butterflyinthewell:

bittersnurr:

kelpforestdweller:

pervocracy:

I’m starting to appreciate more just how scary it is to be a doctor.

You have a patient come in with a stomach ache, nausea, feels tired and sort of generally miserable, no other obvious characteristic symptoms.

Out of 100 patients like this, 90* will be a minor gastroenteritis or whatever, maybe you ate something bad, here’s some nausea medication, go home and eat bland foods and get enough fluid and sleep it off.

And 7 will be appendicitis or gallstones or pancreatitis and need to be admitted to the hospital, 1 will be a heart attack with atypical symptoms, 1 will be the first sign of cancer, and 1 will be some weirdo disorder with a name like “Coleman’s 4268py deletion snydrome, Type II”** that you never heard of.

If I were a doctor, this would make me terrified to ever tell a patient “maybe you ate something bad, go home and sleep it off.”  Even though that’s usually the right answer, and even though it’s a waste of time and money to do an EKG and CT and 4268py test on everyone with a tummy ache–it’s got to be anxiety-provoking to not be certain that you aren’t missing something.  And at some point you will send someone home only to get a call the next day that they collapsed and now they’re in the ICU (or the morgue).  And it’s got to be really hard to go back to work after that and say “go home and sleep it off” to your next patient, even though that’s still usually the right answer.

I’m understanding more these days how tough it is to live with that kind of risk and responsibility.

*not actual statistics

**not an actual thing

there has to be a better way for them to deal with it than not giving a shit about their patients, which is the approach most who deal with me appear to have taken.

are you saying there isn’t enough training or support or something? actually im saying the latter, come to think of it. if it’s really this stressful for doctors, they need more help coping with that so they can stop ruining our lives.

Yeah something I notice that is infuriating is often patients are expected to preform emotional labor for caretakers. Like it doesn’t matter if it is a doctor or one of the many “kid is killed for being a burdern by overstressed parent” stories, the common trend is that the one most viewed as the “victim” in the circumstances is the care provider not the one relying on the care.

Full offense, if you cannot handle the emotional labor of those things, that is in fact one of the BEST uses of therapy. Meanwhile I am stuck in therapy instead, for ptsd, when I am still in the traumatic enviorment because I have to take on the emotional burden of being told that my existance is harming people. My life is so bad it gives my therapist depression sure wish the doctors went instead of coping by telling themselves they are saving me from myself by leaving me to deteriorate.

You are responsible for your own health. You cannot be telling patients they need to learn more coping skills while saying “it is fine I cannot avoid taking my stress out on other people because my reasons are valid”. Then why the fuck is “doctors refused to even run tests until I was bedridden and now my entire life is ruined” not a valid reason?

I am pretty sure the reason this happens is because doctors want to pretend that “only broken people” with actual dxs need to go to therapy. The ironic thing about problems like this is that if you have the dx already that means you probably already are using coping skills but a person who thinks “I am fine and normal” is not going to examine their behavior at all. Instead everyone acts like it is more efficent to give all the emotional labor to the person who is already sick because they can “handle” it better without considering that the reason for this is that person has already applied every coping skill to their life that they could find but it is nowhere near enough when you are carrying the burdens for everyone around you as well.

My dad has very advanced Parkinson’s. He was going to a general neurologist for years named Dr. “H”. Dr. H would up my dad’s meds and never look deeper than the Parkinson’s for what is causing his discomfort. My dad had a maddening sensation in his right leg that wasn’t pain or itch, but it seemed to be coming from his sciatic nerve. The Levodopa meds relieved it somewhat for short periods, but as my dad’s dosages had to be increased to keep up with the symptoms, his window of being rid of that sensation shrank until it disappeared.

My dad eventually got DBS surgery in 2013 (electrodes in the brain to control tremors). He hoped it would make that leg sensation stop. Nope. The guy from Medtronic who adjusted dad’s battery packs turned the charge up to levels that helped dad’s tremors, but didn’t touch the weird sensations and caused side effects like face pulling (lips sagged down) and more stiffness. We had to dial it back and accept the tremor control. Btw it didn’t stop them in his legs, it just made them weaker. His hands have 100% tremor control.

My dad fell into depression. It’s kinda common in Parkinson’s because the reward hormone of dopamine gets depleted. He barely ate. He was losing tons of weight. He developed severe pain in his hands and wrists that we thought was carpal tunnel syndrome at first. We got wrist braces that didn’t help. The possibility of surgery on his hands to release the nerves was becoming a possibility. Then he lost the “surface” feeling in all of his fingertips and most of his feet. At least the terrible pain in his wrists stopped…

Dr. H’s eyes always glazed over when my dad listed off the litany of symptoms and discomforts he had. There were lots. Some were the same ones he had all the time and some were always new. After a lot of back and forth with adjusting the DBS, Dr. H finally said “Well, it’s Parkinson’s! You get worse and then you die,” in the most careless, joking tone I ever heard from a person. My sister had to grab my shirt because I was winding up to punch that man in the mouth. My parents both saw the rage in me. I had to throw both hands over my mouth to hold back the flurry of “you fucking piece of ass piss shit, how dare you dismiss my dad that way. I’ll kick your fucking ass!” level cuss words trying to burst out of me. I’m not someone who likes to get violent or call people names, though it can happen IRL in moments of sheer rage like that!

My very desperate family talked to Dr DB (first / last initial to avoid confusion), the surgeon who did the DBS surgery for dad. He’s a real cool-headed guy and the day he did dad’s surgery, I shook his hand and could feel how steady and sure his grasp was. I asked him to say a prayer while scrubbing in and he later told me he did. (Totally cool guy!) We told him we were desperate to get dad help, and he recommended Dr. B, a personal friend of his who was a lady neurologist with a specialty in Parkinson’s.

We went to Dr. B and OMG she was horrified at the state my dad was in and asked for his complete Parkinson’s and medical history. She did all kinds of tests, LISTENED to him and made changes.

My dad ended up diagnosed with neuropathy alongside his Parkinson’s. (Or maybe it’s part of it, can’t remember.) The discomfort in his leg and pain in his wrists could’ve been solved with one new medication, but he suffered with it for YEARS because Dr. H blamed everything on the Parkinson’s instead of looking deeper.

She put dad on Horizent, a neuropathy medication with a mild antidepressent. Within a few days my dad lost that weird sensation in his leg and started eating normally again. He still continued to lose weight for reasons we don’t know. Dr. B sent him to a ton of specialists to test for things like cancer and Addison’s disease, both of which were negative. She wanted to rule out the worst possibilities first. During all this, she recommended he drink a nutritional shake right before bed because she suspected the Parkinson’s tremors were burning up all his calories, so absorbing calories during sleep when his tremors went away would bring his weight back up. We got him those and he put his old weight back on so well that we had to stop because he was getting overweight. His weight has been healthy for him since. We suspect it was partly depression being helped by the Horizent, because a few months on the Horizent had his personality back to what it was, too.

My dad’s sleep issues went unaddressed for years, but now he’s on sleeping meds that let him at least get a few hours of sleep a night instead of no sleep at all for days at a time. Sleep issues are also a Parkinson’s thing. Try going to sleep when your legs won’t stop shaking and you can’t get comfortable…yeah. He’s on meds that basically knock him out, and even then he only gets maybe 4 hours of sleep because he’s up as soon as it wears off. But 4 hours per night is better than 4 hours per week. He falls asleep during the day a lot, too, usually for 20 minutes at a time.

We’re currently working out why he has pain in his neck and head. We suspect one of his DBS wires might be pinching a nerve. But Dr. B is on top of the issue because she listens to my dad instead of staring at him, writing a prescription and sending him on his way.

My dad’s life is far from comfortable right now, but things are being managed and looked at because Dr. B really listens to him, asks him questions, asks him to clarify if he describes something in an unclear way (happens a lot lol) and she gives an air of genuinely caring about my dad’s discomfort. He’ll tell her he’s scared and she’ll rub his arm and tell him she understands and that she’s doing everything she can to take care of him.

So this leaves me wondering if the doctors who act so cold and uncaring are either close to retiring, burnt out or struggling with compassion fatigue. Still, any doctor who doesn’t look deeper than a patient’s prevalent condition / illness feels plain lazy to me. At least doctors who question themselves show they still have compassion. I never got that feeling from Dr. H.