called, but nothing seemed available. Finally, when I was just about to give up hope, my mom made one last call and the HR person asked, “Can she sew?” Oh, yes, I could, and so I got an interview with Leo at the Crystal Pistol.

On the day of, I went into the office area that I was familiar with and was told I needed to go out to the Pistol for the interview–that was where Leo worked. So, I found my way there, and asked the crew where to find Leo and they directed me backstage, where I found a woman in a tiny cubicle with a two sewing machines facing each other, surrounded by vast yardages of lace, net, tulle, satin, rhinestones and sequins, separated from the rest of the backstage space by a counter and a Dutch door.

As I got a little closer, it appeared that I was looking at her through the neck of the sewing machine…her head was barely over the top of it. I stopped at the Dutch door and told her who I was. She slowly got up and made her way around and through the piles of fabric and to the door and opened it for me, inviting me into her inner sanctum. I stepped in, more than a little nervous, especially when I saw that Leo was probably older than my grandmother and barely taller than my waist. Think Linda Hunt as Hetty in NCIS: LA.

Leo greatly resembled Gertrude Stein and she was, in effect, cubic. She was almost literally as wide as she was tall. She wore long smock tops and loose pants, and she pulled one of those vertical wire shopping carts along behind her coming to work and going home. She had crisp gray hair that she wore pulled back in a severe bun and bright blue eyes in a round face that was soft with wrinkles. She was not a particularly cheerful person, but over time, I could tell when she was amused because her eyes would sparkle even if her expression never changed. She never hurried, but she got everything done on time. She was a brilliant seamstress who had no formal training but she could look at a person for a few minutes and work out a pattern to fit them from thin air. I was immediately intimidated, but she asked me if I had made the top I was wearing, and I said, yes, ma’am, I had, and everything was downhill from there. I was in.

Leo ruled the backstage area. Nobody messed with her. As with the general wardrobe, the performers turned in the part of their costumes that were washed and cleaned every day…tuxedo shirts, or similar, various ties, accessories, even underthings (dance belts–if you don’t know what a dance belt is, Google it), dance hose, leotards. We were responsible for keeping the costumes up, washing the things that could be washed, and maintaining the dressing rooms. But Leo brooked no sloppiness. We kept things cleaned and mopped, but woe to anyone who left a bow tie or a stocking behind and woe to the person who turned in their things bunched up or inside out. There would be fines and no one got their items back until the fines were paid.

In addition to the two sewing machines and piles of fabrics and shiny things, Leo kept a fridge and toaster oven in the tiny space. I’m sure it was some kind of a fire hazard, but no one was going to tell her she couldn’t have them. One of the things she loved to make was cheese toast with tomatoes. She brought big, juicy tomatoes from her yard (her husband, Harold, was a gardener–when he wasn’t watching religious shows on TV, something Leo greatly disapproved of, as Harold was apparently prone to sending money to the televangelists. Leo was nothing if not frugal.) She sliced the tomatoes thick and the cheese thicker, and popped her little open-faced gems into the toaster oven to bubble and ooze into melted perfection.

My mouth watered every time she made this concoction, and I vowed I would try it at home. At work, I brought a cold lunch in and Leo and I ate together while I trained.

The first year, I worked under Leo’s close scrutiny. I learned to fit and alter, to sew yards of rhinestones onto plush velvet without marring the nap, to take regular looking street clothes and turn them into something showy that was also able to be yanked off a moving body in a hurry and replace with an equally showy different garment for quick-change moments. I once even fixed a young man’s zipper while he was still wearing the pants. When I told him sternly, “Don’t MOVE,” and he didn’t, I began to understand where some of Leo’s power came from.

Throughout the season, Leo continued to make her cheese toast with tomatoes. And I started making it at home. It’s such a simple item, but so good…way better than the ubiquitous grilled cheese sandwich and tomato soup. I could never abide tomato soup, even as a child, but the warm tomatoes coated in the melty, bubbly cheddar atop the crispy, buttery toast…that was comfort food at its best.

And so, last night/this morning, as I made my toast, Leo wandered into my head and in just a moment, I relived all those years at the Crystal Pistol, sewing rhinestones and sequins, watching the pretty boys and girls dance brilliantly onstage and cuss like sailors and smoke like chimneys backstage. I felt the swish of the netting around me as I worked in the close confines of Leo’s creative closet. I smelled the funk of costumes that can never really be washed but only “cleaned”…that unique mix of dry cleaning fluid and body odor that never exists anywhere but in the back of a live-performance theater. I thought about the author of the article, writing her food diaries ever day, hoping to preserve her memories of events and people by writing down menus. It’s a powerful technique, if just thinking about cheese toast and tomatoes can carry me back this far to a long-passed period of my life.

I’ve got short ribs in the crock pot tonight. Maybe I should write that down.

Book A Day #26 – Should Have Sold More Copies

The truth is, I have no idea how many copies of this book have been sold. I first discovered it perhaps 15 years ago during my corporate drone days. I can’t remember if I shared it with one of my bosses or if she shared it with me, but both of us were intriged by it, enough for me to go out and get my own copy. I haven’t read it since then and, again, with some of the things that are happening around my job (nothing really bad, just typical corporate behavior), I feel like maybe it’s time to pick it up again. I do think that someone should send a copy of this book to every CEO and other upper management folks at every corporation, large and small, in the country. If corporations want to be seen as people, then perhaps they and the people who run them should act a bit more human.

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