A Spoonful of Sugar Makes the Diagnosis Go Down…

Standard

The doctor came in and announced in front of the entire family, including numerous small children, that the patient had about six months to live. That patient was my uncle, who did die of lung cancer, but I have, since that moment, had a complete and utter distaste for that medical organization, and this was almost 30 years ago.

Gone are the days of the sympathetic bedside manner of the graceful country doctor. LONG gone. In its place are giant healthcare factories, some just a traffic lane short of a “drive-thru” window. Take a number, unless your bleeding is messing up the floor. I was actually told once, in the middle of an obstetrics exam, that I could dress and go down to the pharmacy, buy the device, come back upstairs, and they would place it. I felt like I was in a Pep Boys auto parts store, and Manny, Moe, and Jack were wearing white coats.

Recently I developed an unusual redness in my left eye, but didn’t think too much about it. Seasonal allergies, or a “cold in my eye” as I had heard once was possible. I awoke one morning to an extremely inflamed conjunctiva (the while part) and fear drove me to the Urgent Care while on vacation. The doctor there guessed a bacterial infection, gave me, and it seems everyone in the exam beds around me, an oral steroid. I’m not kidding – the kid on my left was hacking; steroid. The guy on my right had a rash; steriod. I was also given a prescription for some eye drops, and sent on my way.

A day later the inflammation was back, along with pain. Another optometrist visit decided that I was having a rather common reaction to the preservative IN almost every eye drop known to man! I was given another prescription for, you guessed it, a steroid drop. (I should be HUGE right now.) Yet the next morning I noticed on the box that that same preservative was in even this drop! The excruciating pain had convinced me there was something actually in my eye, though a second visit to the same doctor revealed still nothing. “Give it some time,” was the suggestion.

Well, my father, who had just been treated for sarcoidosis- a body response to foreign particles in the tissue- in the eye, went behind my back and made an appointment with his specialist. What I heard there was about the last thing I was expecting: possible benign tumor. In my eye?! The tear duct, actually, but he wouldn’t know unless he cut my eye open and we biopsied it. Fortunately, my trip was coming to an end, so the plan was to follow up with my eye doctor back in Colorado, and just continue to deal with one extremely red eye with the steroid drops.

Upon my return, my home-doctor studied the eye, and then leaned back in his chair in what I can only describe as “the lawyer pose” (Fingers laced on top of and behind the head) I had seen my dad do so often when things didn’t look good and he was devising a plan. He suggested another specialist and a biopsy. He called while I was at work from his personal cell phone later that night, asking me to call him the minute I got the message. Let me tell you, if that doesn’t scare you, nothing will. Although he assured me he wasn’t calling to scare me, his haste spoke volumes.

The sixth visit in less than two weeks, another pupil dilation, and the specialist leaned back in his chair and said he just didn’t “feel” this was something that needed to be biopsied yet. I was both relieved and exasperated as if this doesn’t work, then we start all over again?

So this is an exceedingly long story to get to this: how did we get from “infection” to “tumor” in a span of three days? Is this just to cover all possibilities so there isn’t a lawsuit? And if so, this isn’t the way to practice medicine when a patient’s mind is the most important thing in the entire healing process. And most patients will jump to the most terrible conclusions on their own, thank you very much. Those who do their Internet research are probably a doctor’s nightmare as absolute worst-case scenarios turn up every time. But to needlessly scare patients to cover your own behind CAN’T be doing anyone any good, mentally or physically.

I know that doctors in some institutions are practically timed with patients these days. Three or four minutes per patient, gotta go, bye. Like a quickie hair-cut, if one goes over their time limit, there is a whole new pricing put into place. I also know that doctors are less likely to misdiagnose a patient they know a little better. And a patient who actually knows and likes their doctor is more likely to follow care directives. A study was done where doctor were given a sheet on a patient to interpret their symptoms and provide diagnosis. When the simple act of placing a patient’s picture along with their sheet was put into place, the number of misdiagnosis declined. Ultimately, isn’t that what healthcare (not the Big Drug business) should entail? Healthier patients? Less time in the hospitals? Less paperwork to submit to insurance companies?

Let’s put the human back into healthcare. Heck, let’s start calling it HUMAN care instead. If a doctor had simply asked me first, “What conclusions have you already jumped to?” and then assuaged my fears, a whole lot of heartache could have been avoided. “Medicine is not an exact science,” someone once said. Ain’t that the truth.

Advertisements