CHAPTER 11 — MY SCHEDULE POV: Amelia Carter

Damian Blackwood has rescheduled the same appointment three times by Tuesday morning.

7:42 a.m. The first request comes in through the hospital’s scheduling system. The second is from his office assistant less than an hour later. The third is a message from the cardiology department, politely asking if I could change things around so Mr. Blackwood could attend a corporate meeting before coming to the hospital.

I read the message twice.

And then I ring him.

He answers right away.

“Dr. Carter.”

“Mr. Blackwood. I know you want to reschedule your appointment.”

“I am trying to make it possible to attend without disrupting something that is a matter of importance to the business.”

“You’ve already moved it once.”

“And now I’ve got to shift it again.”

“Why?”

“Somebody moved my board meeting up.”

I look at his file. We will need to explore his symptoms further, given the recent episodes of palpitations and light-headedness. His ECG on admission has not given a definitive answer, and the previous monitoring results need to be reviewed in light of the new information.

Nothing is telling us at the moment that we have to spend all our hours in a hospital.

But nothing makes his follow-up optional, either.

“When does the meeting start?” I ask.

“Nine.”

“And your appointment?”

“Ten.”

“Then come to the appointment at ten.”

A brief silence.

“You’re telling me to walk out of a board meeting before it’s over?”

“I’m suggesting you keep an already arranged appointment.”

“This is a major acquisition we’re talking about.”

“And your medical evaluation is for a condition that requires ongoing care.”

“I know my state.”

“Then you know why the appointment is important.”

He exhales into the phone.

“Can we make it eleven-thirty?”

I look at the schedule.

“I have a patient at eleven.”

“Noon?”

My afternoon clinic starts at twelve-thirty.

“Then after that.”

“Mr. Blackwood, I can’t just move other patients around because your calendar has changed.”

“I didn’t ask you to move other patients.”

“You wanted me to move your appointment into time that’s already booked for someone else.”

Again, silence.

I can almost see him looking at his phone as if the problem is with the device, not the answer.

“Surely there is some room.”

“There is. When it doesn’t compromise your care or the care of another person.”

“And you don’t think this counts?”

“I think we have to stop treating every appointment as a meeting that can be moved whenever something more important comes up.”

The words come out more sharply than I intend.

Neither of us says anything for a moment.

Then he says, “I see.”

His voice is controlled, but the tone of the conversation has changed.

“Your appointment is still at ten,” I tell him. “If you have a genuine scheduling or medical issue, we’ll discuss reasonable alternatives. But I need you to understand that ongoing assessment is not something we fit in around whatever is left of your day.”

“Got it.”

He ends the call.

I put my phone down and glance at the screen.

As far as Damian Blackwood is concerned, I have a feeling that understanding and acceptance are two very different things.

Ten minutes past ten, and he’s still not here.

I wrap up a patient’s medication history, sign off on the notes that are still open, and move on to the next file.

The cardiology receptionist calls at ten twenty.

“Dr. Carter, Mr. Blackwood’s office says he’s running late.”

“How late?” I ask.

“They haven’t confirmed yet.”

I shut my eyes for a second.

“Tell them to give us an ETA.”

A few minutes later, the receptionist calls again.

“His assistant says he hopes to be here by eleven o’clock.”

“Let him know we’ll have to see if we can take him when he arrives. I won’t make another patient give up their appointment.”

“Certainly.”

I return to work.

I should be thinking about the patients waiting to see me, the reports that need to be finished, and the results I need to discuss with Dr. Harris.

Instead, I ask myself how a man can manage a business with hundreds of competing demands and still find it hard to schedule an hour for his own medical care.

I suspect the answer has something to do with the difference between controlling a schedule and controlling everything that can happen inside it.

It’s eleven, and Damian still hasn’t shown up.

Next patient.

At eleven forty-five, as I finish writing up the notes from the consultation, my phone buzzes with a message from an unknown number.

Sorry for the delay, Dr. Carter. I can be there in fifteen minutes. Please let me know if you can still see me.

I look at it.

At least he asked instead of assuming.

Briefly, I answer.

Come into the office. We’ll see what time we have available.

Twenty minutes later, he turns up.

I watch him through the glass panel in the consultation room door as he talks to the receptionist. Dark suit, tie straight, expression composed.

Nothing about him suggests that he has spent the morning negotiating with a number of people to secure a single appointment.

He walks into my office and shuts the door behind him.

“I’m sorry for the delay.”

I point to the chair.

“Thank you. I have a little time before my next appointment, so I can see you briefly. But if we don’t get everything done today, we’ll have to make another appointment.”

“Understood.”

He sits and places his phone on the arm of the chair.

It vibrates almost instantly.

He looks at the screen.

“Do you have to answer that?” I ask.

“No.”

The phone vibrates once more.

He turns it over.

“Sure?”

“I can ignore a telephone, Dr. Carter.”

“I’m glad to hear it.”

He looks up at me.

I suspect he recognises the sarcasm.

Good.

I open his folder.

“How have things been since your last assessment?”

“No more episodes.”

“Any palpitations?”

“Nothing important.”

“What does ‘important’ mean?”

His jaw clenches.

“I’ve never had an episode like the one that brought me in last week.”

“Any shorter episodes?”

He hesitates.

“One.”

“When?”

“Yesterday afternoon.”

“What were you doing?”

“Working.”

“You were sitting down?”

“Yes.”

“Were you feeling dizzy?”

“Not at all.”

“Chest pain or trouble breathing?”

“No.”

“How long did it last?”

“Just a few seconds.”

I write down the information.

“Why didn’t you call the department?”

“Because it stopped.”

“That’s no reason to withhold the information.”

“I didn’t conceal it. You asked me about my life, and I told you.”

“After I enquired directly about shorter episodes.”

He leans back.

“Are we going to argue about every little detail?”

“No. We’re going to get an accurate history of your symptoms so the team can make appropriate decisions.”

I lay down my pen.

“Damian, I don’t expect you to know which symptoms are medically relevant. That is why you’ve come here. But I do expect you to tell me what happens, even if it seems trivial.”

He stares at me for a few seconds.

“Okay.”

“Alright. Your timetable, now.”

His face tightens.

“I thought we were talking about my condition.”

“We are. Your schedule is affecting your ability to attend appointments and give us information regularly.”

“I was here today.”

“Twenty minutes late for our agreed time.”

“I wouldn’t just walk away from a meeting.”

“Then maybe we should discuss why your working day leaves so little time for something you know you need.”

His eyes narrow.

“Your consultation is not about my working day.”

“It becomes relevant if it interferes with your care.”

“I have a multinational company. I have responsibilities that are different from those of a normal patient.”

“No, you have different responsibilities.”

“You don’t know that.”

The words linger between us.

For a moment, he looks honestly surprised.

Then his face hardens.

“You have a way of talking to me as if my work is a nuisance.”

“I don’t consider your work an inconvenience. I think you’re using it as an excuse not to make something a priority that you don’t want to prioritise.”

“You don’t know what I want to do.”

“Then tell me.”

He opens his mouth and closes it again.

The phone beside him buzzes once more.

This time, he doesn’t let it go.

I wait.

“I have people counting on me,” he says finally. “Decisions don’t always wait. I have a doctor’s appointment, but contracts don’t end. Negotiations don’t either. Deadlines don’t either. The responsibilities that come with running a company don’t either.”

“I know that,” I say.

“Do you?”

“Yes. I also know your staff can cover meetings, your assistant can reschedule calls, and your company was here before you walked into the office this morning.”

His eyes narrow.

“You’ve clearly thought this through.”

“I’ve been thinking about your repeated requests to reschedule.”

He looks towards the window.

For the first time since he entered the room, he seems more interested in getting out of the argument than winning it.

“My father had people looking after his affairs as well,” he says.

It is a soft, almost accidental sort of remark.

I remember our last conversation, when he told me about his father’s illness and how the adults around him had hidden things from him.

I don’t ask him to go on.

Instead, I say, “Then you know that letting other people take responsibility doesn’t mean you’ve failed yours.”

His eyes return to me.

“It’s not about that.”

“Maybe not. But you don’t have to personally run every detail of your business to make it work.”

“And you don’t have to coordinate every detail of my medical care for it to work.”

“No. I’ve got a team. That’s why I’m asking you to work with us, not around us.”

He says nothing.

A voice from outside my office calls for a nurse. A trolley rattles along the corridor.

Damian looks towards the door and then at his phone.

The next time he speaks, his voice is lower.

“What do you want me to do differently?”

I’m surprised by the question.

Not because it is difficult, but because it is the first time he has asked without immediately getting ready to argue against the answer.

“Look, I need you to stop treating your appointments like movable roadblocks,” I say. “If you can, stick to the agreed times. If something truly unavoidable comes up, call us early. And tell us about your symptoms when they happen, not when you decide they’re serious enough for attention.”

“And if the company needs me?”

“Then you delegate where you can.”

He lets out a short, disbelieving laugh.

“You make delegation sound easy.”

“I doubt it is. But neither is managing a problem that could have been addressed earlier.”

His face becomes unreadable.

I soften my tone, not my point.

“I don’t want you to quit your job. I’m asking you to make your care a routine, not something you have to bargain with yourself over every time the calendar turns.”

He looks at his hands.

I wonder for a moment whether he will get up and walk away.

Instead, he pulls out his phone, mutes it, and puts it back on the chair.

“Alright.”

I don’t take the words as total agreement.

“What does that mean?”

“That means I’ll have to talk to Adrian about getting my schedule straightened out.”

“Good.”

“And I will report the symptoms.”

“All relevant episodes.”

“Yes, Dr. Carter.”

There is a warning in his tone, but less hostility than before.

I shut his file.

“We’ll arrange the next appointment through the department. The team will review the additional information and confirm what assessment is needed.”

He rises.

“You’re going to take care of this?”

“Yes, if I continue to be involved in your care.”

He looks at me.

“Then I guess we’ll just have to make this work.”

“We will if we’re both willing to do our share.”

He gives a short nod and leaves.

The door closes, and I sit there for a few seconds.

The consultation took less time than I expected, but I feel we’ve finally got to the heart of the problem.

Damian isn’t simply busy.

He has built a life where every responsibility has a place, provided he is the one holding everything together. His work depends on his availability. His decisions depend on his presence. It is as if his health has been allocated whatever time remains after everything else has been dealt with.

Maybe that arrangement worked well for him for years.

It is not serving him now.

I open his file and scroll through the appointments already entered. There are gaps, changes, and notes from scheduling documenting repeated requests to move consultations.

I close the file.

The next conversation can’t be another argument about the relative convenience of ten and eleven.

I need to know what his routine looks like, what is demanded of him, and what assumptions make him think his work has to be accommodated in every facet of his life.

Then we can come up with a plan that is medically appropriate and realistic enough for him to follow.

If I keep negotiating individual app

ointments, we’ll keep having the same conversation.

And Damian Blackwood is far too good at making repeated conversations a means of avoiding the decision itself.

I take my notebook and write one line under his name.

Next meeting: Discuss routine, workload, and sustainable follow-up arrangements.

I underline it.

The problem isn't his schedule.

It’s the life he’s built around it.

And until we address that, every appointment will be an argument.