SubJeff on 4/2/2012 at 20:03
Quote Posted by Kolya
doctors... They're scum. Most of them anyway.
Where do you get this, and why? Are you saying that me and all of my medical friends (and my girlfriend and ex-girlfriend) are scum because we decided to go into a profession that helps people in their greatest time of need? Or that "most" of us are? This attitude amazes me.
You've posted some stuff I've found questionable before but... wtf man, wtf?
demagogue on 4/2/2012 at 20:47
When people need to go to doctors, they have one of their most important assets put at risk (feeling healthy or living like a normal person) and they feel vulnerable and isolated and totally dependent on whatever the doctor says (same with lawyers). So there's an inevitable emotional reaction they're going to have of strong anxiety and lingering distrust or even paranoia. I don't think it has to do with the professional status of the doctor or lawyer. They'd have the same reaction almost whatever the doctor or lawyer says. It's just how humans work in situations where they're afraid of losing something very important to them.
Edit: Not that I'm saying that's what Kolya meant. But it is a general thing I've come to expect from people and don't hold it against them, as long as it's clearly an emotional reaction, which is then how I treat it (it's largely just their emotion talking. The proper response is to ease their anxiety, not necessarily rehearse your professional credentials to them, unless that helps to ease their anxiety too...).
Kolya on 5/2/2012 at 00:28
I'm saying this because most doctors I've met in times when I or friends needed them were of one of these types:
A) The dollar doc: When he looks at your ailment he sees an opportunity. From the moment he greets you with an overwhelmingly friendly smile and moist handshake to the second where you are lying down before him, dozing off on the narcotics, with him blabbering on about the immediately necessary but unfortunately costly treatment, you cannot shake off the feeling that this man would have made an excellent used car dealer. And now you're the car.
B) The hospital doc: Apparently overworked and uninterested. Particularly often found in public hospitals, but not solely. He will help you eventually, but not before he kept you waiting for at least 2 hours, flirted with every nurse in the room and the adjacent rooms, forgot your name AND your problem a few times and then leaves you hanging without a word. Presumably because he's more urgently needed elsewhere. Don't dare to bother hospital doc if it's not life threatening. (Hint: Just because you're in indescribable pain does not mean it's life threatening.) And certainly you don't want to give any suggestions on what your problem might be. Are you the doc? No, you are not. You may have been living in this body for over 30 years but you have no idea of it's intricacies. And don't ever mention Wikipedia.
C) The good natured old doc: He's got a beard, because all good docs eventually grow a beard (yes, even the women), preferably a white one. Just seeing him calms you down and then that low timbre in his voice in which he explains everything in detail to you, the costly treatment as well as the smart treatment which will really help. (Although he's not actually allowed to do this anymore, he'll do it for you.) You feel safe and secure in his big hands that never hurt you. He's a good man. And thorough.
Of course in the end even the smart treatment isn't that cheap, but think of what you might have paid with any other doc for a wrong treatment.
Then one day you have moved to another town and you have to see a doc about a man and how you wish it was good natured old doc. Instead it's some young guy who perfunctorily listens to the abbreviated version of your life and when you mention good natured old doc's special treatments you notice him shaking his head ever so slightly and you immediately distrust him.
Renzatic on 5/2/2012 at 01:12
Not all doctors are scum, Kolya. Though there are a few out there who are, they hardly make up the majority.
Though I will add one type of doctor to your list, simply for the sake of discussion. Fortunately, I've never had to deal with this particular type, but from those who have, I'd be tempted to murder if I ever came across one.
The arrogant "You're an idiot, don't question my diagnosis" Doctor.
I have a friend who was in a terrible car accident roughly 10 years ago. Terrible to the point that his family was choosing pallbearers for his seemingly inevitable funeral, and it took over 100 surgeries to get him through it all. Through small miracles, and the wonders of modern medical science, he not only lived, but has recovered almost fully. Though he can live a perfectly normal life, there have been problems. Mainly that whole teams of doctors have been fine tuning him since. He has to take B12 shots, suffered from severe sleep apnea for a few years due to him being on a respirator for too long, has constant sinus infections. It's a whole laundry list of weird little problems that he's been fixing as they arise since the accident.
About a year ago, he began complaining that he lacked any energy or motivation whatsoever. He'd sleep for 12 hours, and wake up feeling as tired as he went to bed. This is pretty usual. It's how his previous doctors discovered his B12 deficiency, and his sleep apnea. This was something new. And to find out what it was, he scheduled an appointment with a doctor. Some new doctor, apparently. I don't know the reasons why.
He tells me he goes in, discusses his problems, talks about the accident. Goes through the whole spiel. This new doctor looks at him...boredly, according to him...and says "you're depressed". Course old friend bud argues with this diagnosis. "I'd know if I were depressed. I'm not depressed. I don't have any energy".
"You personally won't know if you're depressed or not. I will. Your symptoms point toward depression. You're depressed".
A few weeks pass. He tries out some of the things the doctor recommends. Doesn't help. He's still completely lacking in energy. So he schedules another appointment. The doctor says the same thing, only a little more rudely this time.
"You're depressed. It's all in your head, and you're wasting my time".
They guy didn't even take blood samples or anything. Doesn't even look over his records. He just instantly called depression, and shooed him out the door.
Apparently, he fought with this doctor for a good bit. Never did get him to change his diagnosis. He wanted help. He wasn't getting it. So he goes for a second opinion. This new doctor? He does his job. The diagnosis?
Severe iron deficiency anemia. Possibly due to persistent gastrointestinal bleeding. Quite a bit of a stretch beyond depression.
What amazes me about this story is that a doctor, not a psychologist, would diagnose depression without at least doing blood work. It's almost gallingly amazing considering my friend's medical history. Instead, he just gave him an off the cuff assumption, and refused to listen to him afterwards. He made his diagnosis. Nothing could change his mind.
Tocky on 5/2/2012 at 04:31
Damn if I haven't met all those docs before. I'll add my favorite.
Smartass old grumpy doc: He is busy as hell because he is damn good at it and he knows it. He will tell you that too as it isn't in his nature to hide anything. He won't ask what is wrong with you so much as accuse you of having nothing better to do that day than waste his time. He will make fun of whatever ailments you have and ask if there are any pimples or corns you want to tell him about too. All the while he is doing this he is listening and checking your eyes and ears and temp and doing whatever proding needs done. In the end he will guess correctly and tell the nurse to prepare the square needle for this one. You will get better at his hands or he will send you to a specialist he wouldn't ordinarily let work on his cat but since it is you he has no qualms about. That fellow will turn out to be top shelf and laugh at the referal. You get better. The guy is good but next time you get sick you tell him he isn't worth a damn or you wouldn't have to see him again just to see if he remembers it has been three years and it was just a cold the last time. He does and tells you that you are just a germy little bastard.
Man I miss doc Gilmore.
On the other hand I could strangle the ER doc that sent my nephew home when he was complaining of numbness on one side and had one dilated pupil just because he didn't have insurance. The dumbassery nogiveashitedness was off the chart with that one.
SubJeff on 5/2/2012 at 15:20
It seems that at least some of these issues stem from having to pay for healthcare. Of course my patients don't have to suffer that or any of the surrounding issues.
Quote Posted by Kolya
I'm saying this because most doctors I've met in times when I or friends needed them were of one of these types:
A) The dollar doc: When he looks at your ailment he sees an opportunity.
Meh. That's life in any situation when people can make money from you. It's nothing to do with doctors per se.
Quote:
B) The hospital doc: Apparently overworked and uninterested... ...And certainly you don't want to give any suggestions on what your problem might be. Are you the doc? No, you are not. You may have been living in this body for over 30 years but you have no idea of it's intricacies.
Well he probably is overworked. And? It may also come as no surprise that you're not, despite what you may think, automatically the most important patient in the hospital because you're you.
And living in your body for X number of years doesn't mean you have any idea of it's intricacies, no. This is a ridiculous attitude and one that is most irritating. Wikipedia? The reason people don't like patients looking things up is that they are likely to scare themselves (see this thread for example number one) and many people get so caught up in "what I read on the interweb" that despite ones best efforts people do end up thinking "ffs, if you know so much YOU treat it then".
Quote:
C) The good natured old doc... ...Instead it's some young guy who perfunctorily listens to the abbreviated version of your life and when you mention good natured old doc's special treatments you notice him shaking his head ever so slightly and you immediately distrust him.
Yes, distrust him. There is no chance that good natured doc is slightly out of date, right?
Renz - so your friend almost died, had over 100 surgeries, is alive and the only thing he remembers is that one guy?
He's an ungrateful asshole.
And, fyi, what he described DOES sound like depression. Lack of energy is one of the biological signs of depression. It may surprise you to know that many, many ailments share common symptoms and given his history anyone would at least suspect depression within the list of differential diagnoses. I'm not excusing the lack of investigations or taking note of the history, but iron deficiency anaemia and depression are most certainly
not "Quite a bit of a stretch" beyond each other.
Lack of energy - potential causes (off the top of my head):
- mental illnesses
- endocrine problems
- haematological disorders, not including cancers
- cancer, of any system, including of haematological aetiology
- (unrecognised) sleep disturbance - multiple causes
- cardiovascular disease
- respiratory disease
- nutritional problems, due to eating patterns or another underlying cause, potentially neoplastic
So, you know...
How long was this guy on a ventilator for? I've never seen or heard of anyone who has developed sleep apnea due to being on a ventilator. It's certainly that rare that we never consider it a potential long term problem in patients on ITU, some of whom are on a ventilator for weeks or months.
Quote:
When people need to go to doctors, they have one of their most important assets put at risk (feeling healthy or living like a normal person) and they feel vulnerable and isolated and totally dependent on whatever the doctor says (same with lawyers). So there's an inevitable emotional reaction they're going to have of strong anxiety and lingering distrust or even paranoia.
It's perfectly normal to be concerned if you're in a situation where you have to see a doctor. But it's part of the doctor's job to put you at ease and explore the problem with sensitivity, and to make sure you're well informed and comfortable. I certainly don't think that the majority of patients in the UK feel paranoid in these situations. Of course I make all my patients feel absolutely fantastic through the power of pharmacology so maybe I've got a skewed perspective :p
Renzatic on 5/2/2012 at 18:32
Quote Posted by Subjective Effect
Renz - so your friend almost died, had over 100 surgeries, is alive and the only thing he remembers is that one guy?
He's an ungrateful asshole.
No. He remembers the whole team of doctors responsible for saving his life quite fondly, and even goes to visit them on occasion. The situation I described above happened fairly recently, and it, understandably, pissed him off quite a bit.
Quote:
And, fyi, what he described DOES sound like depression. Lack of energy is one of the biological signs of depression. It may surprise you to know that many, many ailments share common symptoms and given his history anyone would at least suspect depression within the list of differential diagnoses. I'm not excusing the lack of investigations or taking note of the history, but iron deficiency anaemia and depression are most certainly
not "Quite a bit of a stretch" beyond each other.
Lack of energy - potential causes (off the top of my head):
- mental illnesses
- endocrine problems
- haematological disorders, not including cancers
- cancer, of any system, including of haematological aetiology
- (unrecognised) sleep disturbance - multiple causes
- cardiovascular disease
- respiratory disease
- nutritional problems, due to eating patterns or another underlying cause, potentially neoplastic
So, you know...
Exactly. Considering this guy's history along with all the potentialities, having a doctor that immediately calls for depression on the first visit, doesn't cover the basic battery of tests, and refuses to change his mind on the issue, is pretty damn sloppy.
Quote:
How long was this guy on a ventilator for? I've never seen or heard of anyone who has developed sleep apnea due to being on a ventilator. It's certainly that rare that we never consider it a potential long term problem in patients on ITU, some of whom are on a ventilator for weeks or months.
I want to say he was on the ventilator for the entire extent of the coma, which was about 2-3 months, give or take. Both of his lungs had collapsed, and he developed pneumonia on top of it. There could've been any number of reasons why he developed sleep apnea, but I remember him saying the doctors assumed it was because he was on the vent for so long.
SubJeff on 5/2/2012 at 20:34
How much does he weigh and what's hood neck size?
Kolya on 5/2/2012 at 21:32
Quote Posted by Subjective Effect
Yes, distrust him. There is no chance that good natured doc is slightly out of date, right?
Of course he's out of date. That's the point of "good natured old doc".
And as the only person who has lived in his body since birth and seen every problem suffered and every treatment tried the patient is a unique source of information about any current or future ailment and treatment. If you think that's just irritating you may not be such a great doctor as you seem to think.
For example I have suffered through 2 appendicitises in my life. The first time as a child I was brought to a hospital and scheduled for removal of the appendix the next morning. And just for the next few hours and only because I was suffering excruciating waves of pain a nurse gave me a big huge icepack to place on my tummy.
Now any doctor will tell you that you should never ever do that, because while the ice helps ease the pain it can hide an acute breaking of the appendix which would require immediate surgery. However the next morning I was fine. The doctor examined me somewhat baffled and then sent me home.
The second time I had appendicitis was years later and of course they wanted to remove it. I asked for ice instead. OMG NO! NO ICE! Yeah thanks. I went back home put ice on it and the next day I was fine. Still have my appendix and this is years ago as well now. And I didn't even have to undergo surgery. Next time I won't even ask a doc about this anymore.
Renzatic on 5/2/2012 at 22:11
Quote Posted by Kolya
And I didn't even have to undergo surgery. Next time I won't even ask a doc about this anymore.
You might not end up so lucky next time, and end up dying of sepsis from a ruptured appendix. HAVE FUN! :D
Quote Posted by SE
How much does he weigh and what's hood neck size?
He's a chubby bastard, though he ended up losing about half his body weight during his stay. Hood neck size? Hell if I know.
