Dr. Killjoy, Or Why I Learned Not to Trust Doctors as Much as I Once Did
I call him Dr. Killjoy. My gastroenterologist had done all kinds of tests and had me on a strict diet that sapped some delight out of my life. But after months of diligently following his advice, continued bouts with a certain plumbing issue continued to dog me. Old Killjoy threw up his hands and told me he didn’t know what was causing my body to go haywire. I’d just have to watch and learn.
So, I kept a careful journal of foods consumed directly before the volcanic eruptions occurred. It led to a surprising conclusion. The culprit? A handful of almonds that I liked to eat as dessert after lunch. It was only because that journal, and some Internet searches (many of them conducted by two health-obsessed friends) that I managed to get my body under control and find what I should eat, and what supplements would help me.
This is the latest of several situations I’ve encountered that have led me to a conclusion that I can’t underscore enough: we simply can’t expect doctors to resolve our all our ailments — or believe that they will have the right answers. This is not to say I have discontinued visiting doctors. I just don’t have as much faith in what they’ll be able to do for any of us.
Have you seen the series “Dopesick,” on the opioid epidemic, playing on Hulu? (Michael Keaton is phenomenal.) That is another case in point.
Trust Falls Away
My almonds-as-volcanic-disruptor example is a mild one, compared with what I’ve seen in the past. My husband, David, made four visits to doctors at Mt. Sinai Hospital in New York because of severe back pain over the course of several months. One time, he was in such agony he laid on the floor in the waiting room for hours before a doctor would see him. And when she did, she didn’t order the tests that would tell us what we eventually learned: David had Stage 4 cancer. Instead, she suggested he take Tylenol.
We finally learned the truth from another physician who was recommended by a friend. When that doctor heard David’s story, he immediately ordered the right tests. That was eight months after he first began to feel so rotten. Thus began our four-year journey of countless oncologist visits, along with radiation and chemo treatments. Some of the medications David was given were cutting edge, recently approved by the Food & Drug Administration. Inroads are being made for cancer patients. Some progress could be seen in David’s condition, for a while. In the end, his body could no longer fight against the maliciousness spreading inside him.
Two of his cousins had similar cancer experiences — unable to get properly diagnosed as quickly as they should have because the doctors examining them didn’t recognize the root cause of their intense pain early on. In one case, a cousin’s wife figured out that he had cancer. She is no medical professional, but an accountant who did her own meticulous online research.
More recently, a close friend of mine has been suffering from knee replacement surgery that took place a year ago. The pain was supposed to subside long ago. She’s now consulting with a second doctor. The surgeon who performed her operation lacked any sense that something needed to be done to help her — or that the surgery wasn’t properly performed. (There are indications of that.)
Despite all this, some of the people I value most are physicians. Among them is a pain-management doctor in New Orleans, who is one of David’s oldest friends and gave him such critical advice during those final years. And another is a very gifted anesthesiologist and connected us to an excellent oncologist here in New York.
All of this underscores an old saying: that medicine is as much art as it is science. We can’t count on the science being advanced enough, or that the doctors we visit are artful enough, to really help us in the end. Although I give Dr. Killjoy a lot of credit for putting me through the tests and doing as much as he could to help.
What Doctors Face
I also point a finger of blame on the medical system that is common these days, which make it difficult for doctors to spend much time with any one patient — really observing them and understanding their particular discomforts.
Consider this excerpt from an article published in The Lancet, written by a doctor in Edinborough, Gavin Francis:
I see between 12 and 16 patients a morning, and the same again across the span of an afternoon. Where once I might have been given a couple of hours over one patient, the same time now might see me consult a dozen: arranging admission to a hospice, talking a patient with suicidal thoughts through their despair, attending to the subtleties of air movement through someone’s lungs, checking a newborn baby, calibrating epilepsy medicines, testing the ligaments of an injured knee. It’s not unusual to move directly from helping one couple conceive through in-vitro fertilisation to referring another for termination of pregnancy. It’s challenging work, often exhausting, but it’s also enthralling and endlessly rewarding. Modern technology doesn’t intrude much on many of my encounters; I suspect the kinds of daily conversations I have in clinic haven’t changed much in centuries. Similar conversations are going on in health centres all over the world.
Francis works within the United Kingdom’s National Health Service system. But is the fast-paced rotation of patients through doctors’ offices much different here in the United States? Based on what I’ve seen, not really.
Doctors don’t have the time and inclination to deeply listen to patients — and try and suss out what the patients might not say because they aren’t thinking properly or don’t think something is important. At least, that’s what I’ve concluded.
Maybe someday we’ll have our own robots who can give us the personal medical care we need, as I imagine in my sci-fi novel, “The Juice.” But today, it’s up to us, as much as it’s up to doctors, to figure out what’s wrong sometimes. We have to take more of an active role in determining our own illnesses and treatments. We must be skeptical and move on to other doctors if the ones we’re seeing aren’t providing proper care, and potentially the wrong diagnosis.
This can lead us down some dark paths, conjuring up far greater worries than are warranted as we look at sites like WebMD, comparing symptoms with possible dire illnesses. But in some instances, there really doesn’t seem to be a better option.
