For the last ten months, I’ve faced a medical challenge. At first, I had faith the answers could be found locally. But after starts and stops with fifteen different medical providers — none of whom were familiar with my diagnosis nor communicated with each other – it was clear.

I had to act. I had to do something bold to help myself.

The best step, and frankly my only hope for proper treatment, was to look nationally. I decided I must get into Mayo Clinic. But how?

None of my doctors advised me to go. No one I know well has ever been a patient there. I had zero knowledge of the process to be accepted. And yet, the path forward depended upon being seen.

There’s a particular kind of moment when you realize the next step in solving your problem isn’t just difficult, it’s gated. It would mean getting in front of a team of medical specialists who see more cases than they have time, and who had absolutely no reason to prioritize mine.

I wasn’t referred by an insider. I didn’t have a champion. I had to figure out how to get traction in a place where I had none.

Knock, knock, knock: Let me in

What I already knew about Mayo Clinic was that admissions are highly selective and many patients are denied. Reasons can include a mismatch between clinician expertise and patient diagnosis; specific departmental backlogs with waitlists of a year or longer; and, the lack of a strong case made on behalf of the applying patient.

I knew that gaining access hinged on a referral from my primary care physician – someone who, through no fault of his own, didn’t have full visibility into the maze of specialists I had already seen. I could have simply asked for his referral and hoped for the best. But I doubted my request would be viewed as compelling.

Instead, I fell back on my journalism training, analyzing the admission process as a communication challenge. I needed to control the narrative and make my own case. But I needed to speak in the verbiage and with the authority of someone with a medical degree.

Here are the four steps I took to represent myself:

• Making exploratory calls to the three Mayo Clinic campuses to determine which had physicians who would be most interested in the rare nature of my case.

• Telling my local providers of my plan so that when Mayo asked for medical records to gauge if I was a fit, my local physicians would be expecting the requests and would act in a timely manner.

• Creating a detailed timeline of my medical journey, recording every doctor’s visit, adopting the language of the profession to describe symptoms, testing ordered, findings, and provide clear rationale for why I must be seen at Mayo.

• Writing a six-page referral letter in third person, as if I was my PCP, which forced me to strip away emotion and focus on the facts. Instead of sending the draft electronically to my doctor, I hand delivered it. Arriving when his doors opened at 7:30 AM, I waited in the lobby to personally ask his nurse for help. He signed the referral and sent it without a single change.

Four long anxious days later, my cell phone rang. The Mayo Clinic popped up on my screen. I held my breath, said a silent prayer, and answered. They had reviewed my application. I was admitted.

Needing to be Connected is a Universal Challenge

How many times have you felt stuck when the entry point to an organization or a system (e.g. medical, corporate, academic) was impenetrably structured? Access seemed to hinge on familiarity, visibility, or knowing someone on the inside. And yet, you and I always have agency.

There were moments when the daunting odds of acceptance at Mayo caught up with me – when thinking about gaining entrance felt so far out of reach that I had to pause. The swings between discouragement and hope were exhausting. But I kept coming back to a simple working assumption: if there was an opening, persistence would help me find it.

As Oprah Winfrey puts it: “You get in life what you have courage to ask for.”

When the path forward is murky, we underestimate our ability to be connectors. With this experience, I am reminded again that connection isn’t reserved for people with built-in networks or institutional credibility. Connecting is a skill, and like most skills, it favors those willing to use it — sometimes before they feel ready. 

Tell me about your experiences with access   at Ann@AnnLouden.com.