Wednesday, January 07, 2009

I fight authority...we'll see who wins

I am generally someone who follows the rules and respects the authority and instructions of those who know more about a particular topic than I do. This is particularly true of doctors. If something's wrong, I go to see a doctor, s/he tells me what to do about it, and I do it. If they tell me to take medicine, I take medicine. If they tell me to stay in bed and drink lots of fluids, I do. They're doctors, after all. They know shit I don't know.

I watch shows like ER or House and I marvel at the balls of patients who mouth off to their doctors, or cavalierly disregard the doctor's instructions or medical advice. I don't think I've ever sassed one of my doctors. When I get into a doctor's office, I become like an obedient child who would never, ever question the authority of the grown-ups.

But I'm feeling a tad rebellious these days.

I go to a general practitioner for my run-of-the-mill (i.e., non-OB/GYN) medical care. He's a good doctor, very thorough and professional, but also has a nice manner about him, like the kind of guy you'd have fun shooting pool with. But I'm beginning to think he missed his calling as a pediatrician, because he tends to treat his patients like children.

I went to see him on Monday because of my MRSA symptoms, the sores on my belly and the swelling and irritation in my nose. He prescribed an antibiotic cocktail, some ointment to put on my belly sores, and another ointment to put in my nostrils. He explained how to apply the ointment (in small amounts, with just a thin layer on the skin) and how many of each pill to take every day. He also made me an appointment with an ear-nose-throat doctor to lance the cyst in my nose, and told me to come back for follow-up the next day (Tuesday). He also said that if I started to experience a fever or became nauseated, I should go straight to the ER.

I was unclear as to why I needed to go back to see him a day later, but I didn't question it. He's a doctor, after all.

So I went home and took my pills and applied my ointment, and the sores were definitely getting better, though my nose was still swollen and painful. But I took ibuprofen and Tylenol for the pain, and I muddled through. No fever or nausea.

Yesterday I went back for my follow-up. My appointment was at 11:30. I arrived on time. I didn't go into an exam room for 45 minutes. Which irritated me. Once I was in there, the nurse took my temperature and my blood pressure. I then waited another 15 minutes for the doctor. I was annoyed. I also still wasn't clear on why I was there.

When he finally came into the room, he said, "How're you doing?"

"I'm fine. The sores seem to be healing up."

"Good. Any trouble applying the ointment?"

"Um...no." And I'm thinking to myself, does he think I'm retarded?

"Great. No trouble taking the medication?"

"No." WTF??

"OK, good. Well, I just wanted to make sure you weren't experiencing a fever and that all was going well. I know you're seeing the ENT tomorrow. You need to come back to see me on Thursday."

"Why?

"What?"

"Why do I need to come back?"

"So I can make sure you're doing OK. It's really important with MRSA that we monitor your condition."

And then, completely out of character for me, I said, "listen. I'm really not trying to be difficult. But today I had to pay a $25 co-pay and wait for almost an hour, just so your nurse can take my temperature and confirm that I don't have a fever. I know I don't have a fever. I know what a fever feels like. I also know that you told me to look out for symptoms like fever and chills and nausea, so if I did have a fever, I would have gone to the ER or at least called you. I don't need to come in and pay money just to confirm that I don't have a fever."

He was a bit taken aback. He explained again how important it is to follow through with the treatment course and monitor me in the event their are any problems.

"But why do I have to come in to confirm there are no problems? I'm taking my medicine, I'm applying my ointment. Things seem to be healing up. If I develop another sore or if I don't appear to be making progress, I'll let you know. But I don't want to come here if none of those things are happening. You've prescribed a course of treatment. I'm following it. If something goes wrong, I'll come in."

So we went back and forth and negotiated a follow-up visit on Saturday. And then I'm supposed to go see the ENT today.

But I'm not going.

I came up with a way to pop the sore in my nose (I won't get into the details). I squeezed out the pus. I cleaned the inside of my nose with hydrogen peroxide, and then put the ointment on. When I woke up this morning, the swelling was dramatically decreased, as was the pain. It's definitely healing.

Plus the thought of someone poking around inside my nose with sharp instruments gives me the willies. I have a really high tolerance for pain, but if anyone's going to be poking around in my nose, it's going to be me.

So I'm cancelling the ENT appointment. And if I continue to feel fine and things continue to heal, I'm blowing off my Saturday appointment as well. As I explained to Jason, I'm not a child. I don't need to waste time and pay money just so the doctor is reassured that I'm doing what I'm told.

I understand that he's just trying to be thorough and look out for me, and I appreciate that. But I also see the people who go in and out of his office -- the 300-pounders who continue to eat spam with rice and McDonald's burgers and fries and drink sugary sodas even though they're diabetic, so they just go through life hacking off a limb every couple of years. The ones who are incredibly unhealthy but nonetheless refuse to stop smoking or to exercise or change their lifestyles. They'd rather just get one of those motorized wheelchairs and not have to deal with physical exertion. I guess that's what the doctor is used to. With patients like that, there must be an urge to take an overly paternalistic approach and treat them like wayward children.

But it drives me insane. So I'm taking my ball and going home.

3 comments:

  1. Michelle LeGault7:27 PM

    Hey Wendy, you might still want to see the ENT, since the nose is really close to the brain via the sinus cavities and MRSA is a serious deal.

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  2. I look at doctors as meat mechanics, not gods. Their caution is understandable. They have to cover their asses against lawsuits.

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  3. He is just being cautious, and I get it. My feeling is, you've covered your ass, done your job, and now I'm free to disregard your advice at my own peril. If something bad happens, it's on me.

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