Friday, March 12, 2010

Clueless Doctors....

Please do not misread this blog as a condemnation of all Doctors, because it isn't, but...Can I just say many Doctors are simply CLUELESS! Make fun of little blond girls from the "Valley" as much as you want but honestly...what planet did some of these educated men and women come from. Sometimes for such brillant people, you are just dumber than dumb.

I used to work for a pharmaceutical company in the 1970's. During my time there I called on hundreds of doctors. Out of those doctors maybe 10% had what I would call, good people skills. Those doctors could talk to you, without looking down at you, look you square in the eye and be comfortable communicating with you. But, the majority either acted quite superior, or inept when it came to talking. I know, I was a salesperson and regular Joes and Janes on the street brush off sales people all the time, but trust me, it was more than that.

When my mother had cancer I went with her to her oncologist. She had been prescribed a very high dose of steroids and it had been months since the drug was prescribed. When I went to a training session with my company, I spoke to the person who developed and tested that drug. I explained the situation and he said, "She really shouldn't be on the drug for that long and here's why." I took this information back to the Doctor who was aghast that I would question his decision. "You are just like a first year law student." he said. And he dismissed me and my mother. I took my mother back to the car and said I had forgotten someone. Finding him around the corner, I asked for a minute of his time. He rolled his eyes.

I told him I appreciated the fact that he knew much more about medicine than I ever would. I told him he had an impressive resume. I said" I know when you are in a practice where people are dying like my mother it is easy and maybe even somewhat necessary to shield yourself from the emotion of losing so many patients." But I pointed out my mother wasn't a cancer patient her name was Bettie Collis. She is the mother of four children. She is very frightened and she has been having side effects from the medication you have been over-prescribing. I am asking you to call the Doctor who developed this medication and see if you still believe in your decision. I am asking you to accept the fact that in this situation you could actually be wrong.

He did titer the dose down the next week.
Within a week her bowel perforated (a side effect from the high dose of the medication.)

When I had Cancer, I knew the importance of asking questions and waiting for an answer. But when you are the one going through the moment, it is hard to hear all the answers. We did our research and met with several Doctors. Glenn went with me. Overall most of the Doctors we met treated us with respect and compassion. In my case the one possible exception would be the Plastic Surgeon. We visited him to discuss reconstruction. He looked at me with my shirt off and told me I had nice breasts. (That was uncomfortable). Then he said I can understand why you might like reconstruction, but you are over weight. "Why don't you loose weight and you can treat the surgery like a reward."

This left me not only a woman battling cancer, but a woman of unacceptable weight battling cancer. I didn't cry that often in the course of this battle, but that was one of the times. I never did get reconstruction.

This week I have three friends who have shared with me their stories of their battles. One has a recurrence of melanoma. The Doctor looked at her and said "I don't know if you want a PET scan, because you may not like what you see." Excuse me!!! How can that person possibly think that is supportive of someone in such dire straits? She already knows it is very bad, how about telling her what she CAN do about it, not what she CAN'T. If you don't have the answer give her the name of people who are doing studies or people who have had some success. Even if they are outside your organization. Give her some power in a powerless situation. Do not discount her.

The second person has battled with her insurance company just to get a biopsy done of a "suspicious" region in her neck. Everyone agrees the chances are great that it is cancer. But her insurance would not cover the one hospital nearby that could do the biopsy. They finally after months sent her to another hospital where the Doctor said, "it's cancer, but in the area it is I can't get a biopsy. You will have to go to another hospital." So now it has been months and she still doesn't have her definitive diagnosis or plan. HELLO!! Has anyone heard what they have just told her. Does anyone believe the studies that Cancer grows best in a stressful environment?!

The last person of this week, has fought battle after battle with her Kaisers Doctors. This week they were going to biopsy her lump and inject dye into he nipple to determine if her lymph nodes are involved. They had planned on doing the entire surgery without a general anesthesia. In the process of saying why they needed to do this, they told her if they don't "we may not be able to save your life." Ok... remember what I said about stress?!

You have to know your audience. Some people need to be shaken awake so they can put on their battle gear and fight for their lives. Other people are so frightened already, words of potential doom can simply put their whole being into overdrive. It takes a people person to know the difference and I am afraid too often in medicine, a profession about and for people, this skill is non-existent.

So what is the lesson in this. As I was writing this entry I received an email from the person who was recurrent melanoma thanking her girlfriends for the information they sent about other Doctors, other hospitals and studies about her illness. She said, it made her angry, her doctor who obviously didn't have a long term plan for her. She said, just as she was receiving these leads from us, her son called to say he is playing tennis with a melanoma specialist at Stanford. Funny how when she opened her mind to other opinions one was sitting right in front of her and she had never realized it.

What does this tell me? If you find yourself in a corner when you have an illness, staring straight in front to you into the self-limiting direction with there is nowhere to go. Turn around. For God's sake, turn around and start moving.

And for you Doctors out there. Do me a favor. Imagine it is you hearing the words you are about to deliver to your patient. Feel what that feels like for a minute. Just a minute. Be a cancer patient. Be frightened and alone. Be the person who is looking at you for hope. Be that person then say what you want to say. That person is not a Cancer patient she is Bettie, Tracy, Cathy, Cindy, Joe or Robert. They could actually one day BE you. They matter.

They need your respect as much as they need your knowledge. If you reach a point where you don't have either, direct them to someone who can give them what they need. Because, in case you forgot, you are not God.

And to the Doctors who "get it". Thank you. Thank you. Thank you.