On Being a Doctor
Be a doctor? No thanks. Thankless job of too much hard work and too many questions to answer. I would rather clean hotel rooms, as long as the pay were the same.
Last century when I was a child, being a doctor was so different. There really wasn’t much a doctor could do for you. Modern medicine was a baby. Actually it still is a baby. Let’s call it a developing fetus when I was growing up. There were not many blood tests. There was no MRI. Exploratory surgery was a real thing. Being a doctor was being a man of mystery, a showman whose job it was to seem super smart so he could hide his lack of answers. I use “he” purposefully, as nearly all doctors were men back then. Caucasian men. Not their fault it was like that. I’m just sayin’.
Being a patient these days is much better than when I was a child. Back then, no one would bother to open a medical textbook to diagnose me, and I could not Google my symptoms. No one tried to make sense of the strange things my body did. I was up against an impenetrable wall of white men, who made fun of me for my complaints while recommending outrageous surgeries and prescription NSAIDS.
Last century when I was a child, being a doctor was very prestigious. Graduate from medical school and you were going to have a nice life of affluence, live in the best neighborhood, drive a fancy car and probably belong to a country club. Everyone in town would respect and maybe even revere you for being God-like.
Now, it sucks to be a doctor. It’s a grunt job, taking care of unappreciative patients who don’t understand or care about what you have to say. Doctors have too many decisions to make, too many medical articles to read, never-ending work and never-ending demands.
Many doctors I meet are in a glazed over state of exhaustion. They can’t take a long vacation, can’t even call in sick because they won’t get paid and those student loan payments are huge. Physician burnout is a real thing.
My best friend is a doctor. She is not my doctor, just my best friend. Although sometimes she reads my medical reports and gives comments, I try not to ruin the relationship with that nonsense. We e-mail every day, often multiple times, like when we were passing notes growing up in school.
Me: How are you this morning? I’m a little hungover. Drank way too much at Whiskey Festival last night. Was severely nauseous when we got home. That is too much. It’s very hard to pace yourself when you are being overserved. I mean, be a grown-up and control my intake? What? Z and I did not have a fight, even though he was really drunk, too. So that was a miracle. I think it was because that f-ing crazy psychoanalysis I had from that psychiatrist, the one I fired. Maybe I should call that guy back? I just didn’t need to take my feelings out on Z, which I actually did not know I was doing. I have been reading Shockaholic by Carrie Fisher and it is so good, makes me want to take my blog down.
Dr. BFF: I have been wanting to write you all day. Busy clinic. One guy vasovagaled when I had to do a suture repair and then this non English speaking “translator” was having shortness of breath and new onset atrial fibrillation. Between seeing a deluge of patients, reading about stable coronary disease, health effects of toluene/benzene and just biting my lip when I hear patients completely in denial about their health issues...I am ok.
These days, the doctors making the big bucks are the ones doing procedures, such as the neurosurgeon, who is really a spine surgeon, not a brain surgeon. The internist is not paid very well, which is a real shame because we all need a great internist, we all need him to answer our questions well, and who needs a brain/spine surgeon? Maybe only those of us with Ehlers-Danlos. The internist, however, is the most important doctor for everyone and should be better compensated.
Mr. Pennington recently initiated care with a new internist, as our PCP moved away. I have taught him well, to take care of himself and to respect the doctor. He is thin, exercises regularly, does not drink too much and only occasionally smokes a cigar. She sailed into the room with a giant smile on her face.
Internist: I have been cyberstalking your records and your blood work is amazing. You are going to live to be 150, even with your ocular migraines, for which I would like you to see a neurologist, but please don’t panic. Just to be sure.
Mr. Pennington: My wife has a rare disease. My father died of a rare disease, a sporadic one, not genetic. It is no problem. I am happy to get an evaluation.
How easy he has made her day. It is childish not to take care of oneself properly. She did not have to nag him to do it or listen to him complain about health problems resulting from poor self-care. Those are big parts of her job. Grunt work! The neurosurgeon is pretty much the only doctor-God out there, swooping in and to save someone.
In Los Angeles, it is extra terrible to be a doctor. Even they cannot pull in enough money to compete with the celebrity cash that floods this town. This can make them extra grumpy. Twenty-five percent of this nation’s doctors are in California. They have to compete with each other for patients. Stressful life.
Being a Professional Patient, I think it is my job to take care of my doctor and make her feel good. I use “her” deliberately as I appreciate all the diversity in medicine now, in both gender and race. I am still traumatized by that impenetrable wall of white men.
I do not expect that much from the doctor. I am the one with the time to do the research, run around town, get different advice, talk to my people who are the real experts in my disease, and try things out on meself! What does the doc have time for? Probably not even time for a life. From any one of them, specialist or internist, resident or Urgent Care doctor, I am only looking for one tiny suggestion, one tiny piece of advice I can take and use to enhance my rotten health. I take my research to the doctor, with all my bizarre questions and with his prescription pad and authority to order tests, we get to work! They are not used to someone bossy like me, but I get them on board, at least most of the time. I think I missed my calling in life. I would have been an excellent hospital administrator.
I send thank you cards. Thank you for removing my tumor. Thank you for that Benadryl IV in the ER. Thank you for that emergency hernia repair you did on a Friday night. Thank you for your help, I do not know where I would be without you. Happy Birthday. I send gifts, usually via Amazon Prime, because who wants to drive over to the doctor’s office, and have to find and pay for parking?
I am saying thank you, but I am also saying Like me! Feel good when you think of me! Take my call in the middle of the night! Think of me when you are reading those medical articles! Try to manage my Ehlers-Danlos! Spare just a little of your energy and attention for me!
Getting doctors to take care of me is no small task, when I am such a needy patient. My problems are bizarre and complicated, and I am like a pit bull when it comes to getting my questions answered. Often I don’t feel well and my brain is not working, so I am extra annoying. To compensate for how much I demand, I also bring a pad and take notes. Doctors love that. It is not for show. I am a professional.
However, my questions can wait. I am happy to talk about the Clippers, or Paris, or how your stiff joints are ruining your tennis game and wow are those dentists you play with competitive, or your wife who won’t have sex with you. Whisper to me that you have to limit your hours with EDS patients, because we are so so so difficult to help it is too draining. Whisper to me that EDS patients all seem a bit crazy and are so hard to have a conversation with. Privately congratulate me for not having children. Tell me the truth. And also the bad news. I need to hear the bad news. I am a professional, after all, and I can take it without tears. I can hold them in until I get back to my car.
I appreciate the goodwill and intimacy, when I can get it going both ways. I want doctor to leave our appointment feeling good. Refraining from complaining, smiling and saying thank you goes a long way. Also complimenting shoes. My dermatologist has the greatest shoes, and I never fail to tell her.
Whenever I am in a waiting room and someone tries to start a revolt over waiting too long or no parking validation, I shut it down. I say loudly:
Do not drag me into this. This is not a restaurant or a spa. These people have highly specialized jobs. I am fine waiting. This is important.
Make sure the staff overhears you. That is one way to get Favorite Patient Status. Just don’t knock me out of first place. You can be Second Favorite Patient.
Every now and then I meet a master of the profession, a doctor who has not gotten pummeled to death by the unending needs of patients, whose staff respects him and works cooperatively with him, whose brain is still sharp and hasn’t crashed from information overload or sleep deprivation. I am specifically thinking of my endocrinologist, Dr. G. He is thoroughly calm and composed. I get messages from him on Sundays. He will order any unusual test we think my EDS might need. He actually tries to answer all of my super-advanced questions. He gets on the Cedars electronic health records system and schools other doctors I see. Plus he is very, very charming. I stand in awe.