So after my post yesterday, I was unfriended by someone who is a… - Tactical Ninja
Jul. 27th, 2015
So after my post yesterday, I was unfriended by someone who is a doctor. I could be putting 2 and 2 together and getting 27, I could have just got really boring lately, but it looked to me like one of those quitting to avoid an argument situations, because I've turned into someone who thinks I know better than trained professionals, who reads the internet and self-diagnoses, and who won't be told.
It's ok, I recognise how infuriating that is. Reading comments about whether or not prisoners should be allowed to vote makes me want to go all stabby too, because I'm a trained criminologist and I like to think my education is worth something, so seeing laypeople wax eloquently on topics they aren't trained in can be frustrating - especially when if their advice were taken it could lead to further harm. I get it, I really do.
Doctors do often know best. They train for a long time to know stuff about how bodies work, and they have far more knowledge than I ever will on a huge array of things I can't even pronounce, never mind understand. They know the functions of things like cortisol and what the normal ranges are, and can very likely give really good advice on what is or isn't likely to be wrong with me and why.
The problem is, in my experience, they don't.
What they do instead, is to see me for 15 minutes if I'm lucky, in which time I rattle off what I'm feeling and they try to work out what's wrong. Sometimes they order tests, after which I get a text saying 'everything normal' and that's the end of it.
When I said to my doctor that my back pain didn't feel mechanical, she ordered a test and I wasn't sick enough to see a specialist so she said "It's mechanical" and I did what she advised and it didn't help.
When I said to my doctor that I was concerned about the strange beading and ridges on my fingernails, she glanced briefly at them and dismissed it. NB: the first thing you learn when working with hoofed animals is that their health is evident in their hooves. So weird lumpy nails when they have been smooth in the past *does* mean something in my view.
When my doctor said I am probably depressed and I said "I know what depression feels like and this isn't it" she looked at me like "How dare you challenge me?"
When I presented with weird round spots on my legs that look like ringworm but don't itch, that appear for no reason and disappear after a week, she said I had eczema. I was doubtful but she was insistent. Thing is, I know quite a lot of people with eczema and *none* of their rashes look like mine. The steroid cream she gave me makes no difference, and I don't fit the profile - no food allergies, never had asthma, never been prone to skin reactions..
My doctor says I'm depressed and have eczema. She has a bunch of medical training and a number of years' experience at diagnosing people's ailments, and has seen me for a total of about 45 minutes over the last year and had the results of some tests.
I say I'm not depressed and I don't think I have eczema. I have no medical training but a good brain, and 45 years' experience at living in my own body. I like to think I have some idea of how I feel and what's normal and not normal for me. Mostly I'm willing to listen to external advice from those who have more knowledge.
The problem arises when I talk about how I feel and show her the things that are abnormal for me and she dismisses them and tells me things that conflict with what I'm experiencing. And doesn't bother to explain.
Why are my weird fingernails not worth more than a passing glance and dismissal?
Why is my back mechanical despite not having responded to any of the recommended treatments, despite me still being able to do some pretty demanding circus without it hindering me, and despite my efforts to address potential OOS not actually making any difference?
Why do I have eczema? What is the reason that she has decided it's this, and discounted any other possibility, based on looking at it once? Why is it that when I ask about alternatives, she shuts me down instead of discussing them with me as if my perspective has merit?
Why does her view that I'm depressed override my own that I'm not, and why, now she's decided that, is everything I say seen through that frame?
I can't help but think that my 45 years trumps her 45 minutes when it comes to knowing how I feel, and when my descriptions of my own observations are dismissed in favour of something I know not to be true, and I am then treated as if I don't know myself, I get both resentful and disappointed.
I want a doctor that works with me, that doesn't just make decisions that easily fit a predetermined perspective, and who is interested in hearing what I think about my situation. And if I'm wrong, I'd like to hear why, clearly and in detail, so that I can understand and agree rather than just feel like I'm being dismissed with "Doctor knows best."
Because I've been following Doctor Knows Best for a year, and getting nowhere. I have no reason to have any faith that what she says is any more right than what I think, and the more this happens, the less faith I have. Yes, I *will* go and look things up on the internet. And a good doctor would listen to this, consider it, and either give it the merit it's due or explain why she thinks it's incorrect.
But of course, when you only have 15 minutes and can only communicate by text, she can't do that. So we get this situation where I'm ignored and resentful, and she's frustrated by my refusal to accept a glib diagnosis, and nobody's got time to have a real discussion.
All of which costs me $63 a pop.
So yeah, I understand that people who read the internet are a source of frustration for doctors, with their half-baked, untrained ideas. But I think doctors need to understand that dismissing patients' ideas out of hand in favour of a diagnosis that the patient feels is incorrect, with no explanation or discussion, is incredibly frustrating and disempowering. And for me, it chases me away. I have no desire to spend another 15 minutes (and another $63) trying to convince my doctor I know myself well enough to judge whether or not I'm depressed.
And if going to the doctor is pointless enough to be not worth doing, I'm left with trying to figure it out for myself.