Random Asides

Non-faith Non-healing

When I was about 13 years old, I was on vacation in India for the summer, visiting relatives. About 2 days before we were scheduled to go home, I developed a cold and a slight fever. My cousin, who was pre-med at the time, told my mom that she should take me to the doctor. Since we were traveling so soon, it was better to get it checked out.

We went to a doctor that my family had known for years. She was friendly and kind and talked to my mom like the old friend that she was. She checked me out and, as she was listening to my heart, noticed that something was not quite right. I had a slightly irregular heartbeat. She then made me drink some water that she said had a “memory” of some of my blood before I was sick, and it would teach my body how to be healthy again. Since then, I have roamed o’er the land by night, drinking the blood of the pure.

Not really. But within 24 hours, I was admitted into the hospital.

I stayed there for nearly a month, unable to leave my bed, as they continued to try to understand what was happening. As it turned out, I had a viral infection that had affected my heart. The doctor said that had I flown home as planned, the altitude would have worsened the condition and she was sure that plane would have had to make an emergency landing.
I always think of Dr. Divate when I go to the doctor here in the States. As some of you know, I’ve been fighting some sort of malingering, hacking crud for nearly 2 months now. I had bronchitis in January, right before TAM 5.5, got on antibiotics to take care of it. I felt OK for about a week (which included the time I was at TAM, thankfully!) but then got sick again. I’ve pretty much been sick ever since. I’m on the third round of antibiotics, this latest round, prescribed by my doctor over the phone.

My husband went to his pediatrician from when he was a fetus until he was in college, when the doctor retired. Dr. Miles sent his family Christmas cards and had them call him at home, day or night, during emergencies. I think that sort of care and friendship is worth a waiting room full of giant Legos and ducks on the wallpaper.

I know it’s a lot to ask, but I really miss having a doctor who actually knows and cares about you. I find that in the U.S., doctors treat the symptoms and don’t really spend the time to understand the root cause of the problem. Yesterday, when I told the nurse over the phone that I was concerned that this was becoming pneumonia and that I had been sick for 2 months, she discussed it with the doctor and simply called in a stronger round of antibiotics.

I am feeling better and this round will probably be the last. In addition, I’ve taken some time off work and am resting, getting fluids, and doing the usual things that will probably help. But I can’t help but wonder whether her spending just a little more time with me the past 2-3 times I’ve been to see her, might have caught something that would have made me feel better faster.

When I take my dogs in to the vet for a procedure, the vet calls us the day after we take them home, to check on them and see how we’re doing, even if they just got their rabies booster shots. And you wouldn’t believe the extravagant card we got after my husky died, filled with original poems and sketches of Vandal. But the idea of a doctor calling us to check on how we’re doing is unheard of. Why do our animals get a better class of health care than we do?

Or, do I just have a crappy doctor? Do you guys have examples of health care professionals who do go the extra mile for you and your family? Do I just need to search for a better doctor? My demands are simple — I want to be treated with the same attention and dignity as an 11-year-old dog with crappy hips and bad breath. Can I do that here? Or do I just need to save up to put a niece through med school?

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Masala Skeptic

Maria Walters (a.k.a. Masala Skeptic) has spent a lot of time in ‘furrin parts,’ including Hong Kong, Trinidad, and Pittsburgh. Although her passport is from India, she’s spent most of her adult life in the United States. She currently lives in Atlanta and has an unhealthy affection for science fiction, Neil Gaiman and all things Muppet.

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19 Comments

  1. It is incredible how much better attention my dog gets when I take him to the vet then I do when I see a doctor. The only thing I can think of is that doctors know that they are in demand and vets have to make sure they treat your pet well so that you keep coming back. Maybe back in the old days doctors had more of a feeling of responsibility. These days it seems like even our medical industry has fallen to the revolving door of sales. Lets face it Doctors offices are businesses the more people that go in and out the more money they make. So getting you in, giving you antibiotics and then hitting your insurance company has to be done quickly so they can then get the next person in and out.

  2. You are not alone. I've had the same doctor for about six years, and I am beginning to reconsider. She is friendly and helpful when you are in the office. She sees the entire family and remembers our names and various relationships, but every symptom and disease seems to be treated with "this sample I just received" and a prescription for antibiotics.

    My wife had a particularly traumatic episode a couple of years ago that involved prescribing stronger and stronger antibiotics for a symptom that eventually was found to be non-bacteria in nature and was being exacerbated by the antibiotics. It looks to me like the good doctor is simply prescribing medicine for the placebo effect without trying to understand the root cause of the disease.

    I second your question. In asking for a doctor who will actually try to follow my symptoms to the root cause and follow up with me to see if the treatment is working, am I asking more than the US medical establishment can provide?

  3. I think you need to search for a better doctor who will take more time to talk with you. If your doctor does not call you for a follow up, you should feel free to call them, and some US doctors actually have email to communicate with their patients. If they find this type of contact unacceptable, you definitely need to ditch them and find someone better.

  4. I grew up in a rural, small-town area, so when I moved last year to a larger city, I definitely noticed a difference in doctors. My hometown doctors were more personable and attentive. But I chalked that up to the fact that having a smaller patient based made that possible, whereas having a ton of patients makes it much more difficult.

  5. First, Masala, you have my sympathies for the health issues you have been facing. It reminds me of something I recently faced ("malingering, hacking crud" describes it perfectly), the upshot of which was a diagnosis of asthma (which I had *never* had before) brought on by an earlier respiratory infection. I was 46 years old and never would have suspected such a thing, but my doctor did, and the treatments he prescribed cleared up the problem within days.

    My doctor doesn't make house calls, and he does not even make follow-up phone calls — but he always asks lots of probing questions and, more importantly, listens to the answers, even when they are lengthy or, on occasion, frustratingly vague, despite my best efforts to convey them. He also schedules me for follow-up visits in some situations, and he always tells me to contact him or come in before that time if the treatment isn't working as expected.

    My doctor has me undergo lots of tests (including repeated X-rays of my chest and sinuses in this asthma situation), which I often resent at the time, but consider to be a necessary step in his reaching the correct diagnosis.

    He considers more than just symptoms and tests, too; he considers such factors as changes in my diet or exercise routine, traumatic life events (such as when my late companion passed away), and so on. I have always gotten the impression that when he's dealing with me, he gives me his full attention; if it's an act, it is at least a good one, and my treatments have generally been as good and effective as I could hope for.

    I guess the bottom line is that, if you lived in the Dallas area, I would strongly recommend my doctor to you over the one you have now. Since you don't, I suggest you ask around to see if anyone else you know in your area has a doctor like this. Good luck.

    ~Wordplayer

  6. I'm so sorry about your husky, some of the nicest dogs I've known were huskies. I agree with you about doctors though, I see and have seen a lot of doctors over the years. I remember having a really nice pediatrician as a child, but after that most of my medical doctors have been quite nice but I've never had them call me up to see how I was doing. I can understand why it would be difficult for the doctor I see to do this, since the office is always pretty busy. I don't feel that his solution is always to through drugs at what ever ails me. For example I have had an upper respiratory virus since I got back from Rebecca's Talk in NY. It started out with a bad fever, then I started vomitting, s oI went back to the doctor, and they basically told me I should just try and get the mucous out of my system by rinsing out my sinuses with saline spray.

  7. Personally it sounds like you have a crappy doctor.

    Our doctor is very attentive, he takes a very level headed approach, not the "prescribe and forget" approach. He spends time to help us understand what to look for. It's gross stuff but knowing what the difference between clear snot and green snot means can go a long way in helping you understand what's going on with your body (or more importantly your kids). Having an ear scope-thing (I know I'm getting technical) is great and knowing what to look for when you kid complains about their ears or has a runny nose.

    Anyway, enough fawning over our doctor.

  8. It's good to hear so many positive stories about good doctors here. I hope I'll be able to find one. I definitely will be looking for a new one. I did have one doctor that I really liked a couple of years ago but she moved out of town so I was back to having the pick of whoever was at the practice.

    And Skeptigator, don't even get me started on green snot. I've spent more time reviewing and defining the color of phlegm in the past few weeks than anyone should have to… 'it's sort of olive … tending toward chartreuse…'

  9. Masala,

    Hope you feel better soon. There is something nasty going around.

    From the kind of values you are seeking in health care, I would recommend a nurse practitioner. They are registered nurses with Masters degrees, and they tend to focus more on health promotion and prevention in order to decrease incidence of illness vs. trying to cure something that has already caused illness, and they have a reputation of spending longer visits with their patients vs. an average MD. (Although I have to admit that this evidence is more anecdotal rather than evidence-based). Good luck :D

  10. My best doctors have always been those that I tought were the "B" student at school. My GP in Wisconsin found a tumor that would have killed me in a few months. The specialist that operated on me said "most doctors would never have found that." When I talked to my GP he said "well, you said you had dropped 10 pounds without dieting. To you it was a good thing, to me it meant I had to keep looking to find out what was wrong."

    When I had my surgery he asked if he could attend (for free). He said, "no one knows your family like I do. I want to make sure that no decisions are made without input from me." Sure enough he convinced the surgeon to do a more complex surgery so that I could have another child. My GP knew I wanted another child.

    My current doctors are wonderful. My OBGYN is the worlds nicest doctor. He made a mistake once, but I didn't hold it against him as frankly I know him and his family. It was an honest mistake. I still trust him with my life and the health of my daughter.

    My current GP is very clear about "family time" . But when she is working she is all business. Since we know each other very well, I often just have to call her up and she'll prescribe something. She's a good partner with helping me take care of my heart (which is genetically DOOMED) and focuses on how women are different than men. She called up my insurance company and fought with them so I could have a special stress test for my heart, the test she insists is the only one that works for women. Plus we bitch about the woo medicine that is rampant in Vermont.

    I know my doctors are people. They make mistakes, but they talk to me and they care.

    But I can honestly say, I always look for the strong "B" student… I think they try harder.

  11. The best doctor I ever had was Dr. Guo. He was my physician when I lived in Taiwan. I remember the first appointment I had with him, he examined me in minute detail, as opposed to the questionnaires and casual questions that most of my American doctors use.

    He took note of every single scar and its cause (tracheotomy, pylorric stenosis, etc) and put those disorders and their symptoms on a "watchlist" for me.

    My best memory is when I had been utterly felled by a migraine. I had just managed to get to his office before I collapsed. He took me into the back, laid me on a table and injected me with something– I don't know what it was, but he lifted up my shirt saying he needed to see me breathe, and warned me not to fall asleep– and in twenty minutes, the pain was gone.

    Not only did he accomplish what no American doctor had for me, he gave me a sucrose solution afterward to drink. Real after-care!

    Dr. Guo was my hero after that incident.

    And the BEST thing about Chinese nurses and doctors? Needle technique; They never, EVER miss the vein. No hunting or prodding around. They just slip it right in, no fuss, no pain.

    Damn! WHY did I come back to America? I even had HEALTH INSURANCE there, fer fexake!

  12. I have an awesome doctor – and I agree with others here that you should look around. My Doc can be busy and hard to get in to see but it's worth the wait normally. He has a fascination with you and his work and always explains what's going on. I just called him today for the results of a blood test and he spent 10 mins explaining the mechanisms the body uses to maintain blood sugar levels and why the nurse who took my blood was taking nonsense when she told me I has fasted too long before the test.

    I have had bad experiences too so it does pay to shop around. Rav's story about needles is reminding me of the time as a child when we went to see the family doctor only to find he was sick and his dad had come out of retirement to handle cases for the day. He put a needle in my arm and started wiggling it around trying too find the vein!

    Masala – my advice would be to talk to friends, family and co-workers who are local. Word of month is a good recommendation for a doctor I think.

  13. Oh and I meant to add – the moment when I really knew I loved my doctor was when we were talking about supplements and he advised me to get a particular type not a multi vitamin because (and I quote) "some multivitamins list the thing you want but it is often present in practically homeopathic doses"

    Hahaha "practically homeopathic doses" love it!

  14. Sorry about your dog. :( We got a lovely note from the animal ER that had to put our Lucy-cat to sleep, and I know what you mean about the comparative levels of care.

    We had a pediatrician who was much like your husband's Dr. Miles — single-doctor practice, follow-up calls, focused attention, all of that. When my daughter's weight continued to be on the low end of the charts (10th to 15th percentile), he didn't freak out as many doctors would have, because he knew my husband was 6'2" and weighed 145 pounds, so my daughter came by it honestly. The family connection is so crucial. He ended up taking an early retirement because of the insurance/malpractice nonsense.

    My own doctor is not quite as wonderful as some described here, but I have kept her for nearly 13 years because I think she's better than a lot of them. She is a very matter-of-fact, level sort of person, and she is good about listening and giving an honest opinion without being too swayed by my self-diagnosis. ;) Even though she isn't the most touchy-feely sort of person, I think she does a good job at asking personal questions to make sure that my physical symptoms aren't really just stress or mother exhaustion, and I appreciate that.

    Now, my OB/GYN is another story. She delivered my daughter, and I cried when I found out she was only doing office visits (not deliveries) when it came time for my son to be born. She bought a recording of one of my piano performances and actually listened to it, so she is forever on my Good List. :D

  15. There are good doctors. But we have a system in the U.S. where it is hard to keep a primary care practice afloat without the impersonal herding of patients. I'm sure most doctors would love to spend more time with fewer patients, but with fixed reimbursement levels for them, they have to see a certain number of patients a day or go out of business.

    That is the system we have created in this country, and I do mean "we" because it is the fault of the public, not politicians, not insurance companies, us.

  16. I only have one “good doctor” story and it’s wrapped around a “hospital full of incompetents almost killing me” story. Since then, I’ve always said that I’d rather see a vet than a medical doctor. It’s amazing that I didn’t fall into medical woo after that (I do have a lingering mistrust of medicine, but it’s the human element, not the science)… I’d call it a miracle if I believed in them.

  17. Just two things:

    1) I want to second what others here have said about doctors having it rough in the U.S.; having to be budget conscious, spending all their time fighting with insurance companies, etc. There are good ones and bad ones, of course; but if they're rushing you through your visit and not giving you the full attention you need and deserve, it's not necessarily because they're bad doctors. It's often because they don't have much choice.

    2) That being said: You might consider getting a nurse practitioner instead of an M.D. for your primary care provider. In my experience, nurse practitioners are less focused on treating symptoms and more focused on your overall health.

    (Admittedly I'm a little biased, since my wife is a nurse practitioner. But I've had great experiences with them. If you've had bad experiences with doctors, it's worth a try.)

  18. You should try healthcare in the UK. My philosophy these days is: if it's free, it ain't worth it.

    I've just started researching private-sector GPs. I used the private sector for my lumpectomy, and have had private dentistry for years, but I've never had to spend £60 on a routine doctor's appointment before. But, it's that, or not get an appointment at all. RIP NHS :(

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