I should have helped him right then. I should have asked if she could call, since she knew their office anyway. Couldn't they fax over the referral?

But I didn't. I was trying to squeeze in the dosage and frequency of medications in the tiny boxes on the form. Besides, I wasn't sure I wanted to start off my relationship with Big Bertha by telling her how to do her job. 

"Let's reschedule," she said with an awkward cheeriness, as if that was a problem she liked to fix. She spouted off days and times.

"I can't come that early. I have to get my handicapped son on the bus," he said, "and I'm afraid I'd be late."

That should have done it. I should have wheeled over there myself to see if I could help him.

But I didn't. I had three more signature pages to complete and another patient came in, adding to the confusion. I saw Mr. So-and-so leave with an appointment card in his hand.

As I signed the last forms, I heard a deep male voice ask Big Bertha about Mr. So-and-so.

"Didn't have his blah-blah form," she quipped. "We rescheduled."

Soon I met the doctor, the owner of the deep voice. He was excellent, listening to my storied medical history before offering his opinion and advice. His assistants were helpful and compassionate as they helped me move from my wheelchair to the narrow exam bed.

On the way home, I thought how Mr. So-and-so lost the chance to get good medical care and how the doctor lost the chance to see a patient. And I lost the chance to make a difference.

Becky Galli is a freelance writer and columnist who resides in Lutherville. rfsgalli@gmail.com or http://www.rebeccafayesmithgalli.com.