Dear Doctor: by A Patient of Yours
Dearest doctor,
I, like so many others with the ‘invisible illnesses’ out there today, came to you hoping for a little compassion, but mostly just expecting you to do your job and treat me. I had the erroneous conclusion that when a person goes to a doctor, the doctor listens to their symptoms, decides what tests to perform and then runs those tests, and that within a few days to a few weeks, gives you a diagnosis, prescribes medication, follows up as necessary and then you go on your merry way. Of course, I knew serious conditions might require more attention, but what I never imagined was that I’d be here, four years later, still not knowing what is wrong with me, what is causing my symptoms, and having you tell me that maybe I just need to lose weight, get up and move more.. or maybe I’m depressed?
I am depressed: I’m depressed that you can’t find out what’s really wrong with me!
But it’s more than that. When I first came to you, you promised me, with your hand on my leg, comforting voice and soft eyes, that you believed me and that you WOULD get to the bottom of this. Yesterday, though, I sat in your office and you said to me, “Well, you know, with your weight, and with…”
I zoned out at that point. You think I don’t know that I’m fat? You think that for the past few years, while I’ve watched the weight creep up on the scale that I haven’t felt every ounce of added weight? Do you think that when I first started gaining weight and couldn’t keep it off that I didn’t come to you and ask you why that was happening? It’s a symptom, doc, not the problem, but the result of the problem. I’m not making excuses for being fat. I want to lose weight, but I can’t. I’ve tried, and I didn’t cheat, regardless of your veiled accusation otherwise.
Oh, and I do not need to hear how you’re a little overweight too, and how you ‘know how it is for women our age’. Guess what, doc? Your weight has no bearing on my own, and I don’t need you comparing yourself to me. I am not you. You can’t heal yourself through me and you certainly don’t need to fear ever becoming me. I am not what you might become in your future if you’re not careful. I am a person, individual, on my own, with my own body, chemistry and unique conditions. You should treat me like that person, and not an extension of your own fears.
I can forgive you for being human, but I’m having a hard time forgiving you for giving up on me, and I really am tired of your telling me to get up and move around more and that I’ll feel better. Trust me, Doc, there’s nothing I want more than to get up and move around more and feel better, but I don’t do that, not because I don’t want to or I’m too lazy, but because doing so hurts. Fix what hurts, and I’ll be the first one getting up and moving.
And if you can’t figure it out, refer me. I have insurance. My insurance company is good and it won’t cut me off any time soon, as long as you do your job. It’s okay to say that maybe this is something you don’t recognize. I’ve asked twice about a CT scan and once about a sonogram and you said, “Oh, maybe, if we…” Face it, doc. YOU are not going to diagnose every single person who ever comes into your office. You’re just a general practitioner, family medicine. If I have a problem, send me to someone who can diagnose it, treat it, look at it from a different point of view. I would do it myself, but my insurance company requires you to refer me in order to pay. So why not admit defeat and refer me?
Or better yet, why not consider it a strength that you recognize my condition goes beyond you and get me that diagnosis the doctor who specializes in something different might get me. Then you’re being a part of a medical team and once I have the diagnosis, I’m not longer a failure of yours either. You and the other doctor together, as my medical team, will have fixed me, cured me, diagnosed and treated me. Isn’t that what doctors are supposed to do?
So do your job, doc. I don’t expect miracles. I just expect that when I pay over $100 per doctor’s visit that you tell me something other than, “Cheer up, get a hobby! Lose some weight!”
One last thing, if you compare yourself to me one more time in an office visit, I might just bite your head off and eat it right then and there, since you already seem to think I eat everything in sight anyway. I promise, doc, just like you’ve told me, I’ll chew every bite thoughtfully and carefully though.
Sincerely,
Frustrated Patient
Editor’s Note: While TTM and Unsent Letters doesn’t advocate actually eating doctor’s heads, chewing or otherwise, Michy sure can relate to this emotion!
Dear Frustrated Patient,
There is a very special relationship between a doctor and his or her patients. Good doctors hold their patients in high regard, no matter who they are or what lifestyle they live, and they never, ever judge.
However,doctors sometimes ‘hit a brick wall’ with a patient’s problem. It is as frustrating for the doctor as for the patient when no progress is made. Most doctors recognise quickly that a second opinion is needed and refer on. Not doing so may mean that the problem is so vague that your GP does not know who to refer you to.
Or, (very, very rarely) it may mean that something is amiss with that basic special relationship. Doctors call these patients ‘heartsinks’ because their heart sinks when they see him or her walk in.
A good doctor will realise this has occurred and find a way to correct the situation immediately by suggesting a change of doctor or re-triggering their own interest by trying a new approach.
But doctors are human. If the doctor is longterm stressed or has ongoing problems at home, they may be temporarily distracted and not recognise the heartsink situation. He or she may try to overcompensate by empathising too much (leading to the ‘I know how you feel’ scenarios), or simply tolerate the situation, telling themselves they can’t refer on because only bad doctors ‘fail’ that way. And nobody likes to think they are a failure.
If you suspect your doctor sees you as a ‘heartsink’ patient, change your GP. The only cure for the problem is a break from each other- sometimes, sadly, a permanent one.
I hope you get the help you need before long.
Sincerely,
Retired GP.