Monday, September 12, 2016
He said, She heard
This probably explains why I don’t get along well with doctors:
She went to the doctor’s office because of persistent back pain. She gave her birth date as part of the office check-in process.
He came in, looked at the computer screen, and said, “Are you 21 or 22?”
She heard: I have the wrong chart on the screen, and I haven’t bothered to look at you so I haven’t noticed yet.
She said: “I’m 68.”
She thought: When I was 21 or 22, I had 80 years ahead of me. I was just starting out. This is end game. I have at most 30 years left and I want them to be as active as possible. I do not have the health problems of a 21 or 22 year old.
He said: “I just wanted to see you smile.”
She heard: “I can’t find anything real to compliment about you, so I’m making up something preposterous, just to say something. And I don’t care how stressful your back pain is for you, even though it must be awful or you wouldn’t be here. I’m just trying to get you onto the surgery conveyor belt.”
He got her dexa scan up on the screen. “It doesn’t look like you have any fractures.”
She heard: “I haven’t read the report that came with the dexa scan.”
She said: “I read the report. It says specifically No Fractures.”
He said: “We can’t be sure, but it doesn’t look like any. You have low bone density. You are prone to fracture.”
She heard: “I haven’t read any of the clinical experimental literature of the past 20 years.”
She said: “All the research of the past 20 years shows there’s no connection between bone density and bone brittleness.”
He said: “That may be, but you have low bone density and your bones are brittle.”
She heard: I don’t care about anything that contradicts what I was taught in medical school.”
He wrote on her chart: Fracture Risk.
She heard: I was really faking with that 21 or 22 year old nonsense.
She said: I’ve had one broken bone in my entire life and it took a 2-ton car hitting me at 30 miles per hour while I was riding my bike to break it. Lance Armstrong had more damage falling while riding his bike and nobody wrote Fracture Risk on his chart. This injury is not different because he is a young man.
The doctor refused to change his note.
He said: “You need to do weight bearing exercises.”
She heard: I’m not looking at you, so I can’t see the muscles in your arms – muscles that can only develop with weight bearing exercises. Then again, I don’t exercise, so I don’t appreciate muscle development. I don’t even know what to look for.
She decides to start him off easy. “I do push-ups.”
He said: “That’s fine. But you need to do weight bearing exercises.”
She heard: I have no idea what a weight bearing exercise is. It’s just a buzz word that I heard someplace.
She sent him an email listing at least 20 types of weight bearing exercises, including calisthenics. She detailed how she spends over an hour a day doing a variety of them. He did not respond.
She sent the doctor 4 papers from refereed professional journals detailing clinical research studies, all of which show clearly that there is no connection between bone density and bone brittleness. He did not respond.
She asked him to remove the erroneous Fracture Risk from her file. He did not do so.
He did a series of strength and flexibility testing. He gave no feedback. He poked her feet with a pin. He did not ask permission to do something painful. When she told him he should have asked permission he said he thought he had permission to do an examination. He didn’t understand why painful tests are different from other tests, and why he should ask permission to do them. He claimed nobody had ever said anything about painful tests before.
She heard: I don’t care if I hurt you. It’s more important to me to fill out a box on my form than to have your respect and trust.
Three men she knows had recommended this doctor. He never asked any of them about their age. He never commented to any of them about their bone density. He did not write fracture risk on their files, even though they are old.
He tried to talk her into an MRI and tried to talk about surgery. She asked for PT. He said: “Surgery usually works better than PT.”
She heard: “I think PT is a waste of time and money. But I’ll write the prescription if it will make you go away.
He wrote the PT prescription, but checked the Fracture Risk box on the top of the form. She thought he meant to deprive her of useful exercises. He didn’t want the PT to work. They made an appointment to meet again after a month of PT.”
She went to PT, did the exercises. Plus she accidentally discovered that lying on a small exercise ball removed the worst of the pain. The exercises worked to enable her to stand longer and walk longer without her pelvis cramping up. She’ll have to do these exercises every day for the rest of her life. This is end game.
She went back to the doctor’s office for a followup visit.
He asked how she liked being 39.
She said: “My children are older than that.”
She wanted to say: “When I was 39, I had both my breasts and both my hips. I’m not aging well. That’s why I’m here. My age is no joke. And why in your mind has my age suddenly doubled?”
He said, “I see you don’t like being teased.”
He hadn’t read the research papers.
She showed him the exercise ball that eliminates most of the pain if she lies on it for at least 15 minutes every night.
He said: “I knew about that.”
She heard: “I think this home-remedy stuff is useless. If I actually thought it worked, I’d have told you about it.”
He said: “We never need to meet again.”
She heard: I never want to see you again.
It was mutual.