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denim · 07-20-2004, 12:28 PM

From another thread, it occurred to me that there might be a point in talking about doctors. There seems to be a mystique about 'em, and there shouldn't be. I had an advantage growing up with one for a parent, and I can tell you some things about 'em:

Doctors are not God. They're not ALL KNOWING, ALL SEEING, and PERFECT. Any doctor who thinks he or she is, needs to be either shown otherwise, or replaced.
Second opinions are not hard to get. This should be straight-forward, but maybe it's not. I'll explain later.
Treatments may have alternatives, not as in "alternative medicine" but as in "other ways to treat that", some of which might be "alternative medicine".

Doctors are human. They make mistakes, they find out more data after it's too late, they go to school to keep up to date, just like anyone. Suing them because they're not perfect, except in a case of malice or true incompetance, is just cruel. Do you think they like the fact that they fucked up? Do you think they like knowing that they hurt or killed someone because they didn't do some Right Thing?

Let me give you an example from a few months ago. I came down with shingles. I had no idea what it was, but it felt like my left thigh and buttock had been scalded. After a few days of this, I went into the clinic my doctor works at, and saw a doctor I'd not seen before. He diagnosed "shingles", apparently it's fairly common, and a particular medicine which required 5 doses a day for something like 7 or 10 days, I forget.

Now, I heard this and said there's no way I'll remember to take that. I asked him what else was available. He told me he's used this solution for years, and really likes the results. I told him I'm ADD and I'll forget most of the doses so he had to come up with another answer.

There was another, newer med, he said, which you take 3 times a day. I said I was looking for something I could take once a day, with my other meds. He said there wasn't one like that, and really preferred the original one he mentioned.

While I thought about that, I asked him why the med was necessary, as I was raised to only take meds when necessary (you're fucking with your body chemistry when you take a med, just like any other drug). He told me it'd make the pain go away quicker, and be less likely to be permanent (shingles is nasty). Okay, that sounded important enough for me to take a med.

I asked him to speak with my regular doc. He told me she was busy. I said, figure out a way, but speak with her.

She came in, quickly made the same diagnosis, and recommended the 3-a-day med. Okay, now I've got two opinions, and an understanding of what the med is for. I took the 3-a-day med, and it basically worked. I've still got a slightly itchy area on that thigh, but it's better than anything worse, and I took most of the doses on time. I'll inquire about the remaining itchiness next time I go in for something else.

Perhaps the 5-a-day med would have done a better job in a perfect world, but since I'd never remember to take all those doses, it wouldn't matter what its potential was.

Note the points in this anecdote: I took charge in this encounter. The problem was mine, the person who'd have to remember to take the meds was me, and I damn well GOT a second opinion from a doctor I trusted. And that trust has only been built up over a period of years. This guy I didn't know, and I wasn't willing to cut him too much slack as a result. I insisted on understanding what was going on, what alternative therapies there were, and reached an agreement with the doctor as to what I'd do.

I'm no MD, I don't pretend to be. From my perspective, a doctor is a craftsman who knows a particular area, and can be consulted as to how to fix a problem.

Another doctor recommended Vicks Vaporub for a fungus-like problem under one toenail. Not exactly a prescription medicine, eh? Several applications over a period of weeks erradicated a problem I'd had for 5 years. The point is that they might sometimes recommend stuff you'd not expect, but they will have a reason for doing so. If you don't follow why they suggested something, ASK THEM. You can always ask. The Vaporub was recommended by a dermatologist (skin doctor) after my regular doctor's answers on this didn't seem appropriate.

She'd hesitently recommended a pill which was (is?) being heavily pushed on TV for such problems. I didn't like the idea of dosing my entire body to fix a problem in one toe, and said so. She had no problem with that at all, and recommended the derm specialist.

If some doctor won't answer questions, explain to him (betcha it's a "him") that you and he are a team to figure out a fix to what ails you, and if he can't hold up his part, you'll replace him faster than spit. Been there, done that, will probably do it again. Note that I don't mean to be disrespectful, but to not allow the doctor to dis you either. Again, doctors are not God.

I haven't dealt with many surgeons, but I expect the deal is similar: understand what they propose to do, what could happen, what alternative solutions there may be, and make sure you agree. You can always walk out AMA (against medical advice), but you may be making a major mistake in doing so, if you do.

I did so once when I went into a hospital due to a migraine headache, before I learned how to deal with them. The doctor suggested a CAT scan. I asked him if he was paying for it, and why he wanted to try one. Seemed he was wondering if there might be some kind of bleeding. I didn't take that diagnostic idea well. To this day, I wonder what he might have found. OTOH, if I was bleeding in my head as he was suggesting was possible, I'd not be alive now to type this, so I guess he was incorrect. Still, I wonder if something else might have been found to explain other issues.

My dad went in a few years ago, and had a scan done on his chest, just in case. They found a spot in one lung. Scarey! Turned out to be one of the endemic fungii which lives in such places. It turned out to be a case of a House Law: if you don't take a temperature, you can't find a fever (meaning, a possibly pointless complication, see The House of God for more), but it could have been lung cancer. As a doctor, he knew what might be in there, but he prescribed the scan on himself just in case. There is such a thing as knowing too much, too.

Anyway, I hope this diatribe helps someone.

07-20-2004, 12:28 PM	#1 (permalink)
denim Banned Location: Massachusetts, USA	Doctors From another thread, it occurred to me that there might be a point in talking about doctors. There seems to be a mystique about 'em, and there shouldn't be. I had an advantage growing up with one for a parent, and I can tell you some things about 'em: Doctors are not God. They're not ALL KNOWING, ALL SEEING, and PERFECT. Any doctor who thinks he or she is, needs to be either shown otherwise, or replaced. Second opinions are not hard to get. This should be straight-forward, but maybe it's not. I'll explain later. Treatments may have alternatives, not as in "alternative medicine" but as in "other ways to treat that", some of which might be "alternative medicine". Doctors are human. They make mistakes, they find out more data after it's too late, they go to school to keep up to date, just like anyone. Suing them because they're not perfect, except in a case of malice or true incompetance, is just cruel. Do you think they like the fact that they fucked up? Do you think they like knowing that they hurt or killed someone because they didn't do some Right Thing? Let me give you an example from a few months ago. I came down with shingles. I had no idea what it was, but it felt like my left thigh and buttock had been scalded. After a few days of this, I went into the clinic my doctor works at, and saw a doctor I'd not seen before. He diagnosed "shingles", apparently it's fairly common, and a particular medicine which required 5 doses a day for something like 7 or 10 days, I forget. Now, I heard this and said there's no way I'll remember to take that. I asked him what else was available. He told me he's used this solution for years, and really likes the results. I told him I'm ADD and I'll forget most of the doses so he had to come up with another answer. There was another, newer med, he said, which you take 3 times a day. I said I was looking for something I could take once a day, with my other meds. He said there wasn't one like that, and really preferred the original one he mentioned. While I thought about that, I asked him why the med was necessary, as I was raised to only take meds when necessary (you're fucking with your body chemistry when you take a med, just like any other drug). He told me it'd make the pain go away quicker, and be less likely to be permanent (shingles is nasty). Okay, that sounded important enough for me to take a med. I asked him to speak with my regular doc. He told me she was busy. I said, figure out a way, but speak with her. She came in, quickly made the same diagnosis, and recommended the 3-a-day med. Okay, now I've got two opinions, and an understanding of what the med is for. I took the 3-a-day med, and it basically worked. I've still got a slightly itchy area on that thigh, but it's better than anything worse, and I took most of the doses on time. I'll inquire about the remaining itchiness next time I go in for something else. Perhaps the 5-a-day med would have done a better job in a perfect world, but since I'd never remember to take all those doses, it wouldn't matter what its potential was. Note the points in this anecdote: I took charge in this encounter. The problem was mine, the person who'd have to remember to take the meds was me, and I damn well GOT a second opinion from a doctor I trusted. And that trust has only been built up over a period of years. This guy I didn't know, and I wasn't willing to cut him too much slack as a result. I insisted on understanding what was going on, what alternative therapies there were, and reached an agreement with the doctor as to what I'd do. I'm no MD, I don't pretend to be. From my perspective, a doctor is a craftsman who knows a particular area, and can be consulted as to how to fix a problem. Another doctor recommended Vicks Vaporub for a fungus-like problem under one toenail. Not exactly a prescription medicine, eh? Several applications over a period of weeks erradicated a problem I'd had for 5 years. The point is that they might sometimes recommend stuff you'd not expect, but they will have a reason for doing so. If you don't follow why they suggested something, ASK THEM. You can always ask. The Vaporub was recommended by a dermatologist (skin doctor) after my regular doctor's answers on this didn't seem appropriate. She'd hesitently recommended a pill which was (is?) being heavily pushed on TV for such problems. I didn't like the idea of dosing my entire body to fix a problem in one toe, and said so. She had no problem with that at all, and recommended the derm specialist. If some doctor won't answer questions, explain to him (betcha it's a "him") that you and he are a team to figure out a fix to what ails you, and if he can't hold up his part, you'll replace him faster than spit. Been there, done that, will probably do it again. Note that I don't mean to be disrespectful, but to not allow the doctor to dis you either. Again, doctors are not God. I haven't dealt with many surgeons, but I expect the deal is similar: understand what they propose to do, what could happen, what alternative solutions there may be, and make sure you agree. You can always walk out AMA (against medical advice), but you may be making a major mistake in doing so, if you do. I did so once when I went into a hospital due to a migraine headache, before I learned how to deal with them. The doctor suggested a CAT scan. I asked him if he was paying for it, and why he wanted to try one. Seemed he was wondering if there might be some kind of bleeding. I didn't take that diagnostic idea well. To this day, I wonder what he might have found. OTOH, if I was bleeding in my head as he was suggesting was possible, I'd not be alive now to type this, so I guess he was incorrect. Still, I wonder if something else might have been found to explain other issues. My dad went in a few years ago, and had a scan done on his chest, just in case. They found a spot in one lung. Scarey! Turned out to be one of the endemic fungii which lives in such places. It turned out to be a case of a House Law: if you don't take a temperature, you can't find a fever (meaning, a possibly pointless complication, see The House of God for more), but it could have been lung cancer. As a doctor, he knew what might be in there, but he prescribed the scan on himself just in case. There is such a thing as knowing too much, too. Anyway, I hope this diatribe helps someone.