October 2026 - Vol. 23, Issue 5

My primary care doctor tells me to go to the emergency room of one of the two hospitals in my small city. I debate which one will treat me less poorly this time. Will it be the one where, on a previous visit, a surgeon was consulted to decide if I needed an operation on my pancreas that was removed more than a decade ago? He didn’t believe my accounting of my own organs despite the scars that bore evidence of their removal. It’s hard to see the scars from the doorway where he stood, never laying a hand on me, while asserting that no one has ever had their entire pancreas removed before. Or should I go to the other hospital where a nurse told me to “stop being anorexic” when I couldn’t eat the sausage and eggs she brought me for breakfast after  days of vomiting everything I put in my mouth?

I pick one of these hospitals and tell the triage nurse about the high fevers I’ve had for three days and that my doctor has sent me here because I am unable to eat or drink anything. I explain that my pancreas, gall bladder, spleen, and some of my stomach have been removed when she asks about prior surgeries. She also doesn’t believe me about having no pancreas even though the surgery I had in 2012 has been done in specialized centers across the country since 1977.  She asks how much I have been drinking lately when she hears that I have a history of chronic pancreatitis. “I don’t drink at all,” I say, knowing that she is under the mistaken impression that everyone with pancreatitis drinks too much alcohol. While alcohol consumption can cause pancreatitis, there are many other causes too. For me the problem arose from the way my pancreas was formed—a rare birth defect that didn’t cause symptoms until I got older. The pancreas is a finicky organ, easily perturbed, much like this nurse. Often doctors don’t know the reason why someone develops pancreatitis. In medical speak, they say it’s “idiopathic.”

I pull out the card in my wallet that looks like a business card. It’s from the major medical center that removed my pancreas and it says, “I do not have a pancreas.” These cards were printed because so many patients like me have these same issues of not being believed. The card describes how after removing my pancreas they transplanted the islet cells that are responsible for controlling blood sugar into my liver where they have been so unbothered by their new home that they have kept my blood sugar levels remarkably in check. Isolating and removing the islet cells from my pancreas in a method that sounded like a high school chemistry demonstration has saved me from being dependent on insulin. Because of this surgery, I no longer spend 7-10 days at a time in a hospital every few months because of an inflamed pancreas. I will also no longer die from pancreatitis that can lead to multiple organ failure and for which there is no cure.

Although I will not be able to return to my former career as a pilot, I hope with accommodations to return to working in one of the many important aviation jobs that don’t require me to fly. Despite living with chronic pain because of nerve damage and some other complications that affected my ability to eat, I can return to taking care of my daughter who was born with physical and intellectual disabilities from a rare genetic condition. I take her to dance classes each week and walk alongside her as she guides a horse through cones with an exuberant smile on her face from the moment her tiny feet go into the stirrups. I am there for all that, except for the times when I get a series of fevers for no obvious reason or become dehydrated because of vomiting when my intestines take a break from doing their job—a side effect of the many abdominal surgeries.

I wonder why my condition causes such suspicion and judgment when I must go to the emergency room. Is it because my pain is on the inside, hidden from view, and so somehow not real in the eyes of people who should be experts on the mysteries of what goes on inside of the body? Is it because the pancreas has such a scary reputation among physicians that one doctor wrote in his memoir about medical school that one of the few pieces of advice he received during his internship was “Don’t f##k with the pancreas.” Or is it because I have a prescription for opioids for the abdominal pain that sometimes feels like my pancreas has somehow regenerated itself, like an octopus with a missing appendage.

The easily perturbed nurse refuses to call any of the four specialists on the card who can confirm what I am telling her. “We won’t give you opioids for pain,” she states emphatically even though I have never asked for any. Apparently, the stigma of being someone who is prescribed opioids for pain is fueling her wrath this time. The harm that has been done for years by stigmatizing people with addictions continues to have its repercussions for patients like me who have chronic pain. It has turned going to the emergency room into an indictment of the fact that I can’t tolerate the chronic severe pain that accompanies pancreatic diseases.

“It’s the fever and the headache that is making me so miserable,” I repeat. “It’s the worst headache I’ve had in my life,” I say weakly, and I ask for some Tylenol which I think they will have to give me by suppository or I will throw it up. I don’t care. “We are not giving you that either,” she says, before disappearing, leaving me with no pillow or sheet and she takes my call bell away. I have had my pillow and sheet taken away before when a nurse got mad because she had labeled me as drug seeking, but taking my call bell away is a new form of punishment. My teeth are chattering and my eyeballs feel like hot coals. Shouldn’t a fever of over 103 in a sixty-three-year-old be concerning even if the doctors and nurses refuse to believe what organs I have? I feel like crying, but no tears come out. I am too dehydrated for that. They won’t give me an IV either although my mouth has no saliva. I am soon sent away from this ER with no treatment and no answers as to why I am so feverish.

Still unable to eat or drink anything except sips of water, I realize that the only solution is to get a ride to the major medical center that removed my pancreas. The ER staff there is usually kind, perhaps because many of the doctors are in training and are still eager to do whatever brought them into the profession in the first place. I can get them to call in the pancreas specialists although I am not sure the fever is related to my long history with pancreatitis. Yet I know that I have been reduced to “the pancreas in the hallway bed”, not a complete body that could be having an appendicitis or the flu.

After another wait of nearly eight hours, the doctor finally appears apologizing profusely. He orders pain medication right away and then notices I have no IV. “Why didn’t they put in an IV? I put those orders in right away.”  A nurse appears, and then another and another, and after poking me in seven different spots they acknowledge the obvious—I am so dehydrated they can’t find a good vein. Like many chronically ill patients, my veins were not great to begin with but are now all scarred down in the most obvious places to insert a needle.

By the time they call in a paramedic, who they describe as the “vein whisperer,” I am so miserable that I don’t even fake being friendly like I normally do and just continue reading my book. It is the only thing that has gotten me through this ordeal that is too familiar by now. I am reading a book about another female pilot and there is an airplane clearly visible on the cover. The paramedic, whose touch is gentle as he probes for a vein, dismisses himself for a minute and says, “You’ve been through enough.” He comes back with an ultrasound device that can help someone locate a vein and thread the needle in. He sees my book and asks me if I am a pilot. I am delighted by this not only because it’s the first time today that anyone has talked to me like I am anything more than just another in a long line of bodies, but also because few people think I am a pilot. Even if I am reading an aviation text, or wearing a shirt with an aviation theme emblazoned across the front, the thing I am usually asked is “Is your father a pilot?”

“Yes, I am, or was, until I got sick and had to stop flying,” I tell the paramedic. He says, “My sister flies for an airline. She used to take me flying with her all the time when she was building her flight time,” he explains. I smile at the thought of this and tell him that I taught my father how to fly and took him flying with me too when I needed more flying hours to get my first airline job. The paramedic says something about how much fun it was flying with his sister, and how he’s sorry that I got sick and had to stop flying. During this conversation, he has expertly found a vein and inserted an IV without me hardly noticing. Then he is off to the next patient, but he has left a lasting impression with me. Why is it that in the past eight hours in this emergency room, and in my previous visit to another hospital emergency department, no one other than him has taken a moment to find out something about me as a person instead of a sick body in a bed. How many other medical personnel saw the book with the airplane on the cover and never asked me what I was reading? And if they had, might they have stopped making assumptions about me and finally treated me with the dignity and respect I deserve?