Friday, July 31, 2009

Playing Doctor

Sometimes, I get the feeling that many, if not most, of us in the health care field went into our lines of work because we simply don't like being the patient in a health care situation. We'd rather be the people who are in charge, the ones who know what's going on. Maybe I'm projecting, but as kids how many of us wanted to be the patient when we played doctor? I sure didn't. I wanted to be the doctor because being the patient held little appeal. The doctor got to use equipment and DO stuff. The patient just got to lay there and be sick. At no time during these play sessions did the patient question the doctor or get to participate in deducing what was wrong or deciding what to do about it. How did I (and so many others, I'm betting) learn these classic and faulty elements in the roles of doctor and patient at such a young age?

It must start when we are babies or very young children, for most of us. I remember my terrified little brother thrashing around on the table and eventually having to be restrained by four adults (he was 2 or 3 at the time) while the doctor looked into his infected ear with an otoscope. No one spoke to him or asked him what was wrong or why he was so afraid. Poor kid hasn't been to the doctor willingly since then. He's now 21. My own personal experiences with doctors as a child were often less than pleasant. One of my earliest memories is peeing in a doctor's lap as he gave me a shot in the buttocks. Hey, I told him to wait and he refused to listen to me! Note to pediatricians, when a 2 year old says, "Wait, I've gotta pee.", she may be stalling but maybe you shouldn't lay her across your lap in your newly carpeted office (instead of an exam room) and proceed to give her a shot! My dad was standing there unable to keep a straight face while I watched my urine soak the doc's pant leg. Even the doc laughed. I was mortified. Daddy apologized and dried my tears.

As an adult, the experiences don't get much better but by this time I made it a point to visit the doctor only if I was practically at death's door. When you have no insurance, that's an easy resolution to stick to. In 2007, I did have insurance. I also had a UTI that was morphing into some lovely kidney pain. After visiting the ER, I made an appointment with a nephrologist in my area. I was sitting in the exam room when the doctor came in to greet me. He glanced at my chart and said, "History of UTI, eh?". I nodded and he asked me to stand up. At this point, the doctor grabbed my crotch. Let me repeat. HE GRABBED MY CROTCH!!!!!! To add insult to injury, he said, with his hand still at my crotch, "Well, that's your problem right there. It's too hot in there." What the fucking hell??? I was stunned. My mouth simply hung open and no words came out. I did not punch him, though I should have. Nor did I push his hand away or yell any of the million things flying through my brain at that moment. I did nothing. I said nothing. Because he was the doctor. He was the DO-er and KNOW-er. He had the power. I was the patient. All I got to do was be sick. And after that, I was sick.

I don't hate doctors. Far from it. My dislike is for the unequal and counter-productive power dynamic that exists between many doctors and their patients. The existance of this dynamic isn't soley the fault of doctors or the medical community. I think that patients shoulder an equal share of responsibility here. But here's the problem. Most of us were patients before we were ever health care professionals and we've been socialized to be "good patients". A "good patient" doesn't ask too many questions, is compliant, and understands the patients' place in the medical hierarchy is below the doctor/nurse/midwife, etc. Today, we need less "good patients" and more people actively involved in their own health care. We need patient education and respect. We need to stop asking doctors to shoulder the burden of making health care choices for us because when things go wrong (as they sometimes do), whoever made the decision also carries the blame. We need doctors to stop practicing health care that's based on fear of litigation. We need to be the kind of patients who don't just lay there and be sick.

1 comment:

  1. I think that no matter where you go, there will be people who got into the profession they are in because they are book smart... but that doesn't mean they have any people skills. (Doctors and nurses included). I have a story similar to your Nephrologist story... but involves a new-to-me GP, and a very bad experience with a very private female exam. I contacted the head of the clinic after with my complaint/concerns and was very swiftly applogized to and switched to a NP with a much better bedside manner.