Jun 21, 2010

Music, Marijuana, and Moving

Okay, this time Doctor D will be asking the questions!

Doctor D isn't answering questions this week because he's trying to take care of patients while packing up all his earthly belongings and he spent all last weekend camping in Tennessee with thousands of Hippies at Bonnaroo Music Festival, and is still recovering from sleep deprivation and a sunburn. But D did get to enjoy some excellent shows.

D got his musical groove on at quite a few shows such as Dave Matthews, Tori Amos, John Butler Trio, Regina Spector, Gillian Welch, Dave Rawlings, and a lot of no-name bands.

What was the best show, you may ask? Actually it was a British band that I had never heard of before: Mumford & Sons. You should check them out:

But even more noticeable than the music was the ubiq
uitous use of recreational drugs. Apparently D was the only person in the entire festival that was remained sober.

While I really appreciate all the friendly hippies that offered me all the free pot, if Doctor D ever fails a piss test the DEA could take away his prescribing privileges.

All of Doctor D's stoner friends understood and were kind enough to take all the free drugs themselves so as to protect D's license, but what really shocked them was that D had never tried drugs, even in his life before doctoring. They just never appealed to me. I was enjoying life enough without them.
By the way: Have you ever noticed how Baby Boomers (my parents) all say that they "experimented" with drugs in the 60's and 70's? Like it was so scientific! They weren't being irresponsible like kids these days—they were just doing it for science. They are all against drugs now because thanks to their rigorous research the hypothesis that drugs make you high has been proven beyond a doubt.

Doctor D's high friends were outraged that D had never been high. "How can you talk to patients about drugs if you never tried them?!?" They felt D's integrity as a physician was compromised by his lack of experience with recreational drugs.

Now my friends may have been high, but they bring up a legitimate point that a lot of AskAnMD readers have wondered as well:
How can a doctor care for people, when he or she has never experienced what they are going through?
Doctor D has never personally experienced 99% of the conditions he sees.

Of course, no one can experience everything, but why aren't we even trying to integrate personal experience into the training of doctors? Back in the old days they actually valued experience. They even used to intentionally infect medical students with diseases such as Typhoid or Malaria from time to time for research. They figured it was important they knew how it felt to be that sick. I can imagine that program went away after a few students kicked the bucket, but the idea behind it makes sense.
Why aren't medical schools intentionally recruiting students who have been patients with serious illnesses in the past?
What do you think: Should Doctor D try out a relatively benign mind-altering drug such as Marijuana, even if it doen't appeal to him, in order to better understand the experiences and motivations of his stoner patients?

I am eager to hear your thoughts.

...and while discussing:
What do you think of medical marijuana?
More and more states are asking doctors to be the "gatekeepers" for every possible way of getting high. Doctor D is kind of annoyed by this trend.

Doctors have had the pill form of marijuana available for years and its legitimate medical usefulness is very limited. Shift the responsibility to doctors and before you know it our offices get flooded with hippies who suddenly suffer from intractable nausea. If the legislature wants to legalize pot then they should do it in a straighforward manner. Doctor D, for one, will not be writing any prescriptions for weed.
I look forward to our thoughts in the comments. Thanks to everyone for your patience with D's lack of posting this month. The moving truck will be here in a few days and life has been too hectic for regular blogging.

I promise to be back on July 1st with a totally amazing answer post.


Old MD Girl said...

I don't think you have to have tried drugs in order to council patients about them. Even if you HAD tried them, perhaps your experience was different, and you STILL wouldn't understand (in the patient's opinion).

It's like when obese people get angry when a thin doctor councils them about weight loss, as though thin people could NEVER understand feeling hungry, having cravings, resisting temptation or any of the feelings that go with that. Or conversely, when obese people discount their obese dr's weight loss advice because the doctor has so obviously failed at weight loss him/herself.

Sometimes you just can't win. And furthermore, it's impossible to be everything to every patient. Patients who are willing to throw out your advice just because you aren't like them -- or because you ARE like them -- probably aren't really ready to change anyway. As a doctor, you just have to keep trying, and one day you might make a difference to some patient regardless of your experiences as a doctor.

Pissed Off Patient said...

I have never been drunk and have never been recreationally high. I tell people I'm an addictive null, I just lack that gene or something. No interest whatsover.

Some prescriptions meds have thrown me for a loop though. And I can see how Fentanol (Sp?) could be tempting. I like that stuff.

However, I'm not sure what the value is in a doc having been high. Being an asthmatic or diabetic or cancer survivor, that would be useful.

I do wish medical school recruited and made accommodations for people with chronic illness or disabilities. I have only seen one disabled doctor in my life and I bet it came after school was over for him--MS I think.

Anyway, it's great for docs to be buff and workout, but my frustration is they assume I am not because I am lazy instead of truly understanding what my medical history can do to someone. Sometimes you recover, but you're never the same again.


Anonymous said...

First of all, I'm a social worker, and people say the same thing about therapists...he/she could understand me if only he/she were married, single, African-American, White, etc. So I think our experiences as individuals are important, but I also think I can hopefully have empathy for people in different situations than the ones I have experienced. And I think that Old MD Girl is right...even if I have experienced certain things, sometimes this just makes my understanding of the other person's experience more cloudy because I think I know what it's like and maybe I don't.

"I do wish medical school recruited and made accommodations for people with chronic illness or disabilities."

I do agree with this too. That is the one thing about medical professions...it's great to be superhuman and in shape and healthy etc., but sometimes I wonder if my docs even know what it's like to be me and live with my several medical conditions. I also wonder if it gets tiring having to be that healthy all the time...I mean we're all just human, right?

For instance...I do exercise...well when I can breath, and when my heart isn't racing, and when I don't have a migraine, and oh yeah...when my achilles tendonitis and my hip pain isn't acting up...and then in the end I exercise with and despite all this, but sometimes I think it's just unrealistic to expect me to go run a marathon or something. Right now I'm just hoping for moving several times a week. And I want to ask, is that O.K. with you all? O.K. Good.


Anonymous said...

Dr. D, This is only my second visit to your blog, and I'm hooked. I too, have never been high, although my younger brother was a real pothead. I didn't do drugs mostly because I worked in law enforcement, and cops drink. At least the ones I hung around with. When you mention the baby-boomers, exactly what age group are you talking Dude? I'm 57 and a flower child from way back. (Love beads, watermelon wine, peace signs, VW buses, and home made tie-dyed shirts).

That band, Mumford and Sons is fabulous. My kid has a band and they are always looking for inspiration...I will pass it on.

I will be back, good luck moving your boxes. By the way, how old are you Dr. D?

Dragonfly said...

I like Mumford and Sons. They grew on me. The first time I listened I was like "is this entire album the same song on repeat?"

Also never been high, but work with lots of patients who habitually are. Why should I try it so I can advise them from experience that drugs etc are bad? I still would, and why would I put myself at risk? I just figure...what if I liked it? (Disclaimer: I LOVE Weeds, the TV show).
I think people who use that argument are just trying to deflect attention from their own problem.

Doctor D said...

One of the coolest MD's that D ever knew had a fairly severe disability that kept him in discomfort most of the time. He was an kind and caring doc and one of smartest human beings Doctor D ever met.

Then suddenly the awesome doc with the disability was gone. The news was that he had become addicted to pain meds and done some pretty illegal things with his prescriptions. I never saw him again.

By the way, Doctor D is NOT implying that doctors with disabilities are somehow more prone to go off the deep end than anyone else. It was just a really interesting and sad story about a doctor and living with illness and prescription drugs, so I thought it would be interesting here.

Anonymous said...

This post reminds me of the writer Raymond Carver, who once said something like, "If you understand one kind of suffering, you understand all kinds of suffering."

I don't think that a doctor needs to have taken recreational drugs to effectively treat addiction to them---what's important is that he or she understands the craving, the desperation, the pain that might have given rise to a patient's addiction.

But aside from the issue of addiction, if you have ever been drunk, if you have ever meditated, if you have ever fallen in love, or if, yes, you have ever been stirred by listening to great music, you have experienced an altered state of consciousness akin to "taking drugs." The experience itself is not that different except in the details. People of all stripes are looking for ways to get outside of themselves, feel connected to others, and escape from their pain.

Doctor D said...

Excellent question Mo!


Take a guess!

The winner gets a free Medical Mafia Mug!

Anonymous said...

It's obviously impossible for every doctor to have had every experience, but . . . the first time I ever had an NG tube inserted, the intern explained that she and other medical students had practiced doing this on one another, and it WAS reassuring for her to tell me from her own experience that it wasn't that bad. (She was an absolute ace at sliding it in. No gagging or anything.)

I do wish that medical students also took something to give them severe diarrhea for just one morning. I've had doctors be incredibly casual and dismissive about how impossible one's life becomes when you have to "go" 8 to 12 times a morning for weeks on end (following abdominal surgery).

Anonymous said...

I guess 44!! Fess up Dude!

Anonymous said...

I guess a studly 32. And Mrs. D is a brilliant beauty barely beyond teenybopper-ness. (Does that give me extra credit?)


tracy said...

How old is Dr. D? A hot 35!

Anonymous said...

Hey, Doctor D -

I'm so glad you are keeping us posted despite the fact your life is crazy right now . . .

About weed: I, too, lack noteworthy experience with mild altering drugs (well, I've had my share of alcohol). But, I believe there are cases where the medical use of weed is legit. But, assigning gatekeepers has been an issue . . . even in our little town!

The manager of our Chamber of Commerce is rather reserved and has lived an isolated life . . . and she has had to be open minded as the various weed outlets have opened and joined the Chamber . . . she says it takes all the professionalism she can muster to treat them as she would any new business. LOL

- Marie (Coming Out of the Trees)

Anonymous said...

Um . . make that "mind altering drugs", LOL

WarmSocks said...

Guess your age? Hmmm... fairly young, I'd say, but if you've been hired after completing your residency, that requires a certain number of years... 28?

How can a doctor care for people, when he or she has never experienced what they are going through?
By analyzing symptoms, comparing them to what science says of others with those same symptoms, scientifically determining the best treatment, following up to make any needed adjustments to the treatment plan, and maintaining emotional distance so as to keep a clear head.

Why aren't medical schools intentionally recruiting students who have been patients with serious illnesses in the past?
Do medical schools have to do any recruiting? I thought they were turning down applicants. That might change in the future, depending on how the government pay and treats doctors in the coming years. Nothing prevents anyone who wants to attend medical school from applying, and that includes those dealing with their own health issues.

Should Doctor D try out a relatively benign mind-altering drug such as Marijuana, even if it doen't appeal to him, in order to better understand the experiences and motivations of his stoner patients?
No. But you might be interested in a book by Cynthia Tobias, titled The Way They Learn for tips on how to deal with people who require an expert. Some people won't listen to people who don't know what they're talking about. You don't need to experience illegal drugs, because you aren't teaching people how to take/not take drugs; you're teaching people how to have optimal health - and you do know what you're talking about there. There's a difference. My $.02

Good luck getting settled in to your new home, DoctorD!

Old MD Girl said...

I guess 31 years old.

Anonymous said...

Calculation of Doctor D's Age:

youthful irreverence = 15 years old

social media savvy = 20 years old

skepticism of baby boomers = 25 years old

inner wisdom = 50 years old

largeness of heart = 65 years old

The above averages out to a 35-year-old Doctor D.

Sarah G said...

It seems to me that you could just say, "No, I haven't done ____, but I've seen what it can do to a body/a life/your sanity."

None of us have been through the entire range of human experience. It's okay to do without a few (e.g. excruciating pain).

Anonymous said...

I'm in the All or nothing camp concerning Marijuana. Make it legal, tax the crud out of it, fix the broken roads around my house. >:-|
It seems to me that having doctors in charge of it is sort of like having a doctor prescribe 2 martinis for social phobia. It might work, provided you aren't a mean drunk.

I don't think you have to have experienced something to be able to intellectually grasp what it does to your patient. You wouldn't have gone into medicine if you didn't have at least a minute bit of empathy. At least that's my rainbow colored viewpoint about doctors and I'm keeping it for my own mental health.

Aviva said...

ok, I had to come searching through comments in hopes of trying to figure out how I missed a contest guessing Doctor D's age!

I would have guessed you were a bit older than you turned out to be ... but I think I tend to assume anyone I like online is my age or close to it, until I learn otherwise. :-)

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