How many doctors does it take?

22 Apr

Because when we don’t know what’s wrong, we just blame the patient.

I grew up in a medical family and became accustomed to medical jargon at a very young age. You have pink eye? What? Oh! You mean conjunctivitis! I watched my dad study for exams and followed him around the hospital on days off and weekends while he saw patients. I watched how he interacted with them:  politely, professionally, listening, and taking notes about whatever brought them in. I became jaded as a result of this experience assuming all doctors treated their patients like people.

And then I met Dr. B.

My first glimpse into what constituted your average, run-of-the-mill physician began in the winter of 2008 with a neurology consult to figure out what, exactly, was going on with the strange symptoms I was having. I remember thinking I had some sort of communicable disease that I was unaware of because the man couldn’t have been any less personable. He practically climbed over me to sulk into the corner as far away from me as possible. Without ordering any imaging or tests, he prescribed a calcium channel blocker and a triptan, citing “Bickerstaff Syndrome”, a rare migraine disorder, as the cause of my discomfort. I did well for a few months and then the episodes started picking up again, only this time with greater force. I was losing my balance, falling, and feeling generally out of touch with reality during them. I went back and explained the problem hoping we could try a different medication. Instead, he told me I was to blame. “You need a psychiatrist,” he said, “you’re depressed, anxious, and dissociative.” Wait… What? I glanced around the room wondering when he had suddenly morphed into a qualified psychiatrist. That’s right, I’m so depressed I’m falling to the floor! I left that appointment humiliated and when I recounted the conversation to my PCP shortly after, he put a phone call in to the neurologist to let him know he was an asshole (ok, so I may be paraphrasing a bit here) and he referred me to another. Dr. H, or should I say his PA because I only ever saw him once during a 2 year period, really wasn’t any better, but at least neither of them blamed me when they had no idea what was going on.

Unfortunately, my experience with Dr. B wasn’t isolated. In late 2008, I began feeling incredibly run down. The fatigue was overwhelming, but the strange thing was that I was waking up feeling as if I’d run a marathon. Remember that mile run you had to do for gym class as a kid every year? I would wake up feeling like I had done one of those without stretching properly. My PCP realized something was definitely up, but since I was due to have the “magic birthday” (the one where you get booted off your parents’ health insurance), I was forced to find another. Reader take note, when a crisis hits, it will serve you well to have an established relationship with a PCP!

First there was Dr. M who thought I might have MS. When that didn’t seem to fit, she diagnosed me with possible “fibromyalgia”. After her clinic nurse and staff made a huge clerical error with my medical history, I sought help elsewhere.

Unfortunately, Dr. K was no better. She flat out called me a liar and told me no young person develops such a complex myriad of symptoms overnight. Wanna bet? When I called her office after a 3 day bought with terrible constipation and GI pain, she refused to write a prescription for an anti-spasmodic until I could see a GI doctor. Guess when the GI doctor’s next available appointment was? Let’s just say I’d need to poop WAY before then…As Donald Trump would say, “Dr. K, you’re FIRED!”

Fortunately, I was finally able to settle into the office of a more competent and understanding PCP, but he wasn’t exactly skilled in the micro-managing department. I had to learn to self-advocate, which probably wasn’t a bad thing, but I often wonder if we could have solved the mystery had we dug a bit deeper, sooner. Regardless, this PCP loved to refer out because nearly everything was “not really [his] thing”. He also loved to blame everything on anxiety. He had this unusual intonation when he’d make the suggestion too. I’d be allowed to talk for about 15 seconds before he’d interrupt to ask questions and then state, “It sounnnnnds like anx-EYE-ity”. *sigh*

I became quite skilled over the years at screening my team for potential idiots, so a recent experience caught me rather off guard. Last month I was able to get back in to see my former (wonderful!) PCP and without missing a beat, he referred me to see a new GI doctor because supposedly, he liked to “think outside the box”. Now granted, my case is complicated, and I know that. What I didn’t know was that I had been scheduled to see the physician’s assistant (PA), because if I had known, well, I would have canceled the appointment! My PCP’s office was trying to be helpful and scheduled the appointment on my behalf, and unfortunately I didn’t know what was going on until I was sitting in the exam room.

Generally, PA’s tend to subscribe to their assigned physician’s line of thinking, so I settled into my chair and hoped for the best. Guess I didn’t hope hard enough because this girl had to have been fresh out of school and was as green as the balled up dollar bill crumpled in my jean pocket. She looked at me and said, “Hasn’t anyone diagnosed you with IBS? Because that’s what you have.” Really? I had seen three GI specialists, had multiple tests over the course of 4 years and I need a PA to tell me I have IBS? Apparently, she missed the memo that IBS = I Be Stumped.

When I declined the offer for the colonoscopy and medication (because who says, “Oh yes, I’d love to have you stick a camera up my butt, look around, and give me dangerous anesthesia in the process!”) and explained I wanted to find the cause of my symptoms, she said, “We don’t do that here.” Um, I’m sorry. What, exactly, don’t you do? “We don’t find causes. We do butt-cameras, pass out pills, and get people feeling better. We aren’t in the business of analyzing diets and we aren’t in the business of finding causes.” (Again, I’m slightly paraphrasing, but the scary part is only SLIGHTLY!). We chat a bit more, she criticizes me for following an “over-the-top” diet, rolls her eyes when I explain the diagnosis of leaky gut from Dr. A, and tells me there’s nothing wrong with my pancreas, so I shouldn’t be on digestive enzymes.

I felt my temper rising and my irritation beginning to boil over because I hadn’t dealt with this level of closed-mindedness in quite a long time. Sensing my irritation, she asked, “Do you want to schedule a butt photography session with the doctor?” I looked at her and said, “If the doctor subscribes to the same train of thought regarding patient care that you do, I have no interest in returning to this office.” I asked for my medical history forms back, apologized for wasting her time, and left. Sometimes, you just have to know when to walk away. And when to call the office manager. This was a time for both.

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One Response to “How many doctors does it take?”

  1. Kellyn Jeanne April 23, 2012 at 6:40 pm #

    Wow, I have now read EVERYTHING on your blog and I am convinced that you are almost recounting my own experiences!! I have been there, the doctor who thinks it’s all in your head, the one who doesn’t care, the one who thinks your just looking for drugs, the one who only wants to argue because YOU know what you are talking about and he doesn’t, and the one who doesn’t even listen to you. Sometimes I feel like I am the only 20-something that had to go through some of this stuff, the endless doctors and endless times of never getting anywhere with your medical picture!

    *soft hugs*

    Nice to know I am not the only one!

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