Posted by Racer on August 31, 2008, at 12:19:03
In reply to Re: I feel dejected because of my one nephrologist, posted by seldomseen on August 31, 2008, at 9:38:11
I have this view of you as truly brilliant -- stellar insight, superb verbal abilities, amongst the most reliable voices of reason we have in this community -- and you know why? You so often save me the trouble of expressing the same ideas, with far less elegance and concision.
And it's a funny thing about doctors and perspective, too -- I was once diagnosed over the telephone, via the receptionist, by a doctor who had created a reputation for himself in one small area of his field. Despite having an existing diagnosis for the problem, which was adequately supported by objective evidence such as imaging studies. Sometimes a doctor hears what sounds like hoofbeats, and doesn't consider that it might be the Monty Python guys with coconuts -- even if they're in a cinema at the time.
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For me, it depends -- my dentist is adequate, and I'm willing to drive more than 50 miles on the most congested freeway in the area to see him. Similarly, I like and get along with my psychopharmacologist, which I consider vital to the outcome of my treatment. I had a colonoscopy last year, and just didn't like the GI guy whom I was referred to -- so I'll see another next time. I fired my last rheumatologist because his personality bothered me enough that he could have walked on water and I wouldn't have put up with him.
All these examples, though, have something in common: the outcome of treatment has not been life-threatening, so it was a valid choice to decide the relationship with the doctor trumped other considerations for me. (Except psychopharm, of course, but there the relationship really was vital by the time I started seeing this guy.)
If I had a brain tumor, and the most talented neurosurgeon in the area was an arrogant jerk - this example, by the way, because is based on something an acquaintance experienced nearby a couple of years back -- I'm have a hell of a hard time with it. I'd be frightened out of my wits by the whole process. And I'd find some way to get through it, because the consequences are more important than my emotional reaction to any individual. (It's also not an ongoing relationship, which helps.)
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As for WS and the nephrologist -- there's a really great book called "Bedside Manners" about the ways doctors fail patients in the way you're describing. According to the research cited, doctors start to tune out what patients say after -- well, I forget if it was 8 seconds or 13 seconds, but either makes the point. Doctors really don't always listen to patients, and patients have something they want to say. It's an unfortunate situation, but it's also what we have to work with.
So, how to deal with this guy and get a successful result? I've had good luck writing an outline of what I need to say, making a summary list of any relevant tests, signs, symptoms, etc, and basically trying to get his attention in that first ten second period. My experience has been that I've been pretty successful with this -- I see the eye glaze starting about the time I finish saying, "Hello, I'm here because |" but then I'd see that being replaced by engagement once the outline was in play. I even got a more complete hearing when I did that, because I'd have the list to go down, and then the doctor would take what was most relevant and ask other questions about it. I very highly recommend that process, just because I've had such good results from it. (Oh, and signs count more than symptoms, at least until the doctor gets to know you better.)
Also, a lot of doctors do dismiss a lot of what a lot of women say. I won't make any editorial comments about that, only say it's another obstacle to good care in some cases. One option is trying to get a doctor with whom you have a good and well-established relationship to intervene for you. That has also worked for me. And if you can't, rehearse saying "Please listen to what I have to say," without any defensiveness or submissiveness or aggression or resentment. Channel your Inner Vulcan to speak to the doctor. Suppress any emotional reaction when you address the doctor -- just the facts, ma'am, and not too many of them.
And then go have a margarita with a girlfriend and joke about what sorts of identity issues led this guy to that sort of reaction to women. Dismiss him in a way that doesn't interfere with the treatment of your problem, but does relieve your distress at it. Whistle into the wind.
And just as a random note -- man, I talk too much... Even in writing...
poster:Racer
thread:849401
URL: http://www.dr-bob.org/babble/psycho/20080826/msgs/849438.html