tag:blogger.com,1999:blog-3449008677228605302024-03-05T09:20:37.547-05:00Ask An MDWelcome to Dr. D's CLINIC OF DOCTOR-PATIENT RELATIONAL AWESOMENESS!Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.comBlogger134125tag:blogger.com,1999:blog-344900867722860530.post-17967644775648030582011-12-05T11:22:00.001-05:002011-12-05T12:13:31.082-05:00AskAnMD is Hibernating<div style="text-align: justify;">
<i>Okay, it's time for the standard apology:</i></div>
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<b>Doctor D has been remiss in his blogging duties. </b></blockquote>
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Yes, I over-committed himself to multiple projects and AskAnMD faltered just as it was achieving greatness. I see no point in the near future in which I can invest the time in this blog that I once did. <b> I enjoyed blogging as "Doctor D" but for now I have to put this thing on ice:</b></div>
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<span style="font-size: large;"><b>AskAnMD is going into hibernation.</b></span> </blockquote>
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I may post a 3 or 4 answers a year, but I'm not sure when or if it will ever return to regular posting. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh51bM6Y43VLEA03OIa1VBnDYBo4RxPmTmzeIsHvfOB2dHjHk1WX31AM5jEuvieWzmJCreUXL8yyKAOwqgCPWCXlooYVY2ip0Nkb87QiY0kN7twzf_JPhtiOS3aUjDPwXweKvZ3MnQ0SR-l/s1600/Screen+Shot+2011-12-05+at+11.48.13+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="238" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh51bM6Y43VLEA03OIa1VBnDYBo4RxPmTmzeIsHvfOB2dHjHk1WX31AM5jEuvieWzmJCreUXL8yyKAOwqgCPWCXlooYVY2ip0Nkb87QiY0kN7twzf_JPhtiOS3aUjDPwXweKvZ3MnQ0SR-l/s320/Screen+Shot+2011-12-05+at+11.48.13+AM.png" width="320" /></a></div>
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<span style="font-size: x-small;"><i>"No blogging today. Tomorrow doesn't look good either."</i></span></div>
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<b>I'm still checking <a href="http://askanmd.blogspot.com/2007/08/how-to-e-mail-doctor-d.html" target="_blank">email</a> and still getting a ton of it, but I can't guarantee an answer.</b> (PS: <i>Although you should already know better than to email your symptoms to an anonymous blogger asking for a diagnosis, let me remind you again: Don't go there!</i>)</div>
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<b>The archives still getting hundreds of hits a day and lots of comments. If you haven't looked around the <a href="http://askanmd.blogspot.com/2008/08/best-of-askanmd.html" target="_blank">AskAnMD Archives</a> you may find a lot of useful and fun stuff. </b> </div>
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I'm also still tweeting since it requires zero time commitment. <b>You can always drop by <a href="http://twitter.com/Doctor_D_MD" target="_blank">Doctor D's Twitter</a> and we'll have a 140 character conversation. </b></div>
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<b>Thanks for making this blog such an awesome conversation. </b> See you around.</div>
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-Doctor D</div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com0tag:blogger.com,1999:blog-344900867722860530.post-64188564088240820062011-08-12T12:49:00.006-04:002011-08-12T14:08:58.387-04:00Welcome NYT Readers!<div style="text-align: center;"><span style="font-weight: bold;">Welcome to everyone who came from the link in </span><a style="font-weight: bold;" href="http://well.blogs.nytimes.com/2011/08/12/do-patients-have-the-toughest-job-in-medicine/?ref=health">New York Times Health</a><span style="font-weight: bold;"> section!</span>
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<br />Feel free to look around The Clinic of Doctor-Patient Relational Awesomeness.
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<br /><div style="text-align: justify;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEkn2X6yMMpbqji-Mrds-n05aOBeVwklu3POoEDVh6hLuJ0hOWyxgFx3V2xQ-gCUMVo-vgarB-BoykcHfIGG0kR38i8KXFicG0AU-2Rz44UNyXubj2gmpL11WsnhH60Lgg9A06wBh2MAM8/s1600/TV+Doctor.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 191px; height: 261px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEkn2X6yMMpbqji-Mrds-n05aOBeVwklu3POoEDVh6hLuJ0hOWyxgFx3V2xQ-gCUMVo-vgarB-BoykcHfIGG0kR38i8KXFicG0AU-2Rz44UNyXubj2gmpL11WsnhH60Lgg9A06wBh2MAM8/s400/TV+Doctor.png" alt="" id="BLOGGER_PHOTO_ID_5640017444974833218" border="0" /></a>You can <a href="http://feeds.feedburner.com/AskAnMd">subscribe</a> to the feed or <a href="http://askanmd.blogspot.com/2007/08/how-to-e-mail-doctor-d.html">email Dr. D</a>, but Doctor D has been a bit slow of late on posting new content and answering emails so don't hold your breath.
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<br /><span style="font-weight: bold;">The best way to enjoy the delicious goodness of AskAnMD would be to check out </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2008/08/best-of-askanmd.html">Dr. D's Best Answers</a><span style="font-weight: bold;"> page.</span>
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<br /><div style="text-align: center;">Have fun!
<br /></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com4tag:blogger.com,1999:blog-344900867722860530.post-19116685239287364232011-08-10T14:37:00.012-04:002011-08-10T16:32:01.109-04:00The Greatest Medical Myth<span style="font-style: italic; font-weight: bold;">A reader asked her specialist a question that befuddled him, so she wrote Doctor D this question:</span>
<br /><div style="text-align: justify;"><blockquote style="font-weight: bold;"><span style="font-size:180%;">How is a doctor allowed to mess around with </span><span style="font-size:180%;">body parts he doesn't understand?</span></blockquote></div><div style="text-align: justify;"><span style="font-weight: bold;">If doctors were required to understand everything we touched we wouldn’t be able to touch you at all!</span>
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<br /><span style="font-weight: bold;">The human body is still a deep mystery.</span> Doctors understand more than most people, but what we know is still a vague approximation. <span style="font-weight: bold;">Just because our educated guesses often work out well doesn’t mean we have any idea what’s actually going on.</span>
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<br /></div><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The Myth of Physician Omniscience:</span></span>
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<br /></div><div style="text-align: justify;"> <span style="font-weight: bold;">It is a popular myth that doctors know exactly what your body is doing.</span> The myth assumes the human body is a machine that is even understandable in the first place. <span style="font-style: italic;">Doctors learn a ton of stuff in medical school so they must understand everything the body does or can do, right?</span> TV medical dramas have reenforced this myth without you even realizing it. <span style="font-weight: bold;">If you fart or have a rash a doctor should be able to explain exactly why your body is doing that.</span>
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<br /><div style="text-align: center;"><span style="font-size:180%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-5FKBThg7y5oP5aieTZUdbWOOtZjERztPx0fEVN7_ZP2HxQmMJAl4RjCBv6DImZ0XJgd5-A3MmcDUFGuUhqGsx9gwdfiSoSTI31SdB1zF-P1vtQvUHF1KM4uiJsQKzJIih1UrfR0RkpW4/s1600/Doctor+God-complex.png"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 317px; height: 381px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-5FKBThg7y5oP5aieTZUdbWOOtZjERztPx0fEVN7_ZP2HxQmMJAl4RjCBv6DImZ0XJgd5-A3MmcDUFGuUhqGsx9gwdfiSoSTI31SdB1zF-P1vtQvUHF1KM4uiJsQKzJIih1UrfR0RkpW4/s400/Doctor+God-complex.png" alt="" id="BLOGGER_PHOTO_ID_5639313214936805106" border="0" /></a></span><span style="font-size:85%;"><span style="font-style: italic;">"Nope, nothing about your body could ever surprise me!"</span></span>
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<br /><span style="font-weight: bold;">I hate to kill your Santa Claus, but MD’s don’t understand with any real depth what is going on in your body most of the time. </span>
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<br />We are still be useful, but we don’t always know what’s going on behind the scenes anymore than you need to understand the internal combustion in order to press the gas pedal. <span style="font-weight: bold;">Human bodies are exponentially more complex and varied than engines so when what we do doesn’t work, we can be at a loss to know why,</span> although we can often make up some <a href="http://askanmd.blogspot.com/search/label/Bullshit%20Therapy">bullshit</a> that sounds convincing.
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<br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Mythbusting</span></span>
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<br /><span style="font-weight: bold;">D</span><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXQsDUnPNBBm1jqxIRKLauIMR_1y3Aemyyx-3r_DkNlJJBFAVOIFhdSCdsuuG-_cfHSCbSU_WmX4pI68_WKwQjaBP54AdWLbCbcMNM9f3ju3zXs_zSd3XN7zVgLbwHY-9N8JH3uKwTRXnU/s1600/Medical+Mythbusting.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 153px; height: 195px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXQsDUnPNBBm1jqxIRKLauIMR_1y3Aemyyx-3r_DkNlJJBFAVOIFhdSCdsuuG-_cfHSCbSU_WmX4pI68_WKwQjaBP54AdWLbCbcMNM9f3ju3zXs_zSd3XN7zVgLbwHY-9N8JH3uKwTRXnU/s400/Medical+Mythbusting.png" alt="" id="BLOGGER_PHOTO_ID_5639313000110970978" border="0" /></a><span style="font-weight: bold;">octor D has tried to disabuse people of this impossible myth, but nobody’s listening.</span>
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<br /><span style="font-weight: bold;">Patients either don’t believe me,</span> <span style="font-style: italic;">“How nice of you to be so humble, doc, but I know you know what’s going on,”</span> <span style="font-weight: bold;">or they assume the lack of knowledge is some default in my training,</span> <span style="font-style: italic;">“Okay Dr. D if you’re <a href="http://askanmd.blogspot.com/2009/08/incompetent-doctors-series.html">incompetent</a> then refer me to someone who does understand!”</span>
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<br />People just refuse to believe that there could be things that no doctor understands. The body is just too complex! <span style="font-weight: bold;">Every human body is different and is constantly interacting with your mind, soul, other humans, and the environment. Not only is there a lot we don’t know. There is a lot that will always be impossible to know. </span>
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<br />So, why is the myth of Physician Omniscience so deeply ingrained? <span style="font-weight: bold;">When a wrong idea won’t budge it’s usually because it satisfies a deep psychological need. </span>
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<br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">No Thanks, We Prefer Myth To Reality!</span></span>
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<br /><span style="font-weight: bold;">Being ill is terrifying.</span> When your body begins to betray you it is natural to want to know why. Patients need to believe that somewhere out there is a doctor who understands this. <span style="font-weight: bold;"> In their imagination patients replace doctors’ vague, tentative understanding with a mythic understanding that is complete and without doubt. </span><span style="font-style: italic;"> “It’s okay that I feel out of control, because my doctor is on top of it!”</span> This is why <a href="http://askanmd.blogspot.com/2010/01/mystery-diseases-diagnosing.html">mystery illnesses</a> are so unsettling. <span style="font-weight: bold;"> It feels like like being in speeding car with no one at the wheel.</span>
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<br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLYwV-PbLlV-x_BkIXlurDb5a_nO7FyigIthduYG7TFIzmbG-50xbiEUT6ha-A3a7kiOU-77J7Oj3Wq3HhEHVV4LMerZIvK_ZzlbTjhyphenhyphenmdNoNV65Y0XZ3vxVYYY3pvsxIO6OrdasZQPuiH/s1600/Dr+Zeus.png"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 398px; height: 292px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLYwV-PbLlV-x_BkIXlurDb5a_nO7FyigIthduYG7TFIzmbG-50xbiEUT6ha-A3a7kiOU-77J7Oj3Wq3HhEHVV4LMerZIvK_ZzlbTjhyphenhyphenmdNoNV65Y0XZ3vxVYYY3pvsxIO6OrdasZQPuiH/s400/Dr+Zeus.png" alt="" id="BLOGGER_PHOTO_ID_5639310227221562322" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">"Don't worry! Doctor Zeus has this under control."</span></span>
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<br /><span style="font-weight: bold;">Doctors are also responsible for this myth. We perpetrate this falsehood for 2 reasons:</span>
<br /><ul><li><span style="font-size:130%;"><span style="font-weight: bold;">First, we want you to trust us.</span></span> <span style="font-weight: bold;">It takes a lot of trust for you to ingest the chemicals we give you or let us cut you open.</span> We fear that if you knew how little we understand the bodies we work on you wouldn’t let us near you.</li></ul><ul><li><span style="font-size:130%;"><span style="font-weight: bold;">Secondly, we lie to ourselves.</span></span> <span style="font-weight: bold;"><span style="font-style: italic;">Medicine works.</span> </span> <span style="font-style: italic;">This is a good thing, but it allows us to mislead ourselves about how deeply we actually understand what’s going on.</span> It also takes a lot of self-confidence to take on the care an ill person. <span style="font-weight: bold;">Imagining we have god-like knowledge of the body helps us banish self-doubt.</span> Unfortunately, banishing self-doubt is a double-edged sword: <span style="font-weight: bold;">It can give us the confidence we need to pull of some incredible healing, and it can blind us to the humility and insight needed to acknowledge when we don’t understand.</span></li></ul>
<br />One thing you can take as gospel: <span style="font-weight: bold;"> If any physician tells you they totally understand your body they are either lying or deluded.</span>
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<br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">How To Live Without The Myth</span></span>
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<br /></div>This is good and bad news for you. <span style="font-weight: bold;">The good news is that having and MD doesn’t make your doctor the final authority on you.</span> <span style="font-style: italic;">Understanding this can allow you and your doc to have frank discussions on what we do and don’t know about your body.</span> <span style="font-weight: bold;">The bad news, of course, is that full understanding of your body is impossible. </span>
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<br /><span style="font-weight: bold;">But realizing that the body is a fearful and wonderful thing isn’t such a bad discovery. Appreciate your body for the mystery it is!</span>
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<br /><div style="text-align: center; font-style: italic;"><blockquote><span style="font-size:85%;">Doctor D always loves to read your thoughts in the comments.
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<br />Do you think that Dr. D is over-stating the uncertainty of medical science?
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<br />Patients and Heathcare People: How has this Myth affected you?</span></blockquote></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com9tag:blogger.com,1999:blog-344900867722860530.post-86724349405880933182011-07-26T12:55:00.007-04:002011-07-26T17:11:46.991-04:00Psychotic Medical Students<span style="font-weight: bold;">Doctor D gets lots of emails from </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2008/08/should-i-become-doctor-series.html">students considering medical school</a><span style="font-weight: bold;">. </span><br /><br />Hey, if the practice of medicine is your dream then you should go for it, but be forewarned it isn't sexy or glamorous like on Grey's Anatomy. <span style="font-weight: bold;">It is <a href="http://askanmd.blogspot.com/2010/08/i-hate-medicine.html">years of drudgery</a> in which helping patients and feeling awesome about yourself will be the exception rather than the rule.</span><br /><br />But I pray to God you never go totally off your rocker and spend your precious days off making videos like these:<br /><br /><iframe src="http://www.youtube.com/embed/UfoR96w41wk?rel=0" allowfullscreen="" frameborder="0" height="349" width="425"></iframe><br /><br /><br /><iframe src="http://www.youtube.com/embed/va8uzkBDcLA?rel=0" allowfullscreen="" frameborder="0" height="349" width="560"></iframe><br /><br /><span style="font-weight: bold;"><a href="http://twitter.com/#%21/Doctor_D_MD">Doctor D</a> has more relevant material than silly parodies of parodies of parodies, but unfortunately not the time to post it right now.</span><br /><br />He's also about 2 months behind on answering AskAnMD emails. Feel free to chastise him the comments!Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com4tag:blogger.com,1999:blog-344900867722860530.post-84302140617165987342011-06-16T03:02:00.009-04:002011-06-16T03:24:53.387-04:00What To Do If You're A "Bad Patient"<div style="text-align: justify;"><span style="font-weight: bold;">Last post Doctor D explained the sad phenomenon of "</span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2011/05/why-do-you-think-im-bad-patient.html">Bad Patient Syndrome</a><span style="font-weight: bold;">" to a reader who had been branded by doctors as <span style="font-style: italic;">bad</span>. Today in the Clinic of Dr-Patient-Relational-Awesomeness we shall teach you proven therapies for curing Bad Patient Syndrome:</span></div><div style="text-align: justify;"><span style="font-size:130%;"><br /></span><div style="text-align: center;"><span style="font-weight: bold;font-size:180%;" >The Super Simple Solution:</span><span style="font-size:130%;"><br /></span></div> <span style="font-weight: bold;"><span style="font-size:100%;"><blockquote>Find another doctor. If one doctor-patient relationship didn't work there are lots of other fish in the sea. Move on!</blockquote></span><br /></span><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOR67phY3p9lA8qtoVAxvQk2TQW0q6l2P4svnc7FGOfsRXF_EMQ0k9CU3dIniSJXHfIqlJ1EZCWNeH5cBm1QhmlAUXuDVE46oF7CwE4Xqmku1DZIfJAQ-rzllBh69Q2eLq1kjbZUpr1L7C/s1600/Doctor+Sharks+have+a+feeding+frenzy+on+patients.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 307px; height: 203px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOR67phY3p9lA8qtoVAxvQk2TQW0q6l2P4svnc7FGOfsRXF_EMQ0k9CU3dIniSJXHfIqlJ1EZCWNeH5cBm1QhmlAUXuDVE46oF7CwE4Xqmku1DZIfJAQ-rzllBh69Q2eLq1kjbZUpr1L7C/s400/Doctor+Sharks+have+a+feeding+frenzy+on+patients.png" alt="" id="BLOGGER_PHOTO_ID_5618693249961518450" border="0" /></a><span style="font-style: italic;">K</span><span style="font-style: italic;font-size:85%;" >nowing there are lots of fish in the sea isn't always comforting!</span><br /></div><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">When the 'Super Simple Solution' doesn't work:</span></span><br /></div> <span style="font-weight: bold;">Some people seem to get labeled as a "bad patient" wherever they end up.</span> Within a minute of entering the exam room the doc seems to decide that that you are gonna be trouble. Of course, some patients get this label because they really are irredeemable assholes, but most aren't. <span style="font-weight: bold;">Many </span><span style="font-style: italic; font-weight: bold;">"Chronically Bad Patients"</span><span style="font-weight: bold;"> are just people with difficult or </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/01/mystery-diseases-diagnosing.html">undiagnosable</a><span style="font-weight: bold;"> illnesses or a personality that for some reason triggers the suspicion of people with MD behind their name.</span><br /><br /><span style="font-style: italic;">So if you are one of the unlucky innocent victims of Bad Patient Syndrome, I am sorry. It really does suck.</span> <span style="font-weight: bold;">When the simple answer doesn't work the therapy is going to be longer and harder, but it still can work...</span><br /><br /><br /><br /><div style="text-align: center;"><span style="font-size:180%;"><span style="font-weight: bold;">How To Overcome Bad Patient Syndrome:</span></span><span style="font-style: italic;font-size:100%;" ><span></span></span><br /></div><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Don't confront!</span></span></div><span style="font-weight: bold;">If medical professionals' totally wrong impression of you is not grounded in objective reality, then you would think that exposing the falsehood would make it go away.</span> After reading the last post you probably wanted to storm into your doctor's office and yell, <span style="font-style: italic;">"I'm not bad! In fact, I'm a great person. It's YOU who are wrong! Your own fucked-up physician brain that has unjustly labeled me! Dr. D said so on his blog!"</span><br /><br /><span style="font-weight: bold;">While I'm sure it would feel great to tell off your doctors it wouldn't help. It would likely make things worse.</span><br /><br /><br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTwk2o84WsneLPYtojM1afd6gCMiL9Cz8o0VYtSv1ThTLGSIl-NYhMlt0pKx3LE6sBtERtDjVFL6qrJcUdPOHwmv4EJtrdgqtry-_Xlb7QEvUA5NkMg4mJwsBc5Sfz9UITY3dlYEdqBYEk/s1600/When+Doctor+patient+relationships+go+bad.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 261px; height: 179px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTwk2o84WsneLPYtojM1afd6gCMiL9Cz8o0VYtSv1ThTLGSIl-NYhMlt0pKx3LE6sBtERtDjVFL6qrJcUdPOHwmv4EJtrdgqtry-_Xlb7QEvUA5NkMg4mJwsBc5Sfz9UITY3dlYEdqBYEk/s400/When+Doctor+patient+relationships+go+bad.png" alt="" id="BLOGGER_PHOTO_ID_5618704326833195826" border="0" /></a><span style="font-style: italic;font-size:85%;" >Confrontation: It won't always have positive results.</span><br /></div><blockquote><span style="font-weight: bold;">Bad Patient Syndrome is a prejudice, and like most delusions prejudice is most dangerous when you try and expose it.</span> Prejudice is subconscious. Docs don't recognize we think this way. <span style="font-weight: bold;">Your confrontation or insisting on your innocence only confirms our suspicions that you must be a manipulative asshole.</span></blockquote>If you directly attack a delusion it will only entrench itself. You have to work on it subtly until it is the prejudiced person who realizes they were wrong. <span style="font-weight: bold;">Your doctor must think they discovered you aren't a bad patient on their own, without any confrontation from you at all.</span><br /><br />Dr. D only realized he was labeling people as bad patients after he "discovered" that a few "bad patients" were <a href="http://askanmd.blogspot.com/2010/11/my-favorite-patient-died-today.html">amazing amazing people after all</a>. In retrospect, <span style="font-weight: bold;">I think they were quietly working against my prejudice all along.</span><br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Don't act suspicious</span><br /></span></div>Okay, I admit this one is hard. Once you're labeled a bad patient everything you do is suspicious. <span style="font-weight: bold;">Doctor's prejudice against you seems to find confirmation in everything you do, but this doesn't mean you have to give us ammunition.</span><br /><blockquote><span style="font-weight: bold;">The best way to approach this is to imagine yourself in the doctor's shoes.</span> Ask yourself, <span style="font-style: italic;">"If I suspected someone was manipulative, dishonest, or crazy would this behavior seem to confirm my suspicion?"</span> <span style="font-weight: bold;">If the answer is YES or even MAYBE then don't do it!</span></blockquote><span style="font-weight: bold;">When a patient suspect they're being unjustly labeled as being a bad patient the instinct is to resist</span>. Patient's get angry or argumentative. They beg and plead. They lose control of their mouths and emotions. They accuse their doctors of incompetence or malpractice. They behave erratically and refuse to work with their doctors. These desperate attempts to resist only confirm the doctors' prejudice toward them.<br /><br /><span style="font-weight: bold;">Instead your strategy must be to come across as calm and above suspicion. Try to act as normal and well-adjusted with your doctor as you do with your friends and family.</span><blockquote>If your doc seems frustrated with you say in the most genuine way you can, <span style="font-weight: bold; font-style: italic;">"</span><span style="font-weight: bold; font-style: italic;">I know I'm a difficult case, and I realize I'm in the wrong on this.</span><span style="font-weight: bold; font-style: italic;"> </span><span>(Take the blame even if you weren't wrong)</span><span style="font-weight: bold; font-style: italic;"> </span><span style="font-weight: bold; font-style: italic;">I'm still new to needing medical help. How can I do this in a way that help you, doc?</span><span style="font-weight: bold; font-style: italic;">"</span></blockquote><span style="font-weight: bold;">I realize this feels like giving in to an asshole bully who has mistreated you—and in some ways it is—but if you have an illness that needs medical help and the entire medical system is against you then you might have to play along with our delusion for a while.</span> Sorry!<br /><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Knowledge is Power<br /></span></div><span style="font-weight: bold;">If you have been unjustly labeled as a bad patient this may be the most important blog post you ever read.</span> Understanding the bizarre <a href="http://askanmd.blogspot.com/search/label/Doctor%20Psychology">psychology of the medical mind</a> is of the utmost importance for you:<br /><ul><li><span style="font-weight: bold;">First, you can finally realize it isn't your fault:</span> You really aren't a bad person. It really is a false label that has been attached to you by delusional physicians.</li></ul><ul><li><span style="font-weight: bold;">Second, you can understand WHY the doctor's mind becomes this way:</span> While our prejudice against you is totally indefensible, you may realize that it is a warped product of our desire to do our jobs right and help people. Perhaps this will allow you feel sorry for us instead of angry with us.</li></ul><ul><li><span style="font-weight: bold;">Third, you can make peace with the fact doctors are out of touch with reality:</span> It's hard to take a totally reasonable person calling you bad, but you don't mind if a crazy person calls you names because he doesn't know what he's doing. <span style="font-style: italic;">Don't assume doctors are sane just because we have letters after our names!</span> We are subject to psychological trauma just like anyone else--and we get a lot of it in this job. <span style="font-weight: bold;">It is quite possible that you are the most emotionally mature person in your doctor-patient relationship.</span> Treat us like your grandfather with Alzheimers and play along. <span style="font-style: italic;">"Sure Jimmy Carter's the President and the KGB is trying to break into your tool shed each night."</span></li></ul><div style="text-align: center;"><span style="font-weight: bold; font-style: italic;"><span style="font-weight: bold;"><span style="font-size:130%;"><span style="font-weight: bold;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuMjH9FRytnuIdjwvzIm3ChrtW-8t19zZ3Ta5czMZHKOQ0Iz1aWaphpoxbfCK2NKBDwVVd9JSbPPw3bb8widYxFfHeoKbzsIZaEOZ928sNrWAjexL7nH1AnMB4FrPm1SMfnMJOLckKfHwm/s1600/Crazy+MD.png"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 311px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuMjH9FRytnuIdjwvzIm3ChrtW-8t19zZ3Ta5czMZHKOQ0Iz1aWaphpoxbfCK2NKBDwVVd9JSbPPw3bb8widYxFfHeoKbzsIZaEOZ928sNrWAjexL7nH1AnMB4FrPm1SMfnMJOLckKfHwm/s400/Crazy+MD.png" alt="" id="BLOGGER_PHOTO_ID_5618705457462420514" border="0" /></a></span></span></span></span></span><span style="font-size:85%;"><span style="font-style: italic;">"Don't let the white coat fool you. I'm absolutely bat-shit crazy!"</span></span><br /></div><br /><span style="font-weight: bold;">This knowledge will give you the patience and peace of mind to gradually undo the damage of Bad Patient Syndrome:</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Your Long-Term Strategy</span></span><br /></div>If you are stuck as the bad patient no mater where you go then stop switching MDs before you get labeled a "<a href="http://en.wikipedia.org/wiki/Doctor_shopping">doctor shopper</a>." <span style="font-weight: bold;">Pick one doctor and stick with him or her.</span> Pick a doc who seems at least slightly reasonable despite their totally misjudging you. <span style="font-weight: bold;">This should usually be a primary care doctor, but if you have a chronic illness you may want a doc who specializes in your condition.</span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZn8pi9zl4q6jYzZIYVYsSn98hmJ5oJcXoR0SMQ2Yo8JKoSlrnKIer9AyrjaNHUA1wUj3-1b4YBLuNrlVErla6WwVk39SAvlDeAvov3laX9mLXC_xO6GMnDtcUxNpTltal50_RHz60ePfi/s1600/How+to+save+your+prejudiced+doctor.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 145px; height: 215px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZn8pi9zl4q6jYzZIYVYsSn98hmJ5oJcXoR0SMQ2Yo8JKoSlrnKIer9AyrjaNHUA1wUj3-1b4YBLuNrlVErla6WwVk39SAvlDeAvov3laX9mLXC_xO6GMnDtcUxNpTltal50_RHz60ePfi/s400/How+to+save+your+prejudiced+doctor.png" alt="" id="BLOGGER_PHOTO_ID_5618709798005340882" border="0" /></a>Work patiently with your doctor. Don't try to change you doctor's idea that you are a bad patient anytime soon. Your goal is to let his or her mind change on it's own. <span style="font-weight: bold;">Your long-term campaign of patience, kindness, and consistency will eventually wear down your doc's prejudice.</span><br /><br />I'm not saying this is easy. <span style="font-weight: bold;">Changing anyone's misinterpretation of you is hard, and it's doubly hard when it's your doctor and you feel sick and are worried about your health.</span><br /><br /><span style="font-weight: bold;">As you work with this one doctor you will learn a lot about doctors in general.</span> We are an odd bunch, but we are also predictable. <span style="font-style: italic; font-weight: bold;">You'll start to learn how we think: what sets off our prejudices, and also what lowers our defenses and makes us humane.</span> <blockquote>Chances are if you are getting repeatedly labeled a Bad Patient there is something about your style of interaction that sets off alarms in the medical psyche. <span style="font-weight: bold;">Work patiently with one doctor to cure your "Bad Patient Syndrome" and you'll likely find the doctor-handling skills you learned will work with every other MD you encounter.</span></blockquote><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">This Therapy Might Just Save Your MD Too:</span></span><br /></div><span style="font-weight: bold;">Yes, you the "difficult patient" could be the one who saves an MD from becoming and eternal asshole!</span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPi-X_C8-r4sqOHK_Kw4V_-V7AuwQ-5NimQmv6JXFt0rRxZvOUm3bk4MUr6rDdgiWe5F7JUtd385nIqF_mmOgrXsZYYk6npBEiaMNgV1dVNpozHWzDD4lJ50ptMF3KKdgrjHK6LIjOZHlF/s1600/Kind+Patient+with+Burnt+Out+Doctor.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 121px; height: 178px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPi-X_C8-r4sqOHK_Kw4V_-V7AuwQ-5NimQmv6JXFt0rRxZvOUm3bk4MUr6rDdgiWe5F7JUtd385nIqF_mmOgrXsZYYk6npBEiaMNgV1dVNpozHWzDD4lJ50ptMF3KKdgrjHK6LIjOZHlF/s400/Kind+Patient+with+Burnt+Out+Doctor.png" alt="" id="BLOGGER_PHOTO_ID_5618711092857916226" border="0" /></a><span style="font-weight: bold;">Dr. D was once near burn out and lost within the delusion that patients who didn't act the way I thought they should were bad.</span> It only took <a href="http://askanmd.blogspot.com/2010/11/my-favorite-patient-died-today.html"><span style="font-weight: bold;">one patient</span></a> who I had previously written off as a hopeless bad patient to turn me around. <span style="font-weight: bold;">He was so damn genuinely nice to me that I suddenly realized I had been calling one of the most amazing human beings I would ever meet a "hopeless trainwreck."</span><br /><br /><span style="font-weight: bold;">In many ways a "bad patient" has the opportunity to transform a physician and positively affect thousands of other patients in a way a "good patient" never could.</span><br /><br /><div style="text-align: center; font-style: italic;"><span style="font-size:85%;">What do you think?<br /><br /><span style="font-weight: bold;">Have any of you who have been labeled a bad patient every tried this?</span><br /><br /><span style="font-weight: bold;">Do you think heathcare workers are open-minded enough to reexamine their prejudice about a "bad" patient?</span><br /><br />Dr. D always looks forward to reading your stories!</span><br /></div></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com19tag:blogger.com,1999:blog-344900867722860530.post-10197444155261131972011-05-08T02:14:00.020-04:002012-10-06T23:23:14.654-04:00How Could You Think I'm A Bad Patient?<div style="text-align: justify;">
<span style="font-size: 100%;"><span style="font-weight: bold;">Dr. D recently got an interesting letter from a young woman who got along well with doctors and never had significant health problems …then she got sick.</span> She developed problematic symptoms that required that she seek a lot of medical attention. </span><br />
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<span style="font-size: 130%;"><span style="font-weight: bold;">What really shocked her, though, was the distinct feeling of hostility she felt from her doctors.</span></span></blockquote>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMun-J4RNpkMLqKKfnzTDN41JGNbMr_ATGXibDEbxEcJh5PpdJgdUkx5mY9pjvIkEvZmGFfMfhERF_jGLEuy76t5kZZKvmOE9h-ePaxgrI89HTDRWzbASf482bel7PLPy3UypNNJn4Y-Zf/s1600/Passive-Agressive+Doctor.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5604240119952357234" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMun-J4RNpkMLqKKfnzTDN41JGNbMr_ATGXibDEbxEcJh5PpdJgdUkx5mY9pjvIkEvZmGFfMfhERF_jGLEuy76t5kZZKvmOE9h-ePaxgrI89HTDRWzbASf482bel7PLPy3UypNNJn4Y-Zf/s400/Passive-Agressive+Doctor.png" style="cursor: pointer; display: block; height: 305px; margin: 0px auto 10px; text-align: center; width: 305px;" /></a><span style="font-size: 85%;"><span style="font-style: italic;">I could totally smother you with this pillow!</span> </span></div>
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<span style="font-weight: bold;">Her complaints were suddenly greeted with suspicion.</span> Her report of odd pains resulted in a <a href="http://askanmd.blogspot.com/2010/01/question-doctor-d-gets-asked-lot-why.html">lecture on drug seeking</a>. She was subtlety accused of being a lying hypochondriac and manipulating the system. When she broke down and cried at this treatment she was diagnosed with <a href="http://askanmd.blogspot.com/2009/12/of-course-its-all-in-your-head.html">"anxiety problems."</a> <span style="font-weight: bold;">She had suddenly gone from normal healthy person to the bad patient.</span><br />
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<span style="font-weight: bold;">In desperation, she wrote Dr. D to ask, <span style="font-style: italic;">"WTF just happened?"</span></span></blockquote>
<span style="font-weight: bold;">I wish I could say that situations like this are rare, but they aren't.</span> I've written before about <a href="http://askanmd.blogspot.com/2011/03/what-is-nice-patient-syndrome.html">Nice Patient Syndrome</a>. <span style="font-weight: bold;">Unfortunately there is also <span style="font-size: 130%;">Bad Patient Syndrome</span>, and it claims a lot more victims than the former.</span><br />
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While there some despicable patients out there, many of the victims of Bad Patient Syndrome are really nice folks who are getting the run around. <span style="font-weight: bold;">The true illness is a mental one in the mind of medical people:</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIqMC6cn33ePGj0WuSq-7jT7Sb-jaLo8HkmL7VczYhn7TU5oaoIcduHwRfQ1zKX733wNsMR21XMuWpbPMRq2vNlJRir-El2lcriCqK5cf45sB_krBye4BC8MYnDbXjfESm8__nbUOXZPu-/s1600/Shakespeare+and+the+Problem+Patient.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5604239349495269618" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIqMC6cn33ePGj0WuSq-7jT7Sb-jaLo8HkmL7VczYhn7TU5oaoIcduHwRfQ1zKX733wNsMR21XMuWpbPMRq2vNlJRir-El2lcriCqK5cf45sB_krBye4BC8MYnDbXjfESm8__nbUOXZPu-/s400/Shakespeare+and+the+Problem+Patient.png" style="cursor: pointer; display: block; height: 306px; margin: 0px auto 10px; text-align: center; width: 402px;" /></a><span style="font-size: 85%;"><span style="font-style: italic;">"The fault dear Brutus, lies not in our patients, but in ourselves!"</span></span></div>
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<div style="font-weight: bold; text-align: center;">
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<div style="text-align: justify;">
<span style="font-size: 180%;"><span style="font-weight: bold;"><br />Why would doctors label you as being a Bad Patient?</span></span></div>
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<span style="font-size: 130%;"><br />1) We Suspect Everyone</span></div>
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<span style="font-weight: bold;">MD's are a naturally suspicious bunch.</span><br />
<blockquote style="font-style: italic;">
"But why would doctors who chose this profession because they want to help people be suspicious?" </blockquote>
<span style="font-weight: bold;">Doctors have control over work excuses, narcotic pain medicines, and the exams that determine disability.</span> This makes us popular targets of sleazy folks who want to get things they shouldn't. <span style="font-style: italic;">Docs get told more lies middle school teachers and probation officers.</span> <span style="font-weight: bold;">After getting burned a few times we learn to be suspicious.</span> We even find ourselves being suspicious of patients who have nothing to gain from fooling us.<br />
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<span style="font-weight: bold;">Suspicion becomes a habit of mind.</span> Your docs are like the grizzled old detective walking out of an interrogation muttering,<span style="font-style: italic;"> <span style="font-weight: bold;">"His story doesn't add up. He's lying!"</span></span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHRPAkzH3sdqs8C8Q7YKngSPN6rpB7mgt7d6URLoEWti-41AbmGPuegXSSg4c2Rq7laASo5j1Lr-6GwseghrNT7hIP2D4l2wpjfhsBnCf5Db1Ie61WhNHuNqY_yv9NZEoqQLgPwBQ3S9yO/s1600/Interrogation+in+the+Exam+Room.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5604239003292723330" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHRPAkzH3sdqs8C8Q7YKngSPN6rpB7mgt7d6URLoEWti-41AbmGPuegXSSg4c2Rq7laASo5j1Lr-6GwseghrNT7hIP2D4l2wpjfhsBnCf5Db1Ie61WhNHuNqY_yv9NZEoqQLgPwBQ3S9yO/s400/Interrogation+in+the+Exam+Room.png" style="cursor: pointer; display: block; height: 175px; margin: 0px auto 10px; text-align: center; width: 295px;" /></a><span style="font-weight: bold;">Sometimes stories don't add up because people are lying, but sometimes they don't add up because the human body occasionally does strange things.</span><br />
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<div style="font-weight: bold; text-align: center;">
<span style="font-size: 130%;">2) Pattern Recognition</span></div>
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<span style="font-weight: bold;">It is often the patients with <a href="http://askanmd.blogspot.com/2010/01/mystery-diseases-diagnosing.html">weird or atypical symptoms</a> that get labeled as the bad ones.</span> Diseases are typically diagnosed by identifying patterns of signs and symptoms. Doctors get pretty good at recognizing common patterns. <span style="font-weight: bold;"> It gets problematic when your symptoms don't fit any known pattern.</span> We might look up your pattern in the books and run some tests and still come up empty handed. This is frustrating!<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjE3j2l0pxYAZ3KRmT2MwcHRZuwV0I6NPEq39oiaVV3_A3N96s8_439up-pK7kJYvYwSgoaWBboft4NZGjL2R53K_dDrcckTx58b6UyqVVlfSTFx1_AYWGUghQPmB5QYyeNgnrbE53tc-Vb/s1600/The+Pattern+Is+You.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5604237318171042610" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjE3j2l0pxYAZ3KRmT2MwcHRZuwV0I6NPEq39oiaVV3_A3N96s8_439up-pK7kJYvYwSgoaWBboft4NZGjL2R53K_dDrcckTx58b6UyqVVlfSTFx1_AYWGUghQPmB5QYyeNgnrbE53tc-Vb/s400/The+Pattern+Is+You.png" style="cursor: pointer; float: left; height: 219px; margin: 0pt 10px 10px 0pt; width: 164px;" /></a>Learning the patterns of diseases is very useful. <span style="font-weight: bold;">A majority of medical education is dedicated to learning these patterns, but sometimes the doctor's mind begins to slavishly adhere to patterns without exception. We start to think that symptoms that don't fit our patterns aren't "real" problem at all.</span><br />
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<span style="font-weight: bold;">If your symptoms don't fit into any known patterns then you must be full of shit!</span><br />
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The human body, of course, is extremely complex and each person's body is unique and acts slightly differently from all others. <span style="font-weight: bold;"> The number of patients with signs and symptoms that don't fit known patterns shouldn't surprise us at all, but if you bring us a pattern we've never seen before we might just blame you.</span><br />
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<div style="font-weight: bold; text-align: center;">
<span style="font-size: 130%;">3) Impotence</span></div>
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<span style="font-weight: bold;">Doctor's hate to feel helpless. Our work gives us an incredible (almost superhuman) power to identify dieases and save lives.</span> Like all superheros we are expected to use our powers for the good of mankind. Our patients expect us to be all-powerful and we like to feel powerful and needed.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUv8f7myybfj5ezFAOb2cfeNlPeiiuzTr-85mHXFPPeSGvCuUd4oEYUfz0gxEVnUNJ7blwa7avy0y-umKjR8WlXE9HmFx3-FKBXzaCqwdbwUuGoYUhPYXMaGdN3L7-95opp0uEaftS6eep/s1600/Kryptonite+Patient.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5604234396858097858" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUv8f7myybfj5ezFAOb2cfeNlPeiiuzTr-85mHXFPPeSGvCuUd4oEYUfz0gxEVnUNJ7blwa7avy0y-umKjR8WlXE9HmFx3-FKBXzaCqwdbwUuGoYUhPYXMaGdN3L7-95opp0uEaftS6eep/s400/Kryptonite+Patient.png" style="cursor: pointer; float: right; height: 219px; margin: 0pt 0pt 10px 10px; width: 201px;" /></a><span style="font-weight: bold;">Then you come along and we can't help. </span> Heck, we sometimes can't even figure out what's wrong with you!<span style="font-weight: bold;"> Suddenly we go from feeling like superheros to pathetic loosers.</span> Not only are you kryptonite to our superpowers, but you still expect us save you when we find all of our medical powers useless. <span style="font-style: italic;">We hate feeling this way!</span><br />
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<span style="font-weight: bold;">What we should do is admit that we aren't superheroes after all and confess that your situation has confounded our ability to help. </span><span style="font-style: italic;">From personal experience I can tell you this is really hard to do.</span></blockquote>
Feeling powerless is a huge narcissistic injury to our superhero ego. <span style="font-weight: bold;"> It is a lot easier to accuse you of being a villainous bad patient who is unworthy of our heroics, that admit that we aren't as super as we would like to be.</span><br />
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<span style="font-size: 130%;"><span style="font-weight: bold;">4) Of Maybe You </span></span><span style="font-size: 130%; font-style: italic; font-weight: bold;">Are</span><span style="font-size: 130%;"><span style="font-weight: bold;"> Just A Manipulative Asshole?</span></span></div>
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<span style="font-weight: bold;">It does happen sometimes, but I believe many of our bad patients are just getting a bad rap.</span> So if you are one of the unlucky innocent victims of Bad Patient Syndrome I am very sorry.<span style="font-weight: bold;"> It really does suck!</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyeMx-iWYPHwZfmWL68bXHaQaG9bpsu_EaHCz8toBFELIK274GHEfXdL9ImW16Uk-lr77g9b3f8FiEEYbJlQTgQMO1h3l4oYcX9Fpf7mt9j7qFidDF8QTTmRxytHEeEjrgSdjvVcoLz_EL/s1600/Bad+Patient+Syndrome.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5604241203436652082" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyeMx-iWYPHwZfmWL68bXHaQaG9bpsu_EaHCz8toBFELIK274GHEfXdL9ImW16Uk-lr77g9b3f8FiEEYbJlQTgQMO1h3l4oYcX9Fpf7mt9j7qFidDF8QTTmRxytHEeEjrgSdjvVcoLz_EL/s400/Bad+Patient+Syndrome.png" style="cursor: hand; cursor: pointer; display: block; height: 336px; margin: 0px auto 10px; text-align: center; width: 400px;" /></a><br />
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<span style="font-weight: bold;">How do you overcome Bad Patient Syndrome?</span> <span style="font-weight: bold;">Well, it isn't easy, but Doctor D has some suggestions coming up in <a href="http://askanmd.blogspot.com/2011/06/what-to-do-if-youre-bad-patient.html" target="_blank">next week's post</a>.</span> </div>
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<span style="font-size: 85%;">What do you think?<br /><br /><span style="font-weight: bold;">Have you ever been the "bad patient" or been the heathcare provider who misjudged a patient?</span><br /><br />Doctor D always loves to hear your stories and opinions in comments.</span></div>
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Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com18tag:blogger.com,1999:blog-344900867722860530.post-34928607625609442962011-04-27T02:47:00.018-04:002011-04-27T15:09:27.633-04:00Healthcare Should NEVER Be Free<blockquote><span style="font-size:180%;"><span style="font-weight: bold;">Is Healthcare A Right?</span></span></blockquote><span style="font-weight: bold;"><br />Yes, Healthcare </span><span style="font-weight: bold;">probably </span><span style="font-weight: bold;">is a right, but it should never, ever be free</span><div style="text-align: justify;"><br /><span style="font-weight: bold;">Now Dr. D is a Socialist</span> (<span style="font-style: italic;">I’m not talking little ‘s’ Palin-calling-Obama-names socialist, but big ‘S’ from-each-according-to-means-to-each-according-to-needs Socialist</span>) <span style="font-weight: bold;">but he still believes medicine should never be free if we want to keep it.</span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiueHRbOx6ksrFcebL8kMrdmAuOcoWxHyWv3Z0VfFlNiEyXtTeTU7QxGsOx5kS6dzE_JogfnxPppBkg_sS_VfmIT4QUTHUHbhpbx1NtqfVnHlwY0dzWxqCNLFKUT2P5APgIliQU1tYTG2x/s1600/Dr.+D+Socialist.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 73px; height: 90px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgiueHRbOx6ksrFcebL8kMrdmAuOcoWxHyWv3Z0VfFlNiEyXtTeTU7QxGsOx5kS6dzE_JogfnxPppBkg_sS_VfmIT4QUTHUHbhpbx1NtqfVnHlwY0dzWxqCNLFKUT2P5APgIliQU1tYTG2x/s320/Dr.+D+Socialist.png" alt="" id="BLOGGER_PHOTO_ID_5600334420558837954" border="0" /></a><span style="font-style: italic;">So what’s a nice Socialist boy like Dr. D doing defending the financial exploitation of sick people?</span><br /><br />Okay, now that I have your attention…<br /><br /><br /></div><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Rights and Responsibilities</span></span><br /></div><div style="text-align: justify;"><br /><span style="font-weight: bold;">If something is a Right then it must be someone’s Responsibility too. </span><br /><br />We have the right to vote. This means someone is responsible to run a fair election and count the votes. We have the right to a fair trial. This means someone is responsible for maintaining an impartial court and providing a public defender. <span style="font-style: italic;">Make sense?</span><br /><br /><span style="font-weight: bold;">If Healthcare is a Right then someone is Responsible for funding and running an efficient healthcare system that cares for everybody... and that someone is Dr. D.</span><br /><br />Dr. just paid about $60,000 to the US treasury and as a bleeding-heart he also did a lot of volunteering and giving to healthcare for the poor. (Dr. D puts his money where his Socialist mouth is!) <span style="font-weight: bold;">Like most people with well-paying work, D contributes large percentage his resources toward the general welfare.</span><br /><br /><span style="font-weight: bold;">Dr. D is also the dude that gives away the free healthcare. </span><br /><br /><span style="font-style: italic;">WTF, free healthcare in the USA? </span><br /><br /><span style="font-weight: bold;">Yep, if you are broke ER care is free by law. </span><br /><div style="text-align: justify;"><blockquote>News Flash to Republicans: Socialist Medicine has been here for decades! <span style="font-style: italic;">Doesn’t it just make you feel dirty?</span></blockquote></div><span style="font-weight: bold;">If Healthcare is a right then Dr. D is the dude responsible, because over half my waking hours and dollars earned are spent providing that right. </span>Actually, we are all responsible for it.<br /><blockquote style="font-weight: bold;">We're already providing free care<span style="font-style: italic;">—</span>we’re just doing a piss-poor job of it:<br /><br />Bad enough that Republicans are right to complain that our kids already owe China trillions of dollars we’ve wasted on healthcare.<br /><br />Also bad enough that Democrats are right to point out that millions of uninsured are sick and dying without the care they need.</blockquote><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQSLpjT2AbkkhWSRBhyphenhyphenTth1ziJJrYg9ViRARRXaCaUU_Rb8RuXQMDazB6AoO5x7AcqgPpReeucj4cM78c1PUUL7PtT9VxlFrSCbNzU8LmzrW9HHh2s71C-381ywelx0YOJEhXe0UObF_Sl/s1600/Quicksand+and+the+System.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 320px; height: 213px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQSLpjT2AbkkhWSRBhyphenhyphenTth1ziJJrYg9ViRARRXaCaUU_Rb8RuXQMDazB6AoO5x7AcqgPpReeucj4cM78c1PUUL7PtT9VxlFrSCbNzU8LmzrW9HHh2s71C-381ywelx0YOJEhXe0UObF_Sl/s320/Quicksand+and+the+System.png" alt="" id="BLOGGER_PHOTO_ID_5600337711580503122" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">The current state of the healthcare system</span> </span></div><br />So let’s think responsibly about this...<br /><br /><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Human Nature Is a Bitch</span></div><br />We Socialists are big picture dreamers. <span style="font-weight: bold;">We like to feel we do some good, without get bogged down in the details. </span> Young D used to give a $10 to every homeless dude that asked. It felt good and kept me restricted to a diet of mostly ramen during school. Then I started working at homeless shelters and realized that the bills I gave usually ended up spent on crack. <span style="font-weight: bold;">Giving a crackhead money isn’t responsible. Responsibility is a lot harder.</span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh18EhqrnIRUiaNXH9ndSU2EubpBsAvFrSwS2EbV_JHYkK1Z3KYAkXKzaZoJ2MpTZWtd-H7VVF4XlF-Mr23x9apOugZU-eA_QHD9HhF0pB2m_4miTUx-FKuUxJPBk39FzVCEAMRbDcxdcRf/s1600/Dave+Chapelle+Free+Crack.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 188px; height: 217px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh18EhqrnIRUiaNXH9ndSU2EubpBsAvFrSwS2EbV_JHYkK1Z3KYAkXKzaZoJ2MpTZWtd-H7VVF4XlF-Mr23x9apOugZU-eA_QHD9HhF0pB2m_4miTUx-FKuUxJPBk39FzVCEAMRbDcxdcRf/s320/Dave+Chapelle+Free+Crack.png" alt="" id="BLOGGER_PHOTO_ID_5600336572248060706" border="0" /></a><span style="font-style: italic;">Are you comparing sick patients to crackheads?</span> Yep!<br /><br /><span style="font-weight: bold;">We are all subject to the same rules of human nature. The problems of human nature affect everyone and always fuck up our brilliant plans. </span> (This blog has spent considerable time dissecting how the foibles of human nature make doctors one of the most screwed up and difficult types of people you'll meet.)<br /><blockquote><span style="font-weight: bold;">Humans are naturally self-serving and take the path of least resistance. </span></blockquote><br />We occasionally rise above our natures, but <span style="font-weight: bold;">when we create a system we should expect people to generally act like typical human beings—and by ‘typical’ I mean jerks.</span><br /><br />We guarantee the Right to vote and to justice, but because we recognize that human nature people lust for power we have to make a Responsible electoral and jury system that isn’t easy to cheat.<br /><br />I’m in favor of giving free food to people that need it, but if I laid out a buffet of delicious food on the corner with a note that said, <span style="font-weight: bold;">“Just take one plate, and only if you’re hungry.” </span> It would likely all end in the trunk of the first person that drove by—even if that person already had a million in the bank.<br /><br /><span style="font-weight: bold;">Sorry, but human nature sucks! Why do we expect free medical care to be any different?</span><br /><br /><div style="text-align: center; font-style: italic; font-weight: bold;"><span style="font-weight: normal;">But people wouldn’t do that with medical care would they?</span></div><br />Dr. D sees it every single day: People call ambulances to bring them to the ER for runny noses and <a href="http://askanmd.blogspot.com/2009/08/why-would-anyone-ration-healthcare.html">dry hands</a>. People getting a free $1000 emergency room visit demand antibiotics for viral and then don’t fill what is prescribed. People come to the ER to get “checked out” just because there’s nothing good on TV.<blockquote style="font-weight: bold;"><span style="font-size:100%;">Most people will treat anything that’s free like it’s worthless and waste it without even thinking. Just look what we did with this planet God freely gave us!</span></blockquote><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Free Stuff Has Consequences</span></span><br /></div><br />Medical care actually isn’t free. It is really expensive. <span style="font-weight: bold;">It takes a lot of resources and work to create even the simplest doctor’s visit.</span> Somebody is responsible to pay the bills for free care, and even though Dr. D chipped in $60K this year, our kids are still in the hole for 14 trillion bucks.<br /><br /><span style="font-weight: bold;">A responsible system must be sustainable, and free-for-alls just aren’t sustainable.<br /><br /></span><span style="font-weight: bold;">The freeloaders also screw up system so it can't work for the people who actually need it.</span> Dr. D gets to deal with a microcosm of this every time we don’t have space for real emergency patient because the ER is full with people who checked in because they were bored or lonely. It happens a lot.<br /><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Rationing Healthcare</span></div><br />Healthcare is a right. We owe it to our fellow human beings. <span style="font-weight: bold;"> We would be some sorry bastards if we just sat by and watched poor people die preventable deaths.</span> We owe it to our kids to create a responsible and stable system to guarantee these rights. <span style="font-weight: bold;">The only way I see that you could possibly have free medical care is if it is heavily rationed.</span><br /><br /><span style="font-style: italic;">OMG, did Dr. D just say rationing? Get the pitchforks and torches! </span>(BTW, I love how my Conservative friends get so worked up about rationing something they don’t want people to have at all.)<br /><br />Human beings will frequently use their freedom to go all apeshit. <span style="font-weight: bold;">We need to have someone responsible enough to prevent us from exercising our rights to the extent that we harm others. </span><br /><blockquote>We have the right to be free but we also have the police to arrest those who use their freedom wrongly. </blockquote><span style="font-weight: bold;">But nobody wants a police state and nobody wants a free medical system that is constantly saying NO.</span><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-style: italic;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhD6dnj5vJ41ThNw1WlEh6yxrkIU4JI62QoUcR_0iVHeUNVwJzWQH6S5jSD8d_IQfnDloj9T4-4Y8PoNgGFiFQNDPTyWm0fOiJc-7b4n1AQsMCmfllcALYAYb80WTrhSmxsf7GZBs73pZnW/s1600/Free+Medicine+Here%2521.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 417px; height: 208px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhD6dnj5vJ41ThNw1WlEh6yxrkIU4JI62QoUcR_0iVHeUNVwJzWQH6S5jSD8d_IQfnDloj9T4-4Y8PoNgGFiFQNDPTyWm0fOiJc-7b4n1AQsMCmfllcALYAYb80WTrhSmxsf7GZBs73pZnW/s320/Free+Medicine+Here%2521.png" alt="" id="BLOGGER_PHOTO_ID_5600338391314314690" border="0" /></a></span></span><span style="font-style: italic;">Totally free healthcare might not be as nice as you hoped.</span><br /><br /></div><span style="font-weight: bold;">What we really want is for people to restrain themselves.</span> Some saintly folks may do this, but most of us will follow our baser natures to disastrous results.<br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Valuing Healthcare</span></span><br /></div><br /><span style="font-style: italic;">Yeah Dr. D, but if human nature is really that shitty why doesn't everybody misuse their freedom and end up in handcuffs? </span><br /><br />Sorry to bruise your college-educated ego, but it isn’t because you’re such a better person. <span style="font-weight: bold;">You just have a whole lot of incentives to stop you before the handcuffs.</span> <span style="font-weight: bold;">Some are social incentives—you’d be ashamed to act out—but many are financial.</span> Misbehaving will hurt you in the pocketbook.<br /><blockquote><span style="font-weight: bold;">Everyone has different values and motivations, but we all accept that money has some value. </span> If we want universal access to medical care then it has to cost money.</blockquote>It doesn’t have to cost much money. In fact healthcare is best if kept inexpensive. The “free market" cost of healthcare is a huge barrier to most people’s access. <span style="font-weight: bold;">But there has to be some barrier. Drop the cost to $0 and you get a tidal wave of people wasting very costly care. </span><br /><br />I guarantee that if every person who came to the ER had to pay $2 up front the number of frivolous visits would drop by 80%.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYlLomhDEN1UU6gbsjBVGJf78akpyXk5mhxwYPBer17gSNbSfCpxlQFbMh44sJ6LsA_8qfvKwSwTgv2Y99BnTZ4Uo0g4GelkINIIUwZLntTr26Qii0mrEU9ZqVuMR9X4nurG9os31-B95D/s1600/Good+price+for+a+doctor%2527s+visit.png"><span style="font-weight: bold;"><span style="font-style: italic;"><span style="font-weight: bold;"></span></span></span></a><span style="font-weight: bold;"><span style="font-style: italic;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdDgeF_yR06zDDbitnnteS1ADVMafgTA2OszERpvVN_RY9qpbId6XinttlguM3z6n3EQNmk4sslmE_GEJh9nd7C0nj2ljSoWK6AEGR7x0yRxs_cUG25Ci2zto_zQcYJRRILqiVQTGB4RG5/s1600/Good+price+for+a+doctor%2527s+visit.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 165px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdDgeF_yR06zDDbitnnteS1ADVMafgTA2OszERpvVN_RY9qpbId6XinttlguM3z6n3EQNmk4sslmE_GEJh9nd7C0nj2ljSoWK6AEGR7x0yRxs_cUG25Ci2zto_zQcYJRRILqiVQTGB4RG5/s400/Good+price+for+a+doctor%2527s+visit.png" alt="" id="BLOGGER_PHOTO_ID_5600342131842412674" border="0" /></a></span></span></span><br />I’m not saying that no rationing will ever be a necessary, but <span style="font-weight: bold;">if we insure healthcare has value to everyone rationing care will be the exception rather than the norm. </span><br /><br /><span style="font-weight: bold;">You want everyone to have healthcare? Never give it away for free!</span><br /><br /><div style="text-align: center; font-style: italic;"><span style="font-size:85%;"><blockquote>Okay, Dr. D has managed to piss off both the Left and the Right!<br /><br />The floor is now open to your comments. Just try and be civil with each other.<br /><br />Next post Dr. D will studiously avoid politics and return to the regularly-scheduled programing on Doctor-Patient Relationships.</blockquote><br /></span></div></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com15tag:blogger.com,1999:blog-344900867722860530.post-33144838871756908092011-03-27T05:03:00.004-04:002011-03-27T02:48:10.402-04:00What Is Nice Patient Syndrome?<span style="font-style: italic;font-size:85%;" >A reader writes:</span><br /><div style="text-align: justify;"><blockquote style="font-weight: bold;"><span style="font-size:130%;">"My doctor says I'm one of the nicest patients he's ever met. He says that really nice people always get the rare incurable diseases. How can that be?"</span></blockquote></div><div style="text-align: justify;"><span style="font-weight: bold;">Oh no! You've got Nice Patient Syndrome!</span> <span style="font-weight: bold;">Your prognosis is grim!</span><br /><br /><span style="font-weight: bold;">There's only one cure: Do something horrible quick! </span> And I'm not talking about saying a dirty word or two. <span style="font-style: italic;">It takes serious antisocial mommas-lock-up-your-babies-cause-there's-a-crazy-person-with-an-axe behavior to save you from the terrible fate of Nice Patient Syndrome!</span><br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Why would the nicest human beings end up with the worst diseases?</span></span></div><br /><div style="text-align: center;"><div style="text-align: justify;">Ask any doctor, nurse, or therapist... We've all noticed it. <span style="font-weight: bold;">The most saintly human beings any of us have met seem to be the ones that get the rare, miserable, and rapidly fatal diseases</span>. We are all astonished at the sheer angelic goodness of these patients, and we tweet message after heartfelt message about how our patients heal our hearts than we could ever heal them.</div><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsjt27c30-QQ2-7ty95cqQgWe_Ns2wWqYGc76pQLII5WHXas4TUfJCBBKt9QvuFbaqpUqF6Xi1t-S0wkgiEPJdmdmHfXWMyUMm7ClTXngSMz-Iqa1ZKRiStJOrlLM9TKA1-TDLqgxL7kUe/s1600/Why+Do+Bad+Things+Happen+to+Good+People%253F.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 363px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsjt27c30-QQ2-7ty95cqQgWe_Ns2wWqYGc76pQLII5WHXas4TUfJCBBKt9QvuFbaqpUqF6Xi1t-S0wkgiEPJdmdmHfXWMyUMm7ClTXngSMz-Iqa1ZKRiStJOrlLM9TKA1-TDLqgxL7kUe/s400/Why+Do+Bad+Things+Happen+to+Good+People%253F.png" alt="" id="BLOGGER_PHOTO_ID_5588631374822823698" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">Ever notice how this shit only happens to the nicest people?</span></span><span style="font-size:85%;"><br /></span></div><br /><span style="font-weight: bold;">Nice Patient Syndrome really does bring out the best in the assholish medical profession.</span> We give hugs, we fluff pillows, we do bake sales in our spare time. Dr. D once bought a ton of medicines for a nice patient who couldn't afford them. After their untimely demise we go to the funerals of our nice patients and tell their relatives how we never met a better human being.<br /><span style="font-weight: bold;"></span><blockquote><span style="font-weight: bold;">I'm sad to hear that your doctor thinks you are wonderful, because that means have a really scary disease.</span></blockquote>And here's the real kicker: <span style="font-weight: bold;">You aren't half as nice as all the doctors and nurses who are fawning over you think. <span style="font-style: italic;">And they aren't crying for you when their eyes well with tears</span></span><span style="font-weight: bold; font-style: italic;">—</span><span style="font-weight: bold; font-style: italic;">they're crying for themselves.</span><br /><br /><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Mental Distortion<br /></span></div><blockquote> <span style="font-weight: bold;">One thing you have to realize about healthcare workers is that all of us have been traumatized, whether we admit it or not. </span></blockquote><span style="font-weight: bold;">Your average graduating medical or nursing student has seen as much death, pain, and misery as a soldier returning from a war.</span> Most of us wouldn't admit that this affects us. <span style="font-weight: bold;">In fact, </span><span style="font-weight: bold;">we pride ourselves in not letting it get to us.</span> <span style="font-style: italic;">"I'm a professional dammit, and telling the 3rd person this week that they've only got months to live doesn't keep me from doing my job professionally!"</span><br /><br /><span style="font-weight: bold;">We usually do a passable job of managing (suppressing) the emotional effects of our jobs.</span> <span style="font-style: italic;">The first few dying or crying patients may have gotten to us, but we don't feel it anymore. We promise! Just another day at the hospital</span><span style="font-weight: bold; font-style: italic;">... </span><br /><br /><span style="font-weight: bold;">Many of the particular quirks of doctors and nurses are psychological defense mechanisms resulting from the mental trauma.</span> Our experiences may turn us into <a href="http://askanmd.blogspot.com/2009/08/why-are-doctors-such-jerks.html">jerks,</a> but we'll turn patients with scary diagnoses into angel<span>s</span><span style="font-weight: bold;">—</span>either that or monsters.<br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Fear of Dying<br /><br /></span></span></div> <span style="font-weight: bold;">Doctors and nurses cannot do our work if we're afraid, but it is anxiety-producing stuff we see every day. </span> We are the ones that watch everyone suffer and die. We watch young and healthy people get awful diseases. We see miserable people that we just can't fix. We get the fact that everyone inevitably dies someday (and many deaths are not pretty) shoved in our face daily.<br /><br />Watching strangers suffer and die actually isn't as hard as you'd think. <span style="font-weight: bold;">The real mental anguish comes when we reflect that the same sort of thing will eventually happen to ourselves and the people we love dearly.</span> <span style="font-style: italic;">Dr. D does a good job taking care of sick and dying kids, as long as he doesn't wonder if this might happen to Little D someday.</span><br /><br />We need to find some way to think of you as different from us. <blockquote> <span style="font-weight: bold;">If you are totally different from us then whatever awful thing is happening you to won't necessarily happen to us.</span></blockquote>I hate to admit it, but <span style="font-weight: bold;">first we look for the bad in you.</span> If you've made some shitty decisions in your life or you are rude or manipulative with us then we conclude you deserve it. <span style="font-style: italic;">"This sort of stuff happens to assholes like you</span><span style="font-weight: bold; font-style: italic;">—</span><span style="font-style: italic;">Karma, bitch!"</span><br /><br /><span style="font-weight: bold;">But if we don't find some reason to hate you we conclude that you must be a saint. </span><span style="font-style: italic;">You are too good for this wicked world!</span> This burden was laid on you because only a truly superb human being like you could handle it.<br /><br /><div style="text-align: center;"><span style="font-size:130%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiED7xfb_J-LdCnJ6ozarpbQnKPvqtG64Ub9UJhwtruM3puk9h7m-gMcUTLmauTUXFTjvNtaFNoTc-3e5blHYlLYbwtHTLSKXv5JYa1uL8WDDaMrglPCVmTKUhbAolmYC1uYs8vCwHHFTPK/s1600/The+Martyrdom+of+Saint+Nice+Patient.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 249px; height: 322px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiED7xfb_J-LdCnJ6ozarpbQnKPvqtG64Ub9UJhwtruM3puk9h7m-gMcUTLmauTUXFTjvNtaFNoTc-3e5blHYlLYbwtHTLSKXv5JYa1uL8WDDaMrglPCVmTKUhbAolmYC1uYs8vCwHHFTPK/s400/The+Martyrdom+of+Saint+Nice+Patient.png" alt="" id="BLOGGER_PHOTO_ID_5588628155262256706" border="0" /></a></span><span style="font-size:85%;"><span style="font-style: italic;">"Look, we really need you to do this for us. You don't mind, do you dear?"</span> </span></div><span style="font-weight: bold;"> </span><span style="font-weight: bold;"><blockquote>We'd rather admit you are better than us than to admit you're just like us.</blockquote> </span><span>We feel safe from the fear of ending up in your shoes as long as you are absolutely different from us.</span> <span style="font-weight: bold;"></span><span style="font-style: italic;"> "That sort of terrible thing happens to assholes and angels but not normal dudes like me!</span>"<br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The Complications Of Nice Patient Syndrome</span></span></div><br />There are plenty of advantages to Nice Patient Syndrome. <span style="font-weight: bold;"> If you are going to have an awful disease it sometimes isn't so bad to be surrounded by healthcare workers who think that they aren't worthy to be in the same room as you.</span> Trust me, you've got it much better than the ones we conclude are assholes! <span style="font-weight: bold;">We'll bend over backwards for you. You can and should milk this!</span><br /><br />There are, however, disadvantages to being though of as the nicest patient.<ul><li><span style="font-weight: bold;">You aren't a real person to us.</span> Your goodness we keep fawning over is a creation of our own mind.</li></ul><ul><li><span style="font-weight: bold;">We tend to be paternalistic with "Nice Patient Syndrome</span><span style="font-weight: bold;">" patients. </span> We don't want to bother your pretty little head with the dirty details of your disease, so we just make the decisions for you.</li></ul><ul><li><span style="font-weight: bold;">We expect you to handle pain bravely. </span> <span style="font-style: italic;">All that goodness makes you more resistant to pain than mere mortals!</span> We rave about your fortitude in the face of pain, and you want to keep our respect so you won't tell us how much you're hurting.</li></ul><ul><li><span style="font-weight: bold;">When we do treat your pain we will knock your ass out!</span> We adore you so much that if you do mention you're hurting we might Michael Jackson you by accident.</li></ul><ul><li><span style="font-weight: bold;">You actually aren't what we imagine you are.</span> We sometimes send people to meet their maker convinced they have far purer souls than they actually do. Y<span style="font-style: italic;">ou are yourself</span><span style="font-weight: bold; font-style: italic;">—</span><span style="font-style: italic;">the good and the bad. Don't buy into our delusion!</span></li></ul><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">How To Handle Your Sainthood</span></div><br /><span style="font-weight: bold;">Rule #1:</span> Don't try and convince us that you are a normal person. <span style="font-weight: bold;">Sure, you are just trying to be humble, but insisting you have flaws is actually very threatening to us.</span> <span style="font-style: italic;">If you are just like me then whatever scary thing that is happening to you could just as easily happen to me.</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;"><span style="font-size:130%;"><span style="font-size:130%;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilXB2hoZD437JefciCTI-6Jq8nou3j71H360zfRbtKVSavcw4sJ82LRicmIc6yYLUE-NhFvUz-XGMpx93CvNyTMbA7CvCDJhgtiBRedCHOfEOIRnAruN6DtM_dNNjrbB4JKrpe2uxb9kt2/s1600/Nice+People+Scare+Me%2521.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 282px; height: 220px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilXB2hoZD437JefciCTI-6Jq8nou3j71H360zfRbtKVSavcw4sJ82LRicmIc6yYLUE-NhFvUz-XGMpx93CvNyTMbA7CvCDJhgtiBRedCHOfEOIRnAruN6DtM_dNNjrbB4JKrpe2uxb9kt2/s400/Nice+People+Scare+Me%2521.png" alt="" id="BLOGGER_PHOTO_ID_5588637003830792866" border="0" /></a></span></span></span></span></span><span style="font-size:85%;"><span style="font-style: italic;">"I think the world of you Mr. Smith. That's how I keep from wetting my pants when I read your chart."</span></span></div><br /><span style="font-weight: bold;">You can't change us. </span> We are damaged goods. <span style="font-weight: bold;"></span><blockquote><span style="font-weight: bold;">We are frightened by your suffering and Nice Patient Syndrome is a deeply-rooted defense mechanism that isn't going away.</span></blockquote> If you try too hard to prove you have faults you might suddenly get labeled the asshole patient that deserves this and can't die soon enough.<br /><br /><span style="font-weight: bold;">Rule #2: Accept your sainthood! Learn use your new-found powers:</span><br /><br /><ul><li><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDQeNO0Lu_buNNnUNItliAgm1LfVEHVN6FssAp87UXnX9Xef2J3PKvpyuHaWyCB_b1beBtDoDiBAzgmPH6GsXY40NFdHr1cagEYdQERgfY2A41txj3wN9m3EamiRANcaOr3ZjJpgXmFRz0/s1600/Listen%252C+you+delusional+medical+bitches%2521.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 156px; height: 257px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDQeNO0Lu_buNNnUNItliAgm1LfVEHVN6FssAp87UXnX9Xef2J3PKvpyuHaWyCB_b1beBtDoDiBAzgmPH6GsXY40NFdHr1cagEYdQERgfY2A41txj3wN9m3EamiRANcaOr3ZjJpgXmFRz0/s320/Listen%252C+you+delusional+medical+bitches%2521.png" alt="" id="BLOGGER_PHOTO_ID_5588642663997597170" border="0" /></a><span style="font-weight: bold;">Speak clearly and directly.</span> Your words carry a lot of weight with us, but you have to sometimes speak forcefully to overcome the narrative running in our heads of whatever we expect an angelic person would say.</li></ul><ul><li><span style="font-weight: bold;">Kindly but firmly demand control of your care. </span> <span style="font-style: italic;">This is your disease, your pain, your death!</span> Don't let your doctors and nurses take over just because they adore you.</li></ul><ul><li><span style="font-weight: bold;">Defend your fellow patients.</span> Just like you aren't the angel we think you are, the asshole patients aren't half as bad as we think they are. <span style="font-style: italic;">"Difficult patients" </span>are the victims of the same <a href="http://en.wikipedia.org/wiki/Splitting_%28psychology%29">splitting</a> defense mechanism that created <span style="font-style: italic;">"nice patients"</span> like you. <span style="font-weight: bold;">Don't try to convince your MD or RN your fellow patient isn't that bad</span><span style="font-style: italic; font-weight: bold;"></span><span style="font-weight: bold; font-style: italic;">—</span><span style="font-style: italic; font-weight: bold;"></span><span style="font-weight: bold;">it won't work. Just remind us to show more kindness to the assholes.</span> We'll do it if an angelic patient like you asks us.</li></ul><ul><li><span style="font-weight: bold;">Ask for lots of extra ice cream.</span> We'll keep bringing it till you get a stomach ache!</li></ul><br /></div><div style="text-align: center; font-style: italic;"><blockquote><span style="font-size:85%;">Dr. D loves to read your thoughts in the comments.<br /><br />A lot of you who read this blog have some really scary diseases:<br /></span><span style="font-weight: bold;font-size:85%;" >-Have you ever been on the receiving end of Nice Patient Syndrome?</span><span style="font-size:85%;"><br /></span><span style="font-weight: bold;font-size:85%;" >-How did you handle it?</span><span style="font-size:85%;"><br /><br />Healthcare Peeps:<br /></span><span style="font-weight: bold;font-size:85%;" >-What is your experience with Nice Patient Syndrome? </span> <span style="font-weight: bold;font-size:85%;" ><br />-Do you agree with Dr. D's theory of the condition?</span></blockquote></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com12tag:blogger.com,1999:blog-344900867722860530.post-71350456772448992762011-03-21T15:09:00.004-04:002011-03-21T15:19:18.725-04:00A Doctor's Life<span style="font-style: italic;">You're probably wondering where the long, brilliant, and eye-opening post for this week is?</span><br /><br /><div style="text-align: justify;"><span style="font-weight: bold;">Well, this week Dr. D worked 72 hours in the ER.</span> I realize for some docs this is a light week, but as someone who <a href="http://askanmd.blogspot.com/2010/08/i-hate-medicine.html">doesn't actually like medicine</a> this kind of week kicks my ass. I only saw my son awake once this whole week.<br /></div><br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBPsOndqv3YQ6IPlqMfIR6P1a4DUF1-zhpghgNkVy0TNVQjF82GJGNTZYvIF6NpNCFHJCJXStOHXniCl5itp8hE2UHtP2GpwhSUl3GXyRCA-D4eQOHIY9Ea_2hHRDsJ3A3pqo0GghZkTKu/s1600/busy-doctor.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 266px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBPsOndqv3YQ6IPlqMfIR6P1a4DUF1-zhpghgNkVy0TNVQjF82GJGNTZYvIF6NpNCFHJCJXStOHXniCl5itp8hE2UHtP2GpwhSUl3GXyRCA-D4eQOHIY9Ea_2hHRDsJ3A3pqo0GghZkTKu/s400/busy-doctor.jpg" alt="" id="BLOGGER_PHOTO_ID_5586614197234213714" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">Ah, the glamorous life of an MD!</span></span><br /></div><div style="text-align: justify;"><br />But enough bitching by Dr. D... <span style="font-weight: bold;">I have a great post I'm preparing for you. I want to take the time to write something brilliant rather than giving you a crappy rough draft. </span><br /></div><br />Stay tuned!Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com0tag:blogger.com,1999:blog-344900867722860530.post-39178225487696170562011-03-11T00:05:00.008-05:002011-03-26T05:45:53.867-04:00Doctor D Crossed The Line!<style>p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 10pt; font-family: "Times New Roman"; }div.Section1 { page: Doctor</style><span style=";font-family:trebuchet ms;font-size:100%;" ><span style="font-weight: bold;">Doctor D has been blogging about the Doctor-Patient relationship for a while now. It’s sort of the thing I’m known for.</span></span><span style=";font-family:trebuchet ms;font-size:100%;" > I’ve usually been on the doctor side of this equation. Most of my blogging, however, is to help patients figure out the weird world of medicine.</span><span style=";font-family:trebuchet ms;font-size:100%;" ><span style="font-weight: bold;"><br /><br /></span></span><div face="trebuchet ms" style="text-align: justify;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div face="trebuchet ms" style="text-align: justify;"> </div><span style=";font-family:trebuchet ms;font-size:100%;" ></span><p class="MsoNormal" style="text-indent: 0.5in; font-family: trebuchet ms;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjfZHu9AiwaVupX9DcN25xKByYSJjudqEbkMPHj93l_BXTI7sJMBmrWsIYqiVeN6H7LwRnErVPMfTy_htwqdsGFozgzpYHME7HivlTjIzBY3guobq4SUvs5T8hnW9FCldjEDwl3haeEdT-7/s1600/Level+10+Pain%253F.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 109px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjfZHu9AiwaVupX9DcN25xKByYSJjudqEbkMPHj93l_BXTI7sJMBmrWsIYqiVeN6H7LwRnErVPMfTy_htwqdsGFozgzpYHME7HivlTjIzBY3guobq4SUvs5T8hnW9FCldjEDwl3haeEdT-7/s320/Level+10+Pain%253F.png" alt="" id="BLOGGER_PHOTO_ID_5582675662436426306" border="0" /></a></p> <div style="text-align: justify; font-family: trebuchet ms;"><blockquote>Well, guess what? <span style="font-weight: bold;">Doctor D recently found himself on the patient side of a nasty injury!</span><span style="font-size:100%;"><br /><br />Even as Doctor D looked down and realized his leg wasn’t supposed to be that shape he said to himself, </span><span style="font-style: italic;font-size:100%;" >“Self, take mental notes! <span style="font-weight: bold;">The readers of Doctor D’s Clinic of Doctor-Patient Relational Awesomeness will want to know about this."</span></span></blockquote><span style="font-style: italic;font-size:100%;" ><span style="font-weight: bold;"></span></span></div><div style="text-align: justify; font-family: trebuchet ms;"> </div><div style="text-align: left;font-family:trebuchet ms;"> <span style="font-size:100%;"><span style="font-weight: bold;"><br />Here is what Doctor D discovered when he became Patient D:</span></span></div><div style="font-family: trebuchet ms;"> </div><p class="MsoNormal" style="font-family:trebuchet ms;"><br /></p><p class="MsoNormal" face="trebuchet ms"><span style="font-size:130%;"><br /></span></p><p style="text-align: center; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;">1) Doctor D Is Mostly Right</span></p><p style="text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">Any reader of this knows that Dr. D’s insight is typically brilliant and totally useful.<span style=""> </span><span style="font-weight: bold;">I found myself actually looking up posts I had written for the solid and useful advice.</span></span></p><p class="MsoNormal" style="font-family: trebuchet ms;"><span style="font-size:100%;"> </span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">But even D has a lot to learn, so from here on I shall delve into the dark secrets I could only discover when crossing the line to the patient side</span>!<br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;"><span style="font-weight: bold;"><br /></span></span></p><div style="text-align: center;font-family:trebuchet ms;"> <span style="font-size:130%;"><span style="font-weight: bold;">2) </span><span style="font-weight: bold;">Being The Patient Is The Hardest Job In Medicine</span></span></div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"> </p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">We doctors think we have difficult work.<span style=""> </span>We have to slave our asses off for years in school.<span style=""> </span>We are expected to </span><span style="font-size:100%;">be perfect and heroic while working with huge uncertainty.<span style=""> </span><span style="font-weight: bold;">We try to protect your health, comfort, and life, while you patients just lay back and get taken care of!</span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;"><span style="font-size:100%;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiymrTXG-EV_TK8dyc0L0HELRDGtAwdqOfpoEuNq9FBvhhS_EQYCBuk2auzCwV0TFUg_hud8q6AxEOivRUl7TuG8d1ZkUhhwIu1JWKarwGuM3FqyfQs3F1U3tUX7EftNx2UOazJ-N5lXrb0/s1600/Helpless+under+the+surgeons+knife.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 320px; height: 198px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiymrTXG-EV_TK8dyc0L0HELRDGtAwdqOfpoEuNq9FBvhhS_EQYCBuk2auzCwV0TFUg_hud8q6AxEOivRUl7TuG8d1ZkUhhwIu1JWKarwGuM3FqyfQs3F1U3tUX7EftNx2UOazJ-N5lXrb0/s320/Helpless+under+the+surgeons+knife.png" alt="" id="BLOGGER_PHOTO_ID_5582676906219400706" border="0" /></a></span></span></span></span></p><p style="text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style=""><span style="font-size:85%;"><span style="font-style: italic;">Lying here isn't as relaxing as overworked docs think it is.</span></span><br /></span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">Just a few days as a hospital patient cleared my mind of any misconceptions.<span style=""> </span><span style="font-weight: bold;">Abject helplessness combined with severe pain trumps everything.</span><span style=""> </span>And helplessness is far worse than pain.<span style=""> </span><span style="font-style: italic;">Dr. D had never done anything as a doctor that caused more stress than allowing myself to be put to sleep for a major operation with a surgeon I had only spoken to for 30 seconds.</span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-style: italic;"><br /></span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-style: italic;"><br /></span></span></p><p style="text-align: center; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;">3) There Is Much More To Pain Than A Number</span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div> <div style="text-align: justify; font-family: trebuchet ms;"> </div> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p> <div style="text-align: justify; font-family: trebuchet ms;"> </div> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">Doctor D has written a lot on <a href="http://askanmd.blogspot.com/2009/10/never-say-10-how-doctors-interpret.html">pain scoring</a>, so <span style="font-weight: bold;">I attempted to rate my own pain as a matter of curiosity.</span> I have a good imagination for what 10 out of 10 pain would feel like, so I gave the feeling of multiple shattered bones crunching whenever my leg moved a <span style="font-weight: bold;">7</span>,<span style="font-weight: bold;"> </span>which made it the most intense pain I’ve ever felt, but I could totally handle the excruciating acute pain.</span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;">The real surprise was realizing that duration of pain was far worse than intensity.</span><span style=""> </span>I had a throbbing pain during my recovery that I could rate as a 4 if I’m generous, but it lasted for weeks and nearly drove me insane.<span style=""> </span><span style="font-style: italic; font-weight: bold;">Low-intensity pain that won't leave can make a person much more miserable than 10 out of 10.</span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-style: italic; font-weight: bold;"><br /></span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;"><b style="">4) Narcotics suck</b></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">I’ve seen a lot of nice people get addicted to <a href="http://askanmd.blogspot.com/2010/01/question-doctor-d-gets-asked-lot-why.html">opiate pain medicines</a>.<span style=""> </span><span style="font-weight: bold;">So Doctor D was the dude in the ER with a bone sticking out of his leg begging </span><b style="font-style: italic; font-weight: bold;">not</b><span style="font-weight: bold;"> to be given morphine.</span><span style=""> </span>When they finally convinced me to take the narcotics I was please to discover I didn’t get any high.<span style=""> </span>But what I did discover is that they made me miserable in other ways.<span style=""> </span><span style="font-weight: bold;">I was groggy, nauseated, itchy, constipated, and mushy-brained whenever I had to use them.</span><span style=""> </span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR6VBttLEEjZXUa9WrBLHVFIrIrowJqga9XTQp9whoWkzkUdCiGmolHf5T0kyh2Ve0CMQq2fnIATaYORdy9dqJQbB4d5nyieTj06bbnB82l2JPdLfYyIs5w5i6fdcXTDPTq_d3Yb2PsyD2/s1600/Narcotics+Suck.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 155px; height: 129px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgR6VBttLEEjZXUa9WrBLHVFIrIrowJqga9XTQp9whoWkzkUdCiGmolHf5T0kyh2Ve0CMQq2fnIATaYORdy9dqJQbB4d5nyieTj06bbnB82l2JPdLfYyIs5w5i6fdcXTDPTq_d3Yb2PsyD2/s320/Narcotics+Suck.png" alt="" id="BLOGGER_PHOTO_ID_5582679042782085970" border="0" /></a><span style="font-size:100%;"><span style="font-weight: bold;">Their efficacy varies drastically from person to person.</span><span style=""> </span>I can say with certainty that a 400 mg Ibuprofen was significantly better for pain for me than a 10 mg Percocet, but since my Ortho wouldn’t let me use ibuprofen I was stuck with narcotics. <span style="font-weight: bold;">So I then had to deal with the suspicious look when I told the doc I needed more because I had run out.</span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-style: italic;">I am so happy to be off those things!</span><span style=""> </span><span style="font-weight: bold;">As a physician, it was a bit eye opening to experience how inconsistent and imperfect our </span><i style="font-weight: bold;">best</i><span style="font-weight: bold;"> pain medicines are.</span><span style=""> </span>Managing the pain of a fellow human being is about as frustrating a situation as an MD can experience.<span style=""> </span>I doubt my prescribing patterns will change much, but <span style="font-weight: bold;">I do have a deeper appreciation for how hard it is to correctly wield the double-edged sword of pain medicines.</span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: center; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;">5) Being Disabled Can Really Crush An Ego</span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">Regular visitors to The Clinic of Doctor-Patient Relational Awesomeness are likely aware that Doctor D has a very healthy self-esteem.<span style=""> </span><span style="font-weight: bold;">3 weeks of lying on my back absolutely helpless and unable to do anything had me at the lowest place I’ve every been.</span><span style=""> </span>One night I—a generally tough dude—cried myself to sleep.<span style=""> </span>I’m up and moving better now, but I will likely have a limp the rest of my life.<span style="font-weight: bold;"> </span><span style="font-weight: bold;">My whole life I’ve been able to do everything physical I wanted to do.</span><span style="font-weight: bold;"> </span><span style="font-weight: bold;">Now I’m one of the broken people.</span><span style="font-weight: bold;"> </span><span style="font-weight: bold;">It’s going to take some getting used to.</span></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">I know as physician I often see people with broken and damaged bodies.<span style=""> <span style="font-weight: bold;"> </span></span><span style="font-weight: bold;">It kind of annoyed me when people whined about it.</span><span style=""> </span><span style="font-style: italic;">“Look, we can’t fix everything, so be a grown up, get over yourself, and quit complaining!”</span><span style=""> </span>It’s easy to feel this way when you aren’t the one with the disability.<span style=""> </span>I’ve given myself that same pep talk a lot in the last two months—It doesn't work as well when I’m the one with the gimp leg.<span style=""> </span>A lot of my patients have far worse problems than my leg ever was.<span style="font-weight: bold;"> </span><span style="font-weight: bold;">I’m manning up to fact that my leg’s gonna hurt for decades, but I think I’ll be much more patient towards patients with severe disabilities in the future. </span></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-style: italic;font-size:100%;" >You can't say you wouldn't complain about it if you've never been there</span><span style="font-style: italic;font-size:100%;" >—</span><span style="font-size:100%;"><span style="font-style: italic; font-weight: bold;">it's a good thing for docs to keep in mind.</span><br /></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: center; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;">6) There Isn’t A "Sort Of Person" These Things Happen To.</span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">Okay, I have to admit something a bit embarrassing here: <span style="font-weight: bold;">We doctors sometimes think of our patients as a completely alien form of human life.</span><span style=""> </span>It isn’t intentional.<span style=""> </span>We wouldn’t even admit it out loud.<span style=""> <span style="font-weight: bold;"> </span></span><span style="font-weight: bold;">It’s a weird psychological quirk that happens like a reflex.</span></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFtzOyEm1JXHEADr0bCnsMaXUdCfMsYgph3mMAc53f6DHPJuOXM5h0NifjTUeqoV7E85VxHY-bTCf1B8lLa_xPQNL73rodG4LUDqOWtrNLs6Pb_jYg8WsYDxmPvRZb8UyjFMJ2sBZ7J6Z6/s1600/Crippled+Patient.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 91px; height: 142px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFtzOyEm1JXHEADr0bCnsMaXUdCfMsYgph3mMAc53f6DHPJuOXM5h0NifjTUeqoV7E85VxHY-bTCf1B8lLa_xPQNL73rodG4LUDqOWtrNLs6Pb_jYg8WsYDxmPvRZb8UyjFMJ2sBZ7J6Z6/s320/Crippled+Patient.png" alt="" id="BLOGGER_PHOTO_ID_5582682526513437378" border="0" /></a></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;">Doctor’s see so much suffering and misery on a daily basis, </span>and we just can’t spend all our time worrying if it will happen to us too.<span> </span>So we develop this mental trick:<span style=""> </span><span style="font-style: italic; font-weight: bold;">"These things won’t happen to me, because I’m not that sort of person."</span><span style=""> </span>What sort of person? <span style="font-weight: bold;">Well, the sort of person who ends up the patient with a painful or horrible condition, of course!</span></span></p> <p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;"><br /></span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;">Unfortunately, psychological defense mechanisms are useless when the cold, harsh laws of physics apply pressure to human bones.<span style=""> </span><span style="font-weight: bold;">This shit happens to everybody—even doctors.</span><span style="font-weight: bold;"> </span><span style="font-weight: bold;">No one is the sort of person that has a debilitating injury, until it happens.</span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;"><br /></span></span></p><p style="text-align: justify;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /><span style=""> </span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: center; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:130%;">7) Some Doctors Just Can’t Be Helped</span></p> <p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"><br /><span style=""> </span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;">Doctor D has spent a lot of time educating you on how to deal with <a href="http://askanmd.blogspot.com/2009/08/why-are-doctors-such-jerks.html">difficult doctors</a>.<span style=""> </span><span style="font-weight: bold;">One of the worse maladies plaguing the medical field is piss-poor communication, and Dr. D’s orthopedist has about the communication skills of a mentally-retarded clam.</span></span></p><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;">There's a lot that patients can do to <a href="http://askanmd.blogspot.com/2010/08/how-to-get-straight-answer-from-md.html">improve their communication</a> with difficult doctors.<span style=""> </span>I had a lot of questions, and I found myself going and reading my own posts for advice on how to get answers out of a doc with weak bedside manner.</span></p> <p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"><br /><span style=""> </span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p face="trebuchet ms" style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;">In the end I just gave up.</span><span style="font-weight: bold;"> </span><span style="font-weight: bold;">This dude just couldn’t communicate like a normal human being with a patient (even a patient who had an MD).</span><span style=""> </span>I hear he’s an excellent surgeon and the fact that my leg got put back together is proof of this, but his ability to converse was just dismal.</span></p><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-size:100%;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPIKa8rwW2M7wDLAqHO9JDKc5qEhRnVp2HcyXT7G7yGaTWI-hUWT5kZLb4n5b7WeGKv19F04fh0B4JFF_UD0Tp4roz636FwSmDOHFbsM-zsyQHKC8sos7NH1-8ee5O9oQsCtoN0WG_cmOi/s1600/Bad+Communicator+MD.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 272px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPIKa8rwW2M7wDLAqHO9JDKc5qEhRnVp2HcyXT7G7yGaTWI-hUWT5kZLb4n5b7WeGKv19F04fh0B4JFF_UD0Tp4roz636FwSmDOHFbsM-zsyQHKC8sos7NH1-8ee5O9oQsCtoN0WG_cmOi/s320/Bad+Communicator+MD.png" alt="" id="BLOGGER_PHOTO_ID_5582683986567025362" border="0" /></a></span></span></span></p><div style="text-align: center;font-family:trebuchet ms;"><span style="font-size:85%;"><span style="font-style: italic;"> "I'm sorry, but I don't consider speaking with you to be part of my job description."</span></span><br /></div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;">When faced with a doctor who simply will not or cannot communicate a patient has two options: </span><span style="font-size:130%;">Leave or trust blindly.</span></span></p><p style="text-align: justify; font-weight: bold;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style=""></span>Dr. D had a FUBAR leg, there was only one Orthopedist available at 1:00 am, and the ER doc said this dude was a good surgeon.<span> </span>So I trusted him even though he seemed mentally incapable of explaining the operation he was going to do.<span> </span>The gamble paid off and the leg is improving, <span style="font-weight: bold;">but generally I would have to advise that you hit the road when paired with doctors incapable of communicating—especially if your doctor will need to manage your problem longer than a 2 hour surgery.</span></span></p><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-weight: bold;"><br /></span></span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"> </span></p><div style="text-align: justify; font-family: trebuchet ms;"> </div><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><blockquote>Okay, that’s my story and I’m sticking to it!<span style=""> </span><br /><br /><span style="font-weight: bold;">Doctor D is back to limping around the exam room with patients, and so Doctor D’s Internet Clinic of Doctor-Patient Relational Awesomeness is back too.</span><span style=""> </span><a href="http://askanmd.blogspot.com/2007/08/how-to-e-mail-doctor-d.html">Send in those questions</a> and I shall keep dropping knowledge on you!</blockquote></span></p><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><br /></p><p style="font-style: italic; text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:85%;">What do you think?</span></p><p style="font-style: italic; text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:85%;"><br /></span></p><p style="font-style: italic; text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:85%;">Any of you medical folks have similar experiences and want to add some points?</span></p><p style="font-style: italic; text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:85%;"><br /></span></p><p style="font-style: italic; text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:85%;">Any of you with more experience as patients wish Dr. D had picked up more from his time on your side? If so, what did I miss?</span></p><p style="font-style: italic; text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:85%;"><br /></span></p><p style="text-align: center;font-family:trebuchet ms;" class="MsoNormal"><span style="font-size:100%;"><span style="font-size:85%;"><span style="font-style: italic;">Doctor D always loves to hear your thoughts in the comments!</span></span><br /></span></p><p style="text-align: justify; font-family: trebuchet ms;" class="MsoNormal"><br /></p><p style="text-align: justify;" class="MsoNormal"><span style="font-size:100%;"><br /></span></p> <p class="MsoNormal"><span style="font-size:12pt;"> </span></p>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com25tag:blogger.com,1999:blog-344900867722860530.post-49506437245906795212011-03-01T17:45:00.013-05:002011-03-01T19:44:25.021-05:00Is It March Already?<span style="font-size:100%;">How did it get to be March so quickly?</span><span style="font-weight: bold;"> Apparently, in his </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/12/time-out.html">hiatus post</a><span style="font-weight: bold;"> Dr. D said he'd be back before the end of February.</span> <span style="font-style: italic;">Oops!</span><br /><div style="text-align: justify;"><br /><span style="font-weight: bold;">But wait! I have an excuse: </span><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiP508QvKSHJpDQvZhr_OxT7lKWluNINY_2XFy6-OBbZJtpiniXKwmImcVXqHFYwAbw06Q4rp6WHNv0oQnkWyVyZ-X6hvcsDiezzJt2STPWqRr2u2rnXkDQRBQPFeAhbXzgub6gyyHWh1wO/s1600/Dr+D+-+Titanium+Superhero.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 189px; height: 259px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiP508QvKSHJpDQvZhr_OxT7lKWluNINY_2XFy6-OBbZJtpiniXKwmImcVXqHFYwAbw06Q4rp6WHNv0oQnkWyVyZ-X6hvcsDiezzJt2STPWqRr2u2rnXkDQRBQPFeAhbXzgub6gyyHWh1wO/s320/Dr+D+-+Titanium+Superhero.png" alt="" id="BLOGGER_PHOTO_ID_5579273316556968274" border="0" /></a><blockquote><span style="font-weight: bold;">During his hiatus Doctor D found himself on the other side of the exam room.</span> Yes, D managed to destroy most of the bones in his leg and <a href="http://twitter.com/search?q=%23DrDAsAPatient">became an orthopedic patient</a>!<br /><br /><span>I'll have a full report for you soon, but for now I can tell you that</span><span style="font-weight: bold;"> Dr. D's skeleton has been reinforced with Titanium and he is considering changing careers to become a bionic superhero.</span></blockquote><span style="font-weight: bold;">Never fear, readers! <span style="font-size:130%;"><span style="font-size:100%;">Doctor D didn't forget his</span> Clinic of Doctor-Patient Relational Awesomeness!</span></span><span style="font-size:130%;"> </span> So be mellow and keep the questions coming!<br /><br /></div> <div style="text-align: center;"><span style="font-style: italic;">I'll have an awesome post for you to read by this time next week, </span> <span style="font-style: italic;">and <a href="http://askanmd.blogspot.com/2010/12/time-out.html?showComment=1299003323050#c7134123099047445989">Tracy</a> will make sure I keep my word!</span><br /></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com9tag:blogger.com,1999:blog-344900867722860530.post-40631078263557654252010-12-08T14:24:00.011-05:002010-12-08T15:38:19.024-05:00Time Out<div style="text-align: justify;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhE79f0KJLl2GX2EDtom6LnN_6__apt7yzfU_sJ4916IFwu98LsRbNWNBh2Pj8SoQ1looQsAj5EF75GLpsFEtEDlScyHxNXMPB0bZ-Xg7FZkPZX819tElBuq5mvHdqPsv1Z-1ajFdXogfME/s1600/Dr.+D%2527s+Time+Out.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 190px; height: 214px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhE79f0KJLl2GX2EDtom6LnN_6__apt7yzfU_sJ4916IFwu98LsRbNWNBh2Pj8SoQ1looQsAj5EF75GLpsFEtEDlScyHxNXMPB0bZ-Xg7FZkPZX819tElBuq5mvHdqPsv1Z-1ajFdXogfME/s320/Dr.+D%2527s+Time+Out.png" alt="" id="BLOGGER_PHOTO_ID_5548405642210594898" border="0" /></a><a style="font-style: italic; font-weight: bold;" href="http://askanmd.blogspot.com/2010/02/40-days-and-40-nights.html">Last year Dr. D took the season of Lent to unplug</a><span style="font-style: italic;"><span style="font-weight: bold;"> from the internet for a while and contemplate the deeper meaning of life.</span> It was an invigorating time of growth and reflection... </span><br /></div><div style="text-align: justify;"><br /><span style="font-weight: bold;">Yeah, you guessed it, Dr. D is putting his blog on "timeout" again. </span><br /><br /><span style="font-weight: bold;">We're going to pause AskAnMD for 2 months. </span>Dr. D still has a lot of great stuff to blog about, but for now he just doesn't have the time. We'll be back sometime in February.<br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Why?</span></span><span style="font-size:130%;"><br /></span></div><br /><span style="font-weight: bold;">My grandmother as well as </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/11/my-favorite-patient-died-today.html">my favorite former patient</a><span style="font-weight: bold;"> died in November.</span> This got me thinking... Dr. D keeps a list of things to do. That list included: <span style="font-style: italic;">"Call the Dude"</span> and <span style="font-style: italic;">"Visit Grandma D"</span> for many months. I procrastinated even when I knew the end was near for both of them. <span style="font-weight: bold;"> I could have reached out to either of </span><span style="font-weight: bold;">them while they were still alive, but I was too busy.</span><br /><blockquote><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTSQn9X09Pgjn2rUleyiMUqty67i9Q4wARHhw_sWJZS1DlbhaxqvM-O_9ry6cHpW7vjI6KVjYFP0EA9SMN25co5dzJTFHwWz_qb8Sk2hs1XeDSighkka6UW-g0c3Js9RJ82GhghZXhFQSr/s1600/Grandma+D+in+her+prime.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 139px; height: 185px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTSQn9X09Pgjn2rUleyiMUqty67i9Q4wARHhw_sWJZS1DlbhaxqvM-O_9ry6cHpW7vjI6KVjYFP0EA9SMN25co5dzJTFHwWz_qb8Sk2hs1XeDSighkka6UW-g0c3Js9RJ82GhghZXhFQSr/s320/Grandma+D+in+her+prime.png" alt="" id="BLOGGER_PHOTO_ID_5548407807281511810" border="0" /></a><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFJyNqdFDGRaFBnPsNXms-C4nxLXLfOvBFdyNaUAjNRWGx1xZ2ugpMTbRrL6mmwzPn7hI2VhHPhQ5og69OMQj5-TWWXl0pSlN_eALyHL4ZSPRlFdwESXO8c-N6Jl0dC_48IlCkF1F0CJ9h/s1600/The+End+Of+Life.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 139px; height: 186px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFJyNqdFDGRaFBnPsNXms-C4nxLXLfOvBFdyNaUAjNRWGx1xZ2ugpMTbRrL6mmwzPn7hI2VhHPhQ5og69OMQj5-TWWXl0pSlN_eALyHL4ZSPRlFdwESXO8c-N6Jl0dC_48IlCkF1F0CJ9h/s320/The+End+Of+Life.png" alt="" id="BLOGGER_PHOTO_ID_5548408029192743218" border="0" /></a><br /><br /><br /><span style="font-weight: bold;">Grandma D: </span><span><span style="font-style: italic;"><br />1918-2010</span></span></div></blockquote><br /><br /><br /><br /><br />I love this blog, but it takes a lot of my time. <span style="font-weight: bold;">I spend a lot of time thinking on the questions you write me, and writing, re-writing, checking, and formatting a post takes about 6 hours for me.</span><span style="font-style: italic;"> Yeah, I'm that slow! </span><br /><br />Going faster would make me put out rambling, useless junk, and I wouldn't do that to my readers.<br /><br /><span style="font-weight: bold;">So posting every week takes a significant chunk of my free time. So for the next few months I've decided to allot more time to my friends and family who are still breathing.</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">I Shall Return!</span></span><span style="font-size:130%;"><br /></span></div><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM5ZFpU1chXsu9woXGEOnAwel9hxb8h2hVGPmhnJrPrKBFkpkL90gftIej7Vupq3g4sQoNKTgni2kL3GykkmFeh9AERkHK2m_oTAVrXgkgJ6xHDaw-WnqHfMO3Fyiqa-CBR06DngZDAfsI/s1600/I%2527ll+be+Back%2521.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 152px; height: 107px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjM5ZFpU1chXsu9woXGEOnAwel9hxb8h2hVGPmhnJrPrKBFkpkL90gftIej7Vupq3g4sQoNKTgni2kL3GykkmFeh9AERkHK2m_oTAVrXgkgJ6xHDaw-WnqHfMO3Fyiqa-CBR06DngZDAfsI/s320/I%2527ll+be+Back%2521.png" alt="" id="BLOGGER_PHOTO_ID_5548409481471465586" border="0" /></a><span style="font-weight: bold;">Doctor D will be back in his online clinic of doctorly wisdom and sarcasm soon, but for now you'll have to survive the long nights of Winter without him.</span><br /><br /><span style="font-weight: bold;">But be of good cheer!</span> There are lots of great medblogs out there to keep you entertained and informed. The ones listed on the blog roll to your right are an excellent place to start.<blockquote style="font-weight: bold;"></blockquote><span style="font-weight: bold;">You can also catch up on some of the really awesome stuff in the </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2008/08/best-of-askanmd.html">AskAnMD archives</a><span style="font-weight: bold;">, and if you get board and desperate for a fix of Doctor D's inane observations you can </span><a style="font-weight: bold;" href="http://twitter.com/Doctor_D_MD">follow him on Twitter</a><span style="font-weight: bold;">.</span><br /><br /><span style="font-weight: bold;">You can also still </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2007/08/how-to-e-mail-doctor-d.html">email Dr. D</a><span style="font-weight: bold;"> your questions</span><span style="font-weight: bold;">—</span>just don't expect any immediate answers.<br /><br /><span style="font-weight: bold;">Then sometime in mid-February just when you had almost forgetten about Doctor D your </span><a style="font-weight: bold;" href="http://feeds.feedburner.com/AskAnMd">feed for AskAnMD</a><span style="font-weight: bold;"> will roar to life and bring you awesome insights on that will totally blow your mind!</span><br /></div><br />Until then:<br /><div style="text-align: center;"><span style="font-style: italic;">I love you guys!</span><br /><br /><span style="font-style: italic;">Merry Christmas, Happy New Year, and all that other cheerful holiday whatnot!</span><br /></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com8tag:blogger.com,1999:blog-344900867722860530.post-52750638079617799782010-11-29T14:12:00.018-05:002010-11-30T22:19:06.649-05:00The Doctor Will Grope You Now<blockquote style="font-weight: bold;"><span style="font-size:180%;">Doctor D, what are your thoughts on the TSA?</span></blockquote><div style="text-align: justify;">Okay, so no one <span style="font-style: italic;">actually</span> emailed me this, but it’s high time Doctor D set things straight!<br /><br /><span style="font-weight: bold;font-size:130%;" >Dr. D’s prescription for America:</span><br /><blockquote style="font-weight: bold;"><span style="font-size:130%;">Stop being such snively, self-important, brats!</span></blockquote><span style="font-style: italic;">So what gives a medical doctor any right to speak on transportation and counter-terrorism? </span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiK_DdS4jBR_sm_3k7OccHXEYsz4Hq5qdyI1lT5RJdvJAtwSePncHRY9eMLZixpe-mKwjZb3QnsQ0Hw2ArNY3Fxs86YFHVU4SXPOcQjWuQ24HUrehBqBooxfpC_u4CiAGuFN6jif5rBrLTc/s1600/Is+all+touching+dirty%253F.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 111px; height: 146px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiK_DdS4jBR_sm_3k7OccHXEYsz4Hq5qdyI1lT5RJdvJAtwSePncHRY9eMLZixpe-mKwjZb3QnsQ0Hw2ArNY3Fxs86YFHVU4SXPOcQjWuQ24HUrehBqBooxfpC_u4CiAGuFN6jif5rBrLTc/s400/Is+all+touching+dirty%253F.png" alt="" id="BLOGGER_PHOTO_ID_5545086596586462642" border="0" /></a><span style="font-weight: bold;">Doctors also do full body searches. We call them physical exams. </span><br /><br />During these exams we touch and look at every part of the body. <span style="font-weight: bold;">I stick my fingers in vaginas, rectums, and mouths. I even sometimes do these exams on children—Oh, the horror!</span> <span style="font-style: italic;">Lock up that sick man!!!!</span><br /><br />How do doctors get away with this disgusting violations of your rights? <span style="font-weight: bold;">We feel you up under the guise of keeping you safe. The TSA learned their trick from doctors!</span><br /><br /><span style="font-weight: bold;">These exams are theoretically voluntary, but most doctors will decline to take care of you unless you submit to some sort of medical pat-down. </span> What an outrage!<br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Is All Touching Dirty? </span></span></div>Look, we all recognize that this is a weird situation. <span style="font-weight: bold;">Touching a stranger’s body is awkward for both the toucher and the touchee. </span> It is human nature to reserve close physical contact for family, intimate friends, and lovers. <span style="font-weight: bold;">But sometimes we must do things that feel unnatural.</span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizun0FwGRqcrbgNbu3a3Tj1YLX7o5VhzEAuOxerXzPuAZUAuhkPllLGAZzWaIgI8_tO3nKNBeai-kZy-DQpVYGpPscM4xZp_GmF5-UOfUXhrpisSPT5HFB92E-CqR3heegP73b7EYzMsFQ/s1600/Doctor+D+has+to+do+this+in+the+Hosptial.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 194px; height: 195px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizun0FwGRqcrbgNbu3a3Tj1YLX7o5VhzEAuOxerXzPuAZUAuhkPllLGAZzWaIgI8_tO3nKNBeai-kZy-DQpVYGpPscM4xZp_GmF5-UOfUXhrpisSPT5HFB92E-CqR3heegP73b7EYzMsFQ/s400/Doctor+D+has+to+do+this+in+the+Hosptial.png" alt="" id="BLOGGER_PHOTO_ID_5545086841150232034" border="0" /></a><span style="font-weight: bold;">It is my job to touch every person who seeks my help. </span><br /><br /><span style="font-weight: bold;">Sorry, but when we spend all day touching bodies we kind of get used to it.</span> You may see your body as a unique and private expression of yourself, but we see it simply as a dull object that must be checked for signs of danger. <blockquote><span style="font-style: italic;">You may feel violated because I had to check your prostate, but it didn’t bother me one bit.</span><span style="font-style: italic; font-weight: bold;"> Checking your rectum is no more disturbing to me than checking your ear.</span> </blockquote>Of course, we try to be sensitive. Doctor D has had to do some invasive exams on little kids and sexual assault victims. <span style="font-weight: bold;">We should take our patients’ feelings into account, but</span> <span style="font-weight: bold;">not not doing our job at all isn’t sensitivity—it’s incompetence.</span> <span style="font-weight: bold;"> </span><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;"><br />Here's The Naughty Part </span><span style="font-weight: bold;">(</span><span style="font-style: italic;">Stop here if skimming!</span><span style="font-weight: bold;">)</span></span></div><span style="font-weight: bold;">What everybody's getting really worked up about is genitals!</span> You only let people touch those in the most intimate of moments, except of course at the doctor’s office or the airport. Then you get a stranger poking around some sensitive spots.<span style="font-size:130%;"><span style="font-weight: bold;"><span style="font-size:100%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6uyU_bo2DGgVTrxX6Yad3WvfsAgVMqVia224o9QmKVusWkN9JVZn1tVoeyHJ5sNeWuqwc6RP6KE1svuC5ctLyzSZcvKm09BySaYpGJUiugredtWARNxR3okqCFpq9RDG__MXiJosN33hz/s1600/Nakedness+and+Professionalism.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 299px; height: 226px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6uyU_bo2DGgVTrxX6Yad3WvfsAgVMqVia224o9QmKVusWkN9JVZn1tVoeyHJ5sNeWuqwc6RP6KE1svuC5ctLyzSZcvKm09BySaYpGJUiugredtWARNxR3okqCFpq9RDG__MXiJosN33hz/s400/Nakedness+and+Professionalism.png" alt="" id="BLOGGER_PHOTO_ID_5545085906823712258" border="0" /></a></span></span></span><span style="font-weight: bold;">Doctor D will go ahead and answer your question now:</span> <blockquote style="font-weight: bold;"><span style="font-size:130%;">No. We are <span style="font-style: italic;">not</span> thinking about sex, and if you are that’s <span style="font-style: italic;">your </span>problem—not ours.</span></blockquote>We aren’t eunuchs or anything like that—we are just focused on the job. Doctor D is a red-blooded heterosexual man who loves women as much as the next guy, but D can honestly say he has never once felt anything amorous about a patient during an exam. <span style="font-weight: bold;">You could be a supermodel or an 80 year old grandmother and Doctor D feels exactly the same about touching you during an exam. </span> Doctors learn quickly to see the bodies we work on as tasks to be completed rather conduits of passion.<br /><br /><span style="font-weight: bold;">Sure there is the occasional true sicko, but these people so rare that you chances of having one of them examine you is pretty minuscule. </span> Doctor D has known quite a few doctors who were walking hormones and hit on everything of the opposite sex they ever met, and still these docs were nothing but professional and trustworthy when doing physical exams. <span style="font-weight: bold;">A professional touching of the private parts is about as unromantic a situation as possible. </span><blockquote style="font-weight: bold;">The attracting effect of the human body has no power over me when I wear the white coat! "<span style="font-style: italic;">Sorry, but I just don’t feel that way about you. It’s not you—it’s me" </span></blockquote><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Can We Handle This Like Grown-Ups?</span></span></div><span style="font-weight: bold;">I feel for the TSA agents. They are getting harassed for just doing their job. </span> Physical exams suck. I’m sure pat-downs do too. But if they are necessary in order to ensure your safety and they are required to fly, then <span style="font-weight: bold;">you should either grin and bare it or plan a long road trip.</span><br /><br /><span style="font-weight: bold;">This TSA fiasco irritates Doctor D to no end!</span> It’s not that people dislike body searches. That is understandable. <span style="font-weight: bold;">It’s the attitude of enraged entitlement that irks Doctor D. Everybody demands everything be done perfectly, safely, and cheaply and with no inconvenience to them whatsoever:</span><span style="font-style: italic;"><br /><br /></span><div style="text-align: center;"><span style="font-style: italic; font-weight: bold;"><span style="font-size:100%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQFCh7NqPpsEL_PdI-BAbFUM7aYfn1NgKmcwBo_XZjThnksiX3ERqVqlg0oeHUX_jUVpih606Y8Mdddu-vYEEydwAasGuyuc1k5eCFf_b6TgI761Tdxlfa5gRPz0QAajPtFDoR0d3auCE2/s1600/Hissy+Fit+at+the+Doctor%2527s+Office.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 267px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQFCh7NqPpsEL_PdI-BAbFUM7aYfn1NgKmcwBo_XZjThnksiX3ERqVqlg0oeHUX_jUVpih606Y8Mdddu-vYEEydwAasGuyuc1k5eCFf_b6TgI761Tdxlfa5gRPz0QAajPtFDoR0d3auCE2/s400/Hissy+Fit+at+the+Doctor%2527s+Office.png" alt="" id="BLOGGER_PHOTO_ID_5545081856320859490" border="0" /></a></span></span><span style="font-size:85%;"><span style="font-style: italic;">“I feel bad! I demand your full attention. Don’t make me wait; don’t poke at me; and don’t you dare tell me the treatment has risks or side effects! I have a constitutional right to everything I want right now and without any bother!”</span></span><br /></div><br /><span style="font-weight: bold;">And we wonder why the rest of the world thinks we are spoiled assholes?</span><br /><br /><span style="font-weight: bold;">Doctor D will be flying over the Christmas holidays, and when it’s time for his pat-down he will thank the beleaguered TSA agents for keeping us safe.</span><br /></div><br /><div style="text-align: center;"><span style="font-size:85%;"><span style="font-style: italic;"></span></span><blockquote><span style="font-size:85%;"><span style="font-style: italic;">Your thoughts?</span><br /><br /><span style="font-style: italic;">Any of you out there who's had a TSA pat-down that thinks it is worse than a pelvic exam? </span> <span style="font-style: italic;"> </span> <span style="font-style: italic;"><br /><br />Do you think patients should get treatments they want while “opting out” of the physical exam?</span> <span style="font-style: italic;"> </span> <span style="font-style: italic;"><br /><br />While Doctor D always loves to hear your thoughts, <span style="font-weight: bold;">if your comments are too whiny or bratty Dr. D will hunt you down and administer a punitive rectal exam!</span></span></span></blockquote><br /></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com41tag:blogger.com,1999:blog-344900867722860530.post-84758868116988828532010-11-13T08:59:00.012-05:002010-11-13T09:44:54.427-05:00Growing Up Sick<span style="font-weight: bold;">A teacher asks Doctor D about a diabetic teenager in his class:</span><div style="text-align: justify;"><span style="font-weight: bold;"></span> <blockquote><span style="font-weight: bold;">“His sugar readings are often over 400. His mom says this is normal. Can this be normal?”</span></blockquote>Before we start Doctor D has to throw out his usual disclaimer: <span style="font-weight: bold;">No medical treatment advice shall ever rear it ugly head in this post!</span> <span style="font-style: italic;">Okay, I feel so much better!</span> Now on to normalcy:<br /></div> <span style="font-size:130%;"><span style="font-weight: bold;"><br /></span></span><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">What is NORMAL?</span></span></div><blockquote><div style="text-align: justify;"><span style="font-weight: bold;">a)</span> A state of harmony within the body and mind that leads to health and well-being.<br /></div><br /><div style="text-align: justify;"><span style="font-weight: bold;">b)</span> The typical or status quo for a person; the way things usually are. [eg: <span style="font-style: italic;">“Doctor D’s weekly posts are normally late.”</span>]<br /></div><br /><div style="text-align: justify;"><span style="font-weight: bold;">c)</span> WTF? There is no such thing as "normal" for a teenager in the clutches of puberty.</div></blockquote><div style="text-align: left;"><span style="font-style: italic; font-weight: bold;">I’m guessing that mom meant something between B and C.</span></div><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The Trials and Tribulations of Puberty:</span></span><br /><br /></div><div style="text-align: justify;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO_KHb76e-4_7wmBF90aLX1bVMCmJ37U7OXzarqdabkln-csfzh2slOOgEJt7fq9WZ7rOSqleYfZLgoCYbcHqrCZa_BvPkWrznz3x2CTFnp1_My-qvlhdAtcgkTm_bRJw-vu9zsFfB3o3-/s1600/Chronically+ill+teen.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 174px; height: 152px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO_KHb76e-4_7wmBF90aLX1bVMCmJ37U7OXzarqdabkln-csfzh2slOOgEJt7fq9WZ7rOSqleYfZLgoCYbcHqrCZa_BvPkWrznz3x2CTFnp1_My-qvlhdAtcgkTm_bRJw-vu9zsFfB3o3-/s320/Chronically+ill+teen.png" alt="" id="BLOGGER_PHOTO_ID_5539040352485068690" border="0" /></a><span style="font-weight: bold;">The teen years are some of the toughest in a life.</span> You suddenly realize that you are no longer a child and find yourself drowning in a sea of raging hormones. <span style="font-weight: bold;">You don't want to hear your parents advice or follow their rules, you are desperate to fit in with your peers, you feel invincible, and you can’t wait to </span><span style="font-weight: bold;">take risks</span> (especially the ones adults tell you not to). The only people more stressed than teenagers are their parents.<br /><br /><span style="font-weight: bold;">Now add to a chronic illness to all the “normal” teen drama and you have a really volatile mix!</span> If having a chronic illness and being dependent on doctors, tests, and treatments can push even a stable, well-adjusted adult to the limit, just think of the havoc it can wreck when you are 13!<br /><br /><span style="font-weight: bold;">Type I Diabetes is a perfect example of this:</span> <blockquote>Patients are often diagnosed as small children. They often don’t remember a time they weren’t constantly counting carbs and taking insulin under their parents direction. <span style="font-weight: bold;">Doctor D has seen it again and again: a diabetic kid does fine until about 13 when they suddenly decide they have to live a “normal” life.</span> <span style="font-weight: bold;">The teen acts as if there is no illness and begins ignoring all the rules that keep them alive.</span> In my experience chronically ill teens have difficult identity issues and can be in dangerous denial about the seriousness of their illness.<br /><br />Parent during these times get frustrated and burnt out. <span style="font-weight: bold;">The harder they try to manage their teen's illness the more the child resists.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjr_ZLvqjO_r2Ctr1DKcLs6LQaPKywOzH4ipZkomMf3xSCXgktCo33jWNewcmIWO1Sd7Wq92GWQRXSMZJWcxHAdYiKZtEg-qnBRtblZvJqJH-Q-3KnJk9aUWyNuqSO6KlD_VZ0kiY5xdxZ1/s1600/Teen+Parent+Medicine+Conflict.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 323px; height: 280px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjr_ZLvqjO_r2Ctr1DKcLs6LQaPKywOzH4ipZkomMf3xSCXgktCo33jWNewcmIWO1Sd7Wq92GWQRXSMZJWcxHAdYiKZtEg-qnBRtblZvJqJH-Q-3KnJk9aUWyNuqSO6KlD_VZ0kiY5xdxZ1/s400/Teen+Parent+Medicine+Conflict.png" alt="" id="BLOGGER_PHOTO_ID_5539040928178481010" border="0" /></a></span></blockquote><div style="text-align: center;"><span style="font-size:85%;"><span style="font-style: italic;">"I SAID take your insulin!!!!"</span></span><br /><br /></div><span style="font-weight: bold;">These power struggles between parents and teens happen in most homes, but when the teen has a serious chronic illness the tension can rise astronomically!</span><br /><br /><br /><div style="text-align: center;"><span style="font-weight: bold;font-size:130%;" >So why did mom say everything’s okay?</span><br /><br /></div><span style="font-weight: bold;">Parents of chronically ill teens often feel helpless and very guilty that they cannot protect their kid's health the way they used too.</span><br /><br />A teacher asking about his illness could be a very sensitive issue for the the teen and the parent. <span style="font-weight: bold;">I can understand the mother just answering </span><span style="font-style: italic; font-weight: bold;">"oh that's normal for him"</span><span style="font-weight: bold;"> to avoid discussing the extreme stress and difficulty of the situation. </span><br /><br />Sometimes when everything’s going to hell in a handbasket it’s easier just to pretend we’re all fine.<br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">So you really want to help?</span></span><br /></div><br /><span style="font-weight: bold;">But if you know things really aren’t fine, and you’re someone like a relative, teacher, doctor, counselor, friend, etc. you really should try to help the frustrated family. </span><br /><br />Here’s how you offer assistance without making things worse:<br /><blockquote><span style="font-size:130%;"> <span style="font-weight: bold;">1) You must be sensitive to what the teen and the parents are going through.</span></span> If you act like you are just going to ride in on your white horse and save everybody you will get shut out by the parents and teen pretty quick. (<span style="font-style: italic;">Doctor D has learned that one the hard way!</span>) <span style="font-weight: bold;">Start by acknowledging how difficult the situation is to both the teen and the parent.</span><br /><br /><span style="font-size:130%;"> <span style="font-weight: bold;">2) Make it clear that you will protect their privacy. </span></span> <span style="font-style: italic;">The teen should know you won’t embarrass them in front of their peer by exposing their illness against their will. </span> <span style="font-weight: bold;">The parents should know you won’t shame them as bad parents because their teen’s care isn’t working. </span></blockquote><br /><div style="text-align: center;"><span style="font-weight: bold;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTRkk9vDT4go2IzrSeineOiTaaVjHEzUUFOs8u9sPrQioCQwx5GdzikZv-1siBIXPSe3S2hx5f6Z2CuJ62JZL-WthkNTRuuzMpvEOQ1zs8nI2nqdN1ecr4s7U4zeq-iQ0PQCji0IOENUg7/s1600/Awkward+Teens+Superbad.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 174px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTRkk9vDT4go2IzrSeineOiTaaVjHEzUUFOs8u9sPrQioCQwx5GdzikZv-1siBIXPSe3S2hx5f6Z2CuJ62JZL-WthkNTRuuzMpvEOQ1zs8nI2nqdN1ecr4s7U4zeq-iQ0PQCji0IOENUg7/s400/Awkward+Teens+Superbad.png" alt="" id="BLOGGER_PHOTO_ID_5539042128863578770" border="0" /></a></span></span><span style="font-size:85%;"><span style="font-style: italic;">"Embarrassed? Us? No way! We're like the the smoothest guys we know. ...did we seem embarrassed? Because we totally aren't."</span><br /></span></div><span style="font-size:130%;"><span style="font-weight: bold;"></span></span><blockquote><span style="font-size:130%;"><span style="font-weight: bold;">3) Talk to them like they are normal. </span></span> (<span style="font-style: italic;">Normal definition A</span>) <span style="font-weight: bold;">Even sympathy can be irritating and isolating for a family dealing with chronic disease. </span>Talk to the teen and the parents like you are talking to normal people dealing with normal problems.<br /><br /><span style="font-size:130%;"> <span style="font-weight: bold;">4) Use your strategic position. </span></span> Parents and teens often struggle to a stalemate. <span style="font-weight: bold;">Being neither the parent nor the teen offers you a huge tactical advantage for breaking the deadlock.</span> Let’s say you’re an adult such as a teacher or doctor. Sure you’re authority figure, but <span style="font-weight: bold;">you aren’t the parent</span> therefore the teen is much more likely to listen to your advice about sticking with treatment. <span style="font-style: italic;"> So many of the stresses in a teen’s life are social so if you are in or around the social environment you may be in a unique position to explain the stresses the kid is going through to the parents.</span> If you are a peer then you can help the teen "normalize" their chronic illness and see that it’s not something to be ashamed of.<br /><br />Being a semi-independent semi-adult is a weird state that strains the therapeutic partnership with the parents that previously worked so well for the chronically ill child. <span style="font-weight: bold;"> As an outsider you can help both parties create the new strategy that will help the young person manage their disease for years to come.</span><br /><br /><span style="font-size:130%;"><span style="font-weight: bold;">5) Be patient. </span></span> Unhealthy patterns usually don’t straighten out overnight. Nor do strained relationships between chronically ill teens and their caregivers. Often breakthroughs are followed with setbacks. <span style="font-weight: bold;">Take the long view and remember the tumultuous teen years don’t last forever.</span></blockquote><span style="font-weight: bold;">Thanks to this awesome reader for caring about his chronically ill student! </span><br /><br /></div><div style="text-align: center; font-style: italic;"><span style="font-size:85%;">Doctor D always enjoys hearing your thoughts in the comments.<br /><br />Have any of you worked with chronically ill teens or their families?<br /><br />I know some readers have had chronic illnesses since childhood. How did you successfully navigate your teen years?</span></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com10tag:blogger.com,1999:blog-344900867722860530.post-61835061314032448032010-11-01T21:21:00.012-04:002010-11-10T05:10:43.058-05:00My Favorite Patient Died Today<div style="text-align: justify;"><span style="font-weight: bold; font-style: italic;">I just got a call from one of his relatives who found my number in his wallet:</span><br /><br /><span style="font-size:130%;"><span style="font-weight: bold;">“The Dude”</span></span> was one of Doctor D’s first patients. He was assigned me when I was a new doc starting out in residency.<br /><br /><span style="font-weight: bold;">The Dude was one of those people that we all go into medicine to </span><span style="font-style: italic; font-weight: bold;">“help.”</span> He was poor, and on disability, and had never gone any further than high school. The Dude also weighed about 400 pounds and smoked 4 packs a day, and he hated taking medicine .<span style="font-weight: bold;">..and it was new Doctor D’s job to </span><span style="font-style: italic; font-weight: bold;">“take care of him.” </span><span style="font-weight: bold;"></span><br /><br /><span style="font-weight: bold;">Medically speaking, I never was much good for The Dude. </span> He kept doing all the things that eventually lead to his demise. <span style="font-weight: bold;">In the end though, it was he that did me immeasurable good.</span><br /><br />He actually preferred residents to our better-trained teachers, <span style="font-style: italic;">“I love these new Baby Docs when they come each year!”</span> he exclaimed when he met Doctor D. <span style="font-weight: bold;">From then on Dr. D and the Dude were always together.</span> The Dude had a lot of office visits and hospitalizations. <span style="font-weight: bold;">He was the epitome of the </span><span style="font-style: italic; font-weight: bold;">“difficult patient”</span><span style="font-weight: bold;"> and D spent his first year as a doctor stressing about how to save The Dude from impending death.</span><br /><br /><div style="text-align: center;"><div style="text-align: justify;"><span style="font-size:130%;">But it was The Dude who won out.</span><span style="font-weight: bold;font-size:130%;" > His infectious kindness and joy in the face of pain and illness inoculated Doctor D against the harsh medical world around us.</span><br /></div><span style="font-weight: bold;"> </span></div><blockquote>One day D visited The Dude in the ICU and muttered, <span style="font-style: italic;">“How am I going to save you, Dude?”</span><br /><br />The Dude let out a gravelly, smokey chuckle, <span style="font-style: italic;">“You don’t need to save me Doctor D! You’re just nice to me and I appreciate that.”</span></blockquote><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGGd-vygR2-9yC3Xamne5yVb3hVbLqisZBSS2dJxXPYQ2j5c_m2v-coj9E3c-ysfmGQ7oHU05m_xacSK_MM8QXQP78c4uEcE6gSc17M_Pyf5OJsWRtzISzqjwk3RWm4aCy6LEm0lbn6XIi/s1600/The+Dude+laid+to+rest.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 244px; height: 154px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGGd-vygR2-9yC3Xamne5yVb3hVbLqisZBSS2dJxXPYQ2j5c_m2v-coj9E3c-ysfmGQ7oHU05m_xacSK_MM8QXQP78c4uEcE6gSc17M_Pyf5OJsWRtzISzqjwk3RWm4aCy6LEm0lbn6XIi/s400/The+Dude+laid+to+rest.png" alt="" id="BLOGGER_PHOTO_ID_5537861123818522098" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">The Dude is laid to rest</span></span><br /></div><br />Our doctor-patient relationship evolved over our years together. I did less telling him what to do and more sitting at the feet of one of the wisest human beings I have ever known. <span style="font-weight: bold;">The Dude lacked any book smarts, but I know he was brilliant. He understood how a joyful attitude can keep you alive when every textbook says you should have died years ago. </span><br /><br /><span style="font-weight: bold;font-size:130%;" >The Dude had about the most unhealthy body and physical habits you can imagine, but he had the healthiest soul of any person I have ever met. He taught Doctor D that there is so much more to life than diagnoses and treatments.</span><br /><br /><span style="font-weight: bold;">The Dude promised he would try to stay alive long enough to see me graduate from my residency.</span> He ended up outliving his promise by years. I moved to another state after graduation, but we stayed in touch. <span style="font-weight: bold;"> I was no longer his doctor, but we remained friends.<br /></span><span style="font-weight: bold;"></span><br />I took my son Little D on a road trip when he was just a baby to meet my sage friend. It was well worth exposing the kid to a little second-hand smoke. <span style="font-weight: bold;">It was like taking your child to be blessed by a living saint. </span><br /><br />The Dude and I would write or talk on the phone every couple of months. <span style="font-weight: bold;"> I started this blog with The Dude in mind. I wanted to answer questions for real folks like him that didn’t give a damn about medical stuff, but found themselves stuck in doctors offices and hospitals anyway.</span> He's the only patient I ever cared for in real life who knew about my secret identity as Doctor D. He read regularly.<br /><br />We last spoke about 6 months ago. I had <span style="font-style: italic;">“Call The Dude”</span> on my long list of things to do last month, but I never got around to it. <span style="font-weight: bold;">I sure wish I’d called my jolly, smokey old friend!</span><br /><br /><span style="font-weight: bold;">It came as a shock that he's dead—which is strange considering I expected him to die at any moment for the first few years I knew him, but once you really love someone you kind of expect them to live on forever</span>.<br /><blockquote><span style="font-size:130%;">Now The Dude is in a place where he has no need for doctors or medicines.<br /><br /><span style="font-style: italic; font-weight: bold;">Enjoy heaven, my friend! I wish I'd told you that you were the best teacher Doctor D ever had!</span></span></blockquote></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com14tag:blogger.com,1999:blog-344900867722860530.post-80277598175839907852010-10-16T23:00:00.016-04:002010-10-20T21:28:48.309-04:00Warnings and Witch Hunts<span style="font-style: italic;">An addition to</span><span style="font-style: italic;"> our ongoing series on </span><a style="font-style: italic;" href="http://askanmd.blogspot.com/2009/08/incompetent-doctors-series.html"><span style="font-weight: bold;">Incompetent Doctors</span></a><span style="font-style: italic;">:</span><br /><div style="text-align: justify;"><blockquote style="font-weight: bold;"><span style="font-size:130%;">If one of your patients asked your opinion of another doctor whom you know to be incompetent what would you tell your </span><span style="font-size:130%;">patient?</span></blockquote></div><div style="text-align: justify;">Incompetence in a physician is a scary thing! <span style="font-weight: bold;">Doctors deal with problems of life and death and try to heal you with dangerous tools. A doc that isn’t competent can be seriously dangerous. </span><br /></div><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">But how do you know who’s on their game<br />and who’s falling down on the job?</span></span></div><br /><div style="text-align: justify;">It’s tricky for patients because they often don’t know enough about medicine practice to judge competency. <span style="font-weight: bold;"> This makes putting your body under the care of any doctor scary.</span><br /></div><div style="text-align: justify;"><br />So scary, in fact, that an entire malpractice industry has sprung up to reassure patients that incompetent doctors will be severely punished. <span style="font-weight: bold;">Unfortunately malpractice usually ends up a witch hunt that can burn good doctors at the stake and let bad ones go free. </span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNxnLGQWsdAkNl4E0dOTDBRhPFOsBqLspp3vlHA5uNtxjzGKf7sGL0rGHCTE5lPEHBQPH657LOdhULuIr5gE9obPcQV1bEk_vTfIey-paHZ9di_qTc3VE3HJWrZAzjnjEQxLluvdkeIL0E/s1600/We+Found+A+Malpracing+Doctor%21++May+we+burn+him%3F.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 280px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNxnLGQWsdAkNl4E0dOTDBRhPFOsBqLspp3vlHA5uNtxjzGKf7sGL0rGHCTE5lPEHBQPH657LOdhULuIr5gE9obPcQV1bEk_vTfIey-paHZ9di_qTc3VE3HJWrZAzjnjEQxLluvdkeIL0E/s400/We+Found+A+Malpracing+Doctor%21++May+we+burn+him%3F.png" alt="" id="BLOGGER_PHOTO_ID_5528846759636584754" border="0" /></a></span><span style="font-size:85%;"><span style="font-style: italic;">“I saw Goody Doctor D dancing in the woods with the Devil!” </span></span> </div><div style="text-align: center;"><span style="font-size:85%;"><span style="font-style: italic;">“Tis true! One of his patient died!"<br />"It can only mean he dabbles in the witchcraft of incompetence”</span></span><br /></div><br /><span style="font-weight: bold;">Wouldn’t it be nice if you had someone who understands medicine who could tip you off on the bad ones?</span><br /><br /><span style="font-style: italic;">Yes, but it’s a complicated thing to ask your doc if another doc is incompetent or not.</span><br /><br /><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Judge Not, Lest You Be Judged<br /></span></div><span style="font-weight: bold;">Competence is not always as black and white as you might think.</span> There is a good bit of gray and ambiguity involved. <span style="font-style: italic; font-weight: bold;"> The real world practice of medicine involves a lot of educated guessing and trial and error. Even the best doctors occasionally make mistakes or use unorthodox treatments. </span><br /><br /><span style="font-weight: bold;">The real dangerous doctors are the ones that recklessly di</span><span style="font-weight: bold;">sregard patient safety and don’t even care about doing things right</span>. And yes, unfortunately there are lots of doctors like this.<br /><br /><span style="font-weight: bold;">Incompetence may be common, but</span> <span style="font-weight: bold;">it is hard to prove</span>. Doctor D occasionally sees signs of suspected incompetence in patients that have been treated by other docs. An incorrect diagnosis or an unorthodox treatment that seems way out of the expected margin of error and puts a patient at risk.<br /><br /><span style="font-weight: bold;">But these clues in the crime can be misleading.</span> Sometimes Doctor D will see something and say to himself, <span style="font-style: italic;">“Self, what this doctor is doing makes no sense. I wonder if he is incompetent?”</span> <span style="font-weight: bold;"> Later I met the doc only to find that he had an excellent reasoning for what he did, and was obviously acting in his patient’s best interest. </span><br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The Medical Gestapo</span></span><br /></div><span style="font-weight: bold;">But there are </span><span style="font-style: italic; font-weight: bold;">some</span><span style="font-weight: bold;"> doctors that are all too happy to accuse their colleagues of incompetence.</span> These docs believe there is only <span style="font-style: italic;">ONE</span> competent way to practice medicine, and it is the way <span style="font-style: italic;">THEY</span> practice.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHzopUWQuxq6KC0M0exRZfPuk8KHJBC2byY9YIxzeEqzCdHAIkzZ0t53DYdZ3Twdtdc0yW4ESGQ8cODep2aAR5W9q9YHUS95rUJe5qMBKqaZHnuOvT4yghtUriIlv_Yyg7wvnGeE8TJVIg/s1600/Doctor+Big+Brother+is+Watching%21.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 144px; height: 210px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHzopUWQuxq6KC0M0exRZfPuk8KHJBC2byY9YIxzeEqzCdHAIkzZ0t53DYdZ3Twdtdc0yW4ESGQ8cODep2aAR5W9q9YHUS95rUJe5qMBKqaZHnuOvT4yghtUriIlv_Yyg7wvnGeE8TJVIg/s320/Doctor+Big+Brother+is+Watching%21.png" alt="" id="BLOGGER_PHOTO_ID_5528849134423594162" border="0" /></a>These doctors want to be the to secret police who keep medicine in line. <span style="font-weight: bold;">They are typically jerks with a massive god-complex.</span> They gleefully tell every patient who will listen which doctors they think suck.<br /><br />Doctor D has had encounters with the medical gestapo. <span style="font-weight: bold;">They shoot first and ask questions later. </span>They see the world in black and white. There is no gray area for them. <span style="font-style: italic; font-weight: bold;"><br /><br />“Doctor D you didn’t follow the protocol! Are you thinking for yourself? Are you adjusting the protocol for individual patient's situations? Off to the firing squad!”</span><br /><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Dealing with Dr. Danger</span></span><br /></div>Witch hunts both from within and without medicine have soiled the names of a lot of good doctors. <span style="font-weight: bold;">So Doctor D is always careful about fingering another doctor as a dangerous doc, even when he has his suspicions.</span><br /><br />I currently know a doc who I am about <span style="font-weight: bold;">70%</span> certain is a walking public health threat. <span style="font-weight: bold;">I’ve seen a pattern of “WTF?!” medical decisions that make me highly suspicious that this dude either doesn’t know what he’s doing or doesn’t care.</span><br /><br /><span style="font-weight: bold;">How certain do I need to before turn Dr. Danger over to be burned at the stake?</span> <span style="font-style: italic;">Well 100% actually.</span><br /><div style="text-align: center;"><span style="font-style: italic; font-weight: bold;"><span style="font-size:130%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbIL__GalcsZyJ4DEng8hyphenhyphen9fltyurANg8ggQFpV1l1Tnr-87iQXOqN3PUltB6FRT92ricxKlkPG92ig9lQ1UOYgGqona7WNZj9iAbdLlJBnnUOjjubSlJ1HQ6osx2_k5efsLlBgh_51FtG/s1600/Off+to+the+Gallows+with+Dr.+Danger.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 286px; height: 193px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbIL__GalcsZyJ4DEng8hyphenhyphen9fltyurANg8ggQFpV1l1Tnr-87iQXOqN3PUltB6FRT92ricxKlkPG92ig9lQ1UOYgGqona7WNZj9iAbdLlJBnnUOjjubSlJ1HQ6osx2_k5efsLlBgh_51FtG/s320/Off+to+the+Gallows+with+Dr.+Danger.png" alt="" id="BLOGGER_PHOTO_ID_5528850164735857330" border="0" /></a></span></span><span style="font-size:85%;"><span style="font-style: italic;">"We still only have circumstantial evidence, but let's burn him anyway!"</span></span><br /></div><br />I’ve been a target of the Medical Gestapo myself, and I know how damaging misguided doctor purges can be. <span style="font-weight: bold;"> I’m not blowing the whistle on Dr. Danger unless I know beyond a shadow of a doubt that he’s really what I think he is.</span><br /><br /><span style="font-weight: bold;">I’ve only been 100% certain </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2009/12/battle-against-incompetence.html">one time before</a><span style="font-weight: bold;"> and that time I blew the whistle as loud as I could.</span><br /><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Subtle Warnings<br /></span></div><span style="font-weight: bold;">Although I’m not absolutely certain he’s incompetent, I wouldn’t want any of my family seeing Dr. Danger.</span> It would be too much of a risk!<br /><br />I can’t flat-out denounce him publicly, but I do want to steer patients away from the danger I suspect.<br /><br /><span style="font-weight: bold;">This is where subtlety comes in handy: </span><br /><blockquote style="font-weight: bold;">I might say <span style="font-style: italic;">"Dr. Danger does some really unorthodox things."</span> Or I might just fail to praise him, while my facial frown indicates I might not be totally cool with Dr. Danger. Or I could just change the subject and suggest you see Dr. Awesome instead.</blockquote>This is how we doctors subtly steer you away from potential danger.<br /><div style="text-align: justify;"><span style="font-weight: bold;"></span></div><blockquote><div style="text-align: justify;"><span style="font-weight: bold;">But you have to read between the lines, because if you flat out ask,</span> <span style="font-style: italic;">“So Doctor D are implying you think Dr. Danger is a totally incompetent fuctard who has no business practicing medicine?”</span> Doctor D will smile and say, “<span style="font-style: italic; font-weight: bold;">Oh no, Dr. Danger is a delightful person! You have totally misunderstood me!”</span> Then D will give you a wink.<br /></div></blockquote></div><span style="font-weight: bold;">Doctor D puts the B in subtle!</span><br /><br /><div style="text-align: center; font-style: italic;"><span style="font-size:85%;">What do you think?<br /><br /><span style="font-weight: bold;">Docs and Nurses:</span> How do you manage doctors whose competency you doubt?<br /><br /><span style="font-weight: bold;">Patients:</span> Do you think you are able to pick up subtle cues from your doctors?<br /><br />Should Doctor D go gestapo on Dr. Danger?<br /><br /><span style="font-weight: bold;">Any ideas for a better process than this ridiculous system of innuendos and secret winks to keep patients safe?</span> I'm sure there has to be something better.<br /></span></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com17tag:blogger.com,1999:blog-344900867722860530.post-65817306258378038542010-10-09T01:57:00.004-04:002010-10-09T02:07:27.677-04:00It Gets Worse!<div style="text-align: justify;"><span style="font-size:130%;"><span style="font-weight: bold;">So 2 days after Little D broke his leg Lady D his mom goes and breaks hers too! </span></span> She's never fractured a bone in her entire life and she does it the same week as our toddler broke his. WTF?<br /><blockquote>So everyone's asking: <span style="font-style: italic;">"Why all these injuries? Does Doctor D beat his family?"</span></blockquote><span style="font-weight: bold;">No, of course not! But I might want to look into getting rid of the new seesaw:</span><br /></div><br /><div style="background: none repeat scroll 0% 0% rgb(0, 0, 0); width: 440px; height: 272px;"><embed flashvars="playerVars=showStats=yes|autoPlay=no|videoTitle=Rodeo Bull See-Saw Stunt" src="http://www.metacafe.com/fplayer/1165554/rodeo_bull_see_saw_stunt.swf" wmode="transparent" allowfullscreen="true" allowscriptaccess="always" name="Metacafe_1165554" pluginspage="http://www.macromedia.com/go/getflashplayer" type="application/x-shockwave-flash" height="272" width="440"></embed></div><div style="font-size: 12px;"><a href="http://www.metacafe.com/watch/1165554/rodeo_bull_see_saw_stunt/">Rodeo Bull See-Saw Stunt</a> - <a href="http://www.metacafe.com/">Click here for this week’s top video clips</a></div><br /><br /><div style="text-align: justify;"><span style="font-weight: bold;">This is going to be a long 3-4 weeks in the D-house with them both grumpy and in casts!</span></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com12tag:blogger.com,1999:blog-344900867722860530.post-35551438810415401222010-10-08T02:12:00.005-04:002010-10-08T03:23:36.789-04:00Break A Leg!<div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">No insightful answers this week!</span></span><br /></div><br /><div style="text-align: center;"><div style="text-align: justify;"><span style="font-weight: bold;"><a href="http://askanmd.blogspot.com/2010/09/saved-with-dodge.html">Little D</a> got a leg fracture from over-rambunctiousness</span>, so I've had no time to craft a good post for you guys. Sorry!</div><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFtwn2YuJhRnbDBJ0hACPD3Qc-GQz0jtxNDB5fJe7q1zZmsPLOVTp7EDaS8uQKG804ccTGcntsx-l6JXu_etg5au0kFBWp1Or5iVQ3nT0f-7JNJYnnMeusbBfq7Kj8zqATnsMqBSSsDvcs/s1600/Little+D%27s+Broken+Leg.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 295px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFtwn2YuJhRnbDBJ0hACPD3Qc-GQz0jtxNDB5fJe7q1zZmsPLOVTp7EDaS8uQKG804ccTGcntsx-l6JXu_etg5au0kFBWp1Or5iVQ3nT0f-7JNJYnnMeusbBfq7Kj8zqATnsMqBSSsDvcs/s400/Little+D%27s+Broken+Leg.png" alt="" id="BLOGGER_PHOTO_ID_5525565243916536546" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">"But jumping off the furniture is fun, Daddy!"</span></span><br /></div><br /><div style="text-align: justify;">Perhaps it's working extra shifts at the hospital and taking care of a fussy toddler on narcotics, but <span style="font-weight: bold;">I've posted some kind of harsh responses to some comments recently:</span><br /><blockquote>After a very strange tour around the Anorexia blogsphere <span style="font-weight: bold;">I posted </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/09/are-doctors-rich.html?showComment=1286395729971#c1780315610102052814">a very "getyourshittogether" reply</a><span style="font-weight: bold;"> to poor JadedChalice's </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/09/are-doctors-rich.html?showComment=1286203649835#c3336891077986796575">cry for help</a><span style="font-weight: bold;"> in last week's comments.</span><br /><br /><span style="font-weight: bold;">Then I posted <a href="http://askanmd.blogspot.com/2009/12/why-do-incompetent-doctors-flourish.html?showComment=1286516297692#c6839149358280430706">an indignant response</a> to <a href="http://askanmd.blogspot.com/2009/12/why-do-incompetent-doctors-flourish.html?showComment=1286500921976#c7475455135559451768">indignant accusations</a> that I excuse bad doctoring.</span> Excuse me? <span style="font-style: italic;">Anonymous, you picked the wrong week to mess with Doctor D!</span></blockquote><span style="font-weight: bold;">As you can see Doctor D is in no condition to provide any sage wisdom right now.</span> Hopefully next week when he hasn't been up all night with a miserable 2 year-old D will get back to answering your questions brilliantly!<br /></div><br /><div style="text-align: center; font-style: italic;"><span style="font-size:85%;"><span style="font-weight: bold;">Perhaps some of you could undo the damage of Doctor D's brutal Tough Love Campaign by going back and providing some kinder and gentler responses to JadedChalice and my Anonymous admirer?</span><br /><br />You guys are awesome!<br /></span></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com8tag:blogger.com,1999:blog-344900867722860530.post-6119765017405874162010-09-29T00:05:00.009-04:002010-09-29T01:37:30.035-04:00Are Doctors Rich?<div style="text-align: center;">(Part of an ongoing series <a style="font-weight: bold;" href="http://askanmd.blogspot.com/2008/08/should-i-become-doctor-series.html">Should I Become A Doctor?</a>)<br /></div><div style="text-align: justify;"><span style="font-weight: bold;"><br />People rarely ask about income directly, but Doctor D gets a lot of wink-wink nudge-nudge questions about his finances such as,</span><div style="text-align: center;"><blockquote><span style="font-style: italic; font-weight: bold;">“So what you drive, doc, a BMW?”</span><br /><span style="font-size:85%;"><br /><span style="font-size:100%;">or</span><br /></span><br /><span style="font-style: italic; font-weight: bold;">“It’s hard making ends meet sometimes, but you wouldn’t know about that, would you doc?”</span></blockquote> </div>So to answer your questions<span style="font-weight: bold;"> Doctor D will throw open the doors to the secret realm of physician personal finance:</span><br /><div style="text-align: center;"><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKRLd_pZdX92aCb3EV6WhZ_aPgB4ijBEnYFZYLTwpCAPjewAK2ZxC5zO-wSo4dkFSwDSR-IhjN9BnRaENSEC9NnN64oW0h8JDq3Fe80gehFge04AilpHlGwOQl95QUckcr9RP-Z7x9nJ1C/s1600/Cash+Money+Doctors-+Lil+Wayne.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 299px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKRLd_pZdX92aCb3EV6WhZ_aPgB4ijBEnYFZYLTwpCAPjewAK2ZxC5zO-wSo4dkFSwDSR-IhjN9BnRaENSEC9NnN64oW0h8JDq3Fe80gehFge04AilpHlGwOQl95QUckcr9RP-Z7x9nJ1C/s400/Cash+Money+Doctors-+Lil+Wayne.png" alt="" id="BLOGGER_PHOTO_ID_5522194524402746770" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">"Where'd I get the money? Med School, Bitches!"</span></span><br /></div><br /><span style="font-weight: bold;">Last year Dr. D made about 150,000 dollars</span>, which is a lot of money. (<span style="font-style: italic;">The <a href="http://askanmd.blogspot.com/2010/02/medical-mafia-price-fixing-in-medicine.html">Medical Mafia</a> makes sure MD's get paid well in exchange for our souls!</span>) <span style="font-weight: bold;">Uncle Sam and student loans took a pretty large chunk of that, but still Doctor D has more than every non-medical person he knows</span>, and he is a <a href="http://askanmd.blogspot.com/2009/11/primary-care-best-and-worst-job-in.html">Primary Care Doctor</a>, which is one of the lowest paying specialties!<br /><br />Now before you start filling out medical school applications dreaming of big money let me warn you about the downside: <span style="font-style: italic; font-weight: bold;">You spend about a decade of your life working for free and amass a mountain of debt to get here.</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Dropping Out and Adding Up</span></span><br /></div>Everyone considering the financial benefits of medical school should calculate their <span style="font-weight: bold;">drop-out sibling equation:</span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilK0hVriK4FpOcot49MTnA0RIyrCYxFMeE1XYOmgTjCGwL5qtKkBUICn5ORk3Two1y1y1JLJwod9Fn7YffiRuvNmYci-dZFoVcrg2YM2ob1xTNVaxvbNd0g36klWpB1Z5K6XOjSUc6gD_O/s1600/Big+Money+Medical+School.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 150px; height: 169px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilK0hVriK4FpOcot49MTnA0RIyrCYxFMeE1XYOmgTjCGwL5qtKkBUICn5ORk3Two1y1y1JLJwod9Fn7YffiRuvNmYci-dZFoVcrg2YM2ob1xTNVaxvbNd0g36klWpB1Z5K6XOjSUc6gD_O/s320/Big+Money+Medical+School.png" alt="" id="BLOGGER_PHOTO_ID_5522200159917712322" border="0" /></a><br /><br /><span style="font-weight: bold;">Doctor D has a brother about his age.</span> Brother D was a smart dude, but he never liked school so he dropped out in high school. <span style="font-weight: bold;">Brother D immediately started making money working at low-skilled but steady jobs while Dr. D was toiling away at medical education. </span><br /><br />Brother D’s lifetime earning was very gradually rising while Dr. D’s debt was increasing, until one day Dr. D started making big bucks. <span style="font-weight: bold;">Dr. D and Brother D sat down and did the math problem. </span><br /><br />The answer: <span style="font-weight: bold;">41</span> <blockquote style="font-weight: bold;"><span style="font-size:130%;">Doctor D will be 41 years old before his MD catches up with his drop-out brother's GED in lifetime income!</span></blockquote> Our paths diverged at about 17 years old. Doctor D is 32 now so he has another 9 years till he’s made as much money in his life as Brother D.<br /><br /><div style="text-align: center;"><span style="font-weight: bold;font-size:130%;" >Medical School isn’t exactly the quick way to riches.</span><br /></div><br /><span style="font-weight: bold; font-style: italic;">But in this economy who can complain about making six figures?</span> Doctors do it all the time, but nobody is listening.<br /><br /><span style="font-weight: bold;">Doctors work hard and we get rewarded. It just isn’t as rewarding as some pre-med students and patients think.</span><br /><br /><div style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoZsAuUfrrqkkDwSc6-jOPVT6NbKWwiy_tgjVQmLtPolu_7cIzoAubzJF4HCpdACF6ggJWVCox6Uby_iCr_AvzbqV5FVF4cftqrTMOc0gmY1t4VL9i5vT-hRv3SUYsh5UN2OuzS3PdLGcB/s1600/Pimpin'+In+Med+School.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 268px; height: 196px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgoZsAuUfrrqkkDwSc6-jOPVT6NbKWwiy_tgjVQmLtPolu_7cIzoAubzJF4HCpdACF6ggJWVCox6Uby_iCr_AvzbqV5FVF4cftqrTMOc0gmY1t4VL9i5vT-hRv3SUYsh5UN2OuzS3PdLGcB/s400/Pimpin'+In+Med+School.png" alt="" id="BLOGGER_PHOTO_ID_5522201238760338482" border="0" /></a></div><div style="text-align: center;"><span style="font-size:85%;"><span style="font-style: italic;">"You know you laidies can't resist!</span></span>"<br /><br /></div><span style="font-weight: bold;">By the way, Dr. D drives the cheapest car Toyota makes—it’s the first new car he ever owned.</span><br /></div><div style="text-align: center; font-style: italic;"><blockquote><span style="font-size:85%;">What do you think?<br /><br /><span style="font-weight: bold;">Pre-meds and Med Students:</span> Did the financial rewards of affect your career choice?<br /><br /><span style="font-weight: bold;">Patients:</span> Do you think income differences between you and your doctor harms your doctor-patient relationship?<br /><br /><span style="font-weight: bold;">Doctors:</span> Are you satisfied with your income? Do you feel you deserve more or less?<br /><br />Doctor D always loves to read your thoughts in the comments.</span></blockquote></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com40tag:blogger.com,1999:blog-344900867722860530.post-79168258459627603562010-09-22T21:41:00.010-04:002010-10-08T03:08:01.749-04:00Saved With A Dodge<div style="text-align: center;"><span style="font-weight: bold;">Part 4 of </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/08/how-to-get-straight-answer-from-md.html">Straight Answers From Doctors</a></div><div style="text-align: justify;"><br />Doctor D has dodged some questions in his career, but <span style="font-weight: bold;">he has also been on the receiving end of some non-answers and can attest to their usefulness on the patient's side of things.</span><br /><blockquote style="font-weight: bold;"><span style="font-size:130%;">How the $#@% can a doctor dodging a question help the patient?</span></blockquote>Let me tell you a story:<br /><br /><div style="text-align: justify;">Doctor D’s son <span style="font-weight: bold;">Little D was born with a very rare genetic condition which required he see an expert at a big university.</span> As a parent I can tell you that this sucks. Lady D and I did a lot of worrying about our baby.<br /><br /><div style="text-align: center;"><span style="font-size:130%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqVI4CgOA8VMh8tSpzi9aOKFIUkAF14rJvzJvHQSkfanCCpiuw4LrkRXZufAIfpndhJ-xDqMBs41A_6eYPt2MJZMVdi7F6g2FlZU1CzlxQzzKzgNnsOHaBhUNoDE5bzigENtlQvsVYjjj5/s1600/Little+D+sick.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 274px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqVI4CgOA8VMh8tSpzi9aOKFIUkAF14rJvzJvHQSkfanCCpiuw4LrkRXZufAIfpndhJ-xDqMBs41A_6eYPt2MJZMVdi7F6g2FlZU1CzlxQzzKzgNnsOHaBhUNoDE5bzigENtlQvsVYjjj5/s400/Little+D+sick.png" alt="" id="BLOGGER_PHOTO_ID_5519928664769996322" border="0" /></a></span><span style="font-style: italic;font-size:85%;" >"Daddy, I don't feel good!"</span><br /></div></div><br />Medical people are often the worst patients. <span style="font-weight: bold;">We know <span style="font-style: italic;">just</span> enough to be really difficult. Or we just know <span style="font-style: italic;">too</span> much, and it gets in the way of our common sense. </span><br /><br /><span style="font-weight: bold;">Doctor D had never even heard of his son's super rare disease so he read everything he could find.</span> Unfortunately the mutation was so rare that research was almost non-existent. Doctor D read every published study on the disease an found more questions than answers.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUVMnYNDOIjQkvWjLavK0PCIlwM5I_2sV6H5p23kxRJ7GaWv1n2oeVT_HqiZBhM97CxRDLk0QAaPnQ_HnEm-TG-LfXwKcU4CleKP6OH4sASAkBa6-LJs0YquuftHZFI-_WPQxwrTNv9nn6/s1600/Expertologist.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 138px; height: 159px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUVMnYNDOIjQkvWjLavK0PCIlwM5I_2sV6H5p23kxRJ7GaWv1n2oeVT_HqiZBhM97CxRDLk0QAaPnQ_HnEm-TG-LfXwKcU4CleKP6OH4sASAkBa6-LJs0YquuftHZFI-_WPQxwrTNv9nn6/s320/Expertologist.png" alt="" id="BLOGGER_PHOTO_ID_5519931252744199186" border="0" /></a><span style="font-weight: bold;">The poor Expertologist got way too many questions from Doctor D.</span> Some he answered. Others he totally dodged. <span style="font-weight: bold;">Near the end of the appointment Doctor D asked a very specific question about a potential complication.</span><br /><br /><span style="font-weight: bold;">The Expertologist smiled and said, </span><span style="font-style: italic; font-weight: bold;">“Oh, I think he’ll grow up and play sports and have kids of his own some day.”</span><br /><br /><span style="font-weight: bold;">Doctor D was totally frustrated.</span> <span style="font-style: italic;"> “I’m a f*#@ing MD! Of course, I know that this mutation doesn’t affect the reproductive system</span><span style="font-style: italic;"> or the muscles</span><span style="font-style: italic;">. <span style="font-weight: bold;">You didn’t answer my specific question!” </span></span><span style="font-weight: bold;">Yeah, I considered yelling that, but instead I smiled and left the office.</span><br /><br /><span style="font-weight: bold;">I still don’t know why the Expertologist gave me a non-answer.</span> Maybe no one knew the answer? Maybe a full answer would have taken a long discussion of probabilities and complex research he didn’t have time for? Maybe he was just sick of this non-expert doctor who asked so many questions?<br /><br />Doctor D was pissed. <span style="font-weight: bold;">But on the way home Doctor D looked in the rearview mirror at his sleeping baby and realized that vague answer had been just what he needed to hear:</span> <span style="font-weight: bold; font-style: italic;">“Chill out, Doctor D. Your kid is doing fine. He’ll be okay.”</span><br /><br /><div style="text-align: center;">And you know what? Little D is doing just fine.<span style="font-style: italic;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEglip-GaR5oeArPNortl4dNRcDaC3bliqStPwb3AhIsIdJPvNbi0kMkrcHhaxIxAGPwd6o5G9ifJcoLWYLkfliyD77xSHpbMNXjQWdeY9nfpF4Fw5SkSjNr5RGs2xHidROb6qRrAlLYZBNO/s1600/Little+D.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 257px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEglip-GaR5oeArPNortl4dNRcDaC3bliqStPwb3AhIsIdJPvNbi0kMkrcHhaxIxAGPwd6o5G9ifJcoLWYLkfliyD77xSHpbMNXjQWdeY9nfpF4Fw5SkSjNr5RGs2xHidROb6qRrAlLYZBNO/s400/Little+D.png" alt="" id="BLOGGER_PHOTO_ID_5519932962515486034" border="0" /></a></span><span style="font-size:85%;"><span style="font-style: italic;">Little D: </span><br /><span style="font-style: italic;">Growing perfectly as long as his parents can refrain from killing him during his Terrible 2's</span></span><br /></div><br /><span style="font-weight: bold;">Sometimes patients don’t need factual answers.</span> Doctor D had hundreds of questions tumbling around in his over-educated head. <span style="font-weight: bold;">Expertologist could have taken all day answering every question, but the real question was </span><span style="font-style: italic; font-weight: bold;">“Is my kid alright?”</span><br /><br /><span style="font-weight: bold;">This brilliant Expertologist totally dodged even trying to answer my question and told me what I needed to hear</span>, <span style="font-style: italic;">“You kid is okay.”</span><br /><div style="text-align: center;"></div><blockquote style="font-style: italic;"><div style="text-align: center;"><span style="font-size:85%;">What do you think?<br /><br /><span style="font-weight: bold;">Have you ever been glad an MD dodged your question?<br /><br /></span><span style="font-weight: bold;">Do you think there is any place for this in medicine? </span><br /><br />Doctor D always loves hearing your thoughts in the comments!<br /></span></div></blockquote></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com12tag:blogger.com,1999:blog-344900867722860530.post-36529863400161627842010-09-13T15:38:00.009-04:002010-09-13T17:48:00.561-04:00How To Get A Straight Answer From A Doctor<div style="text-align: center;"><span style="font-weight: bold;">(Part III of </span><a style="font-weight: bold;" href="http://askanmd.blogspot.com/2010/08/how-to-get-straight-answer-from-md.html">Straight Answers From Doctors</a>)<br /></div><br /><div style="text-align: justify;"><span style="font-weight: bold; font-style: italic;">The answer is really very simple:</span><br /><blockquote style="font-weight: bold;"><span style="font-size:180%;">Don’t accept a non-answer answer from a doctor on a question that really matters to you!</span></blockquote>If you get a dodgy, vague, or useless answer don’t take it lying down. <span style="font-weight: bold;"> Politely insist that the doctor elaborate and clarify until you get a reply that you understand.</span><br /><br /></div><div style="text-align: center;"><div style="text-align: justify;">We doctors are <a href="http://askanmd.blogspot.com/2009/08/overcoming-doctorphobia.html">totally scary</a>, but <span style="font-weight: bold;">if you have to have the guts to ask the question a second or even third time most docs will do their best to insure you get an answer that makes sense to you.</span> <span style="font-style: italic;">Force the issue!</span><br /></div><span style="font-style: italic;"><br /></span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEBF3Y5Cta5_9rc6eeEAHuDumeGRbl07IFk6kpRdncjDr2dE31Hvnvaf2xK9BH_GS-ugn4q4k2r7MlPcb6cZPTubbAJFIFVBYTS9Xf1KxsJlYC1fDZdKLxZn6F9062PrmiXhfZvvzxaDNV/s1600/Persistent+questions.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 255px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEBF3Y5Cta5_9rc6eeEAHuDumeGRbl07IFk6kpRdncjDr2dE31Hvnvaf2xK9BH_GS-ugn4q4k2r7MlPcb6cZPTubbAJFIFVBYTS9Xf1KxsJlYC1fDZdKLxZn6F9062PrmiXhfZvvzxaDNV/s400/Persistent+questions.png" alt="" id="BLOGGER_PHOTO_ID_5516509315583852450" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">"Okay doc, now I need you to explain that again in plain English."</span></span><br /></div><br /><div style="text-align: justify;">Sometimes the doctor will have to look something up and get back to you. Sometimes the doc will have to work to explain something complicated in a way that you can understand. Sometimes if there is no definite answer available your doctor can help you understand the nature of the uncertainly.<br /><br /><span style="font-weight: bold;">Most doctors will work hard to get you an answer, but if your doc blatantly dodges your question after multiple direct inquiries you might just be stuck with a god-complex prick.</span> This is good to know so that you can <a href="http://askanmd.blogspot.com/2008/08/how-to-choose-primary-doctor-series.html">find another physician</a> ASAP who works well with you.<br /></div><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">A few tips for truth-seekers:</span></span><br /></div><div style="text-align: justify;"></div><blockquote><div style="text-align: justify;"><span style="font-size:180%;"><span style="font-weight: bold;">Be Ready:</span></span> Medical decisions and predictions can be really complicated. Add the amount of uncertainly that we work with and <span style="font-weight: bold;">the straight answers can get really difficult to grasp.</span> Most of the questions we dodge have difficult answers that might leave you with a headache. <span style="font-weight: bold;">Don’t assume that the full answer is always going to make things more clear.</span><br /><span style="font-size:180%;"><br /></span><span style="font-size:180%;"><span style="font-weight: bold;">Be Reasonable:</span></span> <span style="font-weight: bold;">You shouldn't use the nuclear <span style="font-style: italic;">I-won’t-leave-till-I-get-an-answer</span> option for every question that pops into your head.</span> Doctors don’t mind giving the full answer from time to time, but if you have an insatiable curiosity you may want to do your own <a href="http://askanmd.blogspot.com/2009/09/medical-information-online.html">research with Dr. Google</a>. <span style="font-style: italic;"> You don’t want to be that patient your doctor groans to see because he knows he’s going to end up running an hour behind every time he sees you.</span><br /></div></blockquote><br /><div style="text-align: center;"><span style="font-size:180%;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwjoTZt1JwOnvA8ihLwp7wnJAZme1b4bz953EvFDIRdmIBkh4eULeSdm2Mq6nP2-L_QYJIt5bVGdUnEMn0DU1ni6zFnYZk_V4A4p3dD0aTfyDqKfqumBDt_jnEfgoLW_1DysuxKrRxt82o/s1600/Dwight+Schrute-+Difficult+Patient.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 298px; height: 372px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwjoTZt1JwOnvA8ihLwp7wnJAZme1b4bz953EvFDIRdmIBkh4eULeSdm2Mq6nP2-L_QYJIt5bVGdUnEMn0DU1ni6zFnYZk_V4A4p3dD0aTfyDqKfqumBDt_jnEfgoLW_1DysuxKrRxt82o/s400/Dwight+Schrute-+Difficult+Patient.png" alt="" id="BLOGGER_PHOTO_ID_5516505792862504770" border="0" /></a></span><span style="font-size:85%;"><span style="font-style: italic;">"Doc, suppose my pancreas was a sentient being trying to assassinate me.<br />How would that change your treatment plan?"</span></span><br /></div><span style="font-size:180%;"><br /></span><div style="text-align: justify;"></div><blockquote><div style="text-align: justify;"><span style="font-size:180%;"><span style="font-weight: bold;">Accept Disappointment:</span></span> <span style="font-weight: bold;">Some patients confuse <span style="font-style: italic;">"a straight answer"</span> with <span style="font-style: italic;">"the answer I wanted."</span></span> Sorry! You can ask till you're blue in the face but your doctor still has to say, <span style="font-style: italic;">"Your runny nose doesn't need antibiotics"</span> and <span style="font-style: italic;">"90 year-old Aunt Ethyl probably won't recover"</span> every time. <span style="font-weight: bold;">Persistence won't change facts, but it may force exasperated docs to tell you a white lie just to make you quit badgering them.</span> You don't really want to force doctors to be dishonest with you.<br /></div></blockquote><br /><div style="text-align: justify;"><span>Consider yourself warned! </span><span style="font-weight: bold;"> Use the "nuclear option" with caution. Now go forth and find out what your doc is really thinking!</span><br /></div><div style="text-align: center;"><span style="font-size:85%;"><span style="font-style: italic;"></span><blockquote><span style="font-style: italic;">What do you think? Have you every forced the issue till you got the answer? Tell your experience in the comments! </span><br /><br /><span style="font-style: italic;">Doctor D has typically been on the doctor side of this interaction, and can say a patient dedicated to answers always gets them from me. </span><br /><br /><span style="font-style: italic; font-weight: bold;">But do you as patients think this approach works?</span></blockquote><span style="font-style: italic; font-weight: bold;"></span><br /></span></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com15tag:blogger.com,1999:blog-344900867722860530.post-38046782863867977532010-09-08T22:25:00.007-04:002011-03-27T03:08:06.267-04:00Why Do Doctors Dodge Your Questions?<div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Part II of <a href="http://askanmd.blogspot.com/2010/08/how-to-get-straight-answer-from-md.html">How To Get A Straight Answer From A Doctor</a><br /></span></div><br />Before he tells you how to get a straight answers from physicians, <span style="font-weight: bold;">Doctor D is going to stall for time by explaining why doctors give vague answers.</span><br /><div style="text-align: justify;"><span style="font-size:130%;"><br /></span></div><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Why Would A Good Doctor Give Useless Answers?</span></span><br /></div><div style="text-align: justify;"><blockquote><span style="font-size:130%;">1) <span style="font-weight: bold;">There is an answer, but your doctor doesn’t know it.</span> </span> Don’t be hard on doc for this one. <span style="font-weight: bold;">There is no MD in the world that knows the entire breadth of medical knowledge.</span> Some docs pretend they do. Trust me, they're faking it. While it may not help you <span style="font-style: italic;">"I don't know"</span> is a refreshing answer to get from a doctor. MDs don't often admit this.<br /><br /><span style="font-size:130%;">2) <span style="font-weight: bold;">Your doctor knows the answer, but it is too complicated to explain.</span></span> A lot of the physical processes doctors think about are pretty complex. <span style="font-weight: bold;">Translating all the technomedical concepts into layman’s terms to sensibly explaining it would just take a lot of time and bore you to tears</span>, so the doc just gives you a vague answer instead.<br /><br /><span style="font-size:130%;">3) <span style="font-weight: bold;">The answer depends on a lot of variables.</span></span> <a href="http://askanmd.blogspot.com/2009/12/what-are-my-chances-doc.html">Predicting</a> the course of an illness or recovery can be tricky. <span style="font-weight: bold;">A lot of things that are in our control and out of our control can make a straightforward </span><span style="font-style: italic; font-weight: bold;">“here’s what to expect”</span><span style="font-weight: bold;"> answer impossible.</span> Doctors are busy. It would take a lot of time to explain all the variables. So they often dodge any answer that asks they explain the future.<br /><br /><span style="font-size:130%;">4) <span style="font-weight: bold;">There is no answer.</span></span> You’d be surprised how many of your questions just don’t have have answers. Doctors have no idea of the answer and no good way of finding out. <span style="font-style: italic;">Sorry! </span> <span style="font-weight: bold;">Most patients (and quite a few doctors) get unnerved at the amount of real uncertainty in the world of medicine. We often cover the uncertainty with total bullshit.</span> We make up things that sound intelligent. For example: <span style="font-style: italic; font-weight: bold;">“Probably a virus...”</span> is secret doctor code for <span style="font-style: italic;">“I have no idea why you feel this way, but it probably isn’t serious.”</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCXmZa1gM4Mzv2ACxw72mhXFDPuRnUuaC1TzxzyynFzwLDnZVOJdsUzec_gt76TTOMAmm52qutWSqp5UwN6gUbFaPVIzCrr9jnTTQZ4bD-d4Zry3xsRlnMESPrUbPyiQbAVqxPAN9Gojco/s1600/Probably+a+virus..png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 291px; height: 212px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCXmZa1gM4Mzv2ACxw72mhXFDPuRnUuaC1TzxzyynFzwLDnZVOJdsUzec_gt76TTOMAmm52qutWSqp5UwN6gUbFaPVIzCrr9jnTTQZ4bD-d4Zry3xsRlnMESPrUbPyiQbAVqxPAN9Gojco/s400/Probably+a+virus..png" alt="" id="BLOGGER_PHOTO_ID_5514411484865954114" border="0" /></a></span><span style="color: rgb(0, 0, 0);font-size:85%;" >"If I tell you it's a virus will you stop bugging me?"</span></div><span style="font-size:130%;"><br />5) <span style="font-weight: bold;">The answer went right over your head.</span></span> The doctor did answer your question. Doc just said the answer in technomedical jargon that made no sense to you. <span style="font-weight: bold;">While you may have technically gotten a "straight answer", the doc replying in a foreign language you don’t speak really doesn’t count. </span><br /><br /><span style="font-size:130%;">6) <span style="font-weight: bold;">The answer doesn’t matter.</span></span> <span style="font-style: italic;">"Look, y</span><span style="font-style: italic;">ou silly patient, I give out info on a need-to-know basis, and you don’t need this answer!"</span> <span style="font-weight: bold;">This is probably the root of all vague, dodgy answers given by doctors. We don’t think the answer is important for you to know. </span> It won’t make a difference. Answers take time and energy that might be spent on something productive. <span style="font-style: italic;">"Trust me, if you needed to know the answer I would have told you already!"</span></blockquote><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;"><br />All doctors dodge questions!</span></span><br /></div><span style="font-weight: bold;">Doctor D does it too.</span> Some questions really aren’t as important as others. We are busy and if we took all the time to answer every question we wouldn’t be able to actually help many people with with what’s wrong.<br /><br /><span style="font-weight: bold;">And not everyone wants the full answer: </span><blockquote><span style="font-weight: bold;">As a young physician, Doctor D actually tried to fully answer every patient’s question. </span> He looked up answers. He explained complex medical processes and variables. He educated people on uncertainty. <span style="font-weight: bold;">And you know what... nobody liked it!</span> Patient’s eyes would glaze over. Doctor D was constantly running late. His patients didn’t always want to get the<span style="font-style: italic;"> full</span> answer.<br /><br />When he switched to need-to-know answering his efficiency improved and his patients were happier. <span style="font-weight: bold;">Yes, a lot of people are very satisfied with vague meaningless answers.</span> Not everyone needs the full truth. Some people just needed to know I heard their concerns.<span style="font-style: italic;"><span style="font-size:130%;"><br /></span></span></blockquote><div style="text-align: center;"><span style="font-style: italic;"><span style="font-size:130%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_4aB2SsINfVG3m0ZaX5UVGzSNBNgg4QCM47UI9zKFQ-rWWwCALG7T14h7xHg-pszEIcV6L5PMkGsBvSL-JcIDo_5Wj_CFQysxWnne9cqZ47OdLho728UHR5ICpC5n4MyRjazxNBe_gxPV/s1600/You+don%27t+want+to+hear+what+the+doctor+thinks.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 199px; height: 219px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_4aB2SsINfVG3m0ZaX5UVGzSNBNgg4QCM47UI9zKFQ-rWWwCALG7T14h7xHg-pszEIcV6L5PMkGsBvSL-JcIDo_5Wj_CFQysxWnne9cqZ47OdLho728UHR5ICpC5n4MyRjazxNBe_gxPV/s400/You+don%27t+want+to+hear+what+the+doctor+thinks.png" alt="" id="BLOGGER_PHOTO_ID_5514410120832088114" border="0" /></a><span style="font-size:78%;">"You want my real answer, or the answer you want?"</span></span></span><br /></div><span style="font-style: italic;"><span style="font-size:130%;"><br /></span></span>But, obviously <span style="font-style: italic;">not everyone is happy with non-answers from doctors.</span> <span style="font-weight: bold;"> Doctor D’s email is full of desperate patients complaining that their doctors really aren’t answering their burning questions.</span><br /><br /><br /><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh26zvEA0i2qliIqaPt3k3oDPcr7UWsUzmDkVkFRZiO-0WKcZSEB_jvTpTvPVY7Sojb7q45hOGlZ4HUQsbYhDLRo6EnB2NKOvrrGUFyWnlO05j4AHujm2_ah22oAtNZGb30AB_RXHZ211FF/s1600/Honest+Answers+from+a+Doctor%3F.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 239px; height: 180px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh26zvEA0i2qliIqaPt3k3oDPcr7UWsUzmDkVkFRZiO-0WKcZSEB_jvTpTvPVY7Sojb7q45hOGlZ4HUQsbYhDLRo6EnB2NKOvrrGUFyWnlO05j4AHujm2_ah22oAtNZGb30AB_RXHZ211FF/s320/Honest+Answers+from+a+Doctor%3F.png" alt="" id="BLOGGER_PHOTO_ID_5514409553194503682" border="0" /></a><span style="font-weight: bold;font-size:130%;" >So we have a problem: </span><br /></div> <span style="font-weight: bold;">Full, straight answers to every question would take so much time and energy that the medical system would grind to a halt, but some of your questions need full answers.</span><br /><br />Doctor try their best to help filter what answers you need most,<span style="font-weight: bold;"> but in the end it is only you who can say what you really need to know. </span><br /><span style="font-size:130%;"></span><blockquote><span style="font-size:130%;"><a href="http://askanmd.blogspot.com/2010/09/how-to-get-straight-answer-from-doctor.html">Next Week</a>:<span style="font-weight: bold;"> Doctor D will teach you how to extract real honest-to-goodness straight answers from an MD</span></span>!</blockquote><br /><div style="text-align: center; font-style: italic;"><span style="font-size:85%;">What do you think?<br /><br /><span style="font-weight: bold;">Are you okay with an MD giving you vague answers or dodging your questions?<br /><br /></span>Medical People: <span style="font-weight: bold;">Do you think it is possible to honestly and thoroughly answer every patient question?<br /><br /></span>Doctor D always loves to hear your opinions!<br /></span></div></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com11tag:blogger.com,1999:blog-344900867722860530.post-22688827128788352632010-09-07T21:53:00.007-04:002010-09-08T18:01:56.543-04:00Vague Answers<span style="font-style: italic;">A reader asks Doctor D:</span><br /><div style="text-align: justify;"><blockquote style="font-weight: bold;"><span style="font-size:180%;">“What should I do when my doctor’s answers are vague and useless?”</span></blockquote></div><div style="text-align: justify;">This patient was frustrated that every time she asked her doctor what to expect <span style="font-weight: bold;">she got useless answers like </span><span style="font-style: italic; font-weight: bold;">“Maybe”</span><span style="font-weight: bold;"> or </span><span style="font-style: italic; font-weight: bold;">“That’s a great question!”</span><span style="font-weight: bold;"> or </span><span style="font-style: italic; font-weight: bold;">“I wish I knew”</span><span style="font-weight: bold;"> or other replies so vague as to offer no real answer at all.</span><br /><br /></div>So D the ever-helpful wrote her back:<br /><blockquote style="font-weight: bold;">“<span style="font-style: italic;">Dear reader,</span><br /><br /><span style="font-style: italic;">Great Question! I wish I knew. Maybe that’s just how doctors are?</span><br /><br /><span style="font-style: italic;">Love always,</span><br /><span style="font-style: italic;">Doctor D.</span>”</blockquote><div style="text-align: center;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCAkQ4bMvNDp1zsvMIwxkSCUnx-p0AlYiyChjv3CwshvJwdUp90T1bP1ZqFCm-oe_dMQWmu47Klx_Xa7KpRZM30hQoOmw-mGk_8l65FMklx0FCmT_kwCccL3X-kgljKT9qtIYHwspTCQln/s1600/Foolishness+from+a+Doctor.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 300px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCAkQ4bMvNDp1zsvMIwxkSCUnx-p0AlYiyChjv3CwshvJwdUp90T1bP1ZqFCm-oe_dMQWmu47Klx_Xa7KpRZM30hQoOmw-mGk_8l65FMklx0FCmT_kwCccL3X-kgljKT9qtIYHwspTCQln/s400/Foolishness+from+a+Doctor.png" alt="" id="BLOGGER_PHOTO_ID_5513987311448547730" border="0" /></a><span style="font-size:85%;"><span style="font-style: italic;">"Admit it, <a href="http://askanmd.blogspot.com/2010/08/you-want-online-diagnosis.html">bullshit answers</a> feel so much better coming from a professional like me!"</span></span><br /></div><span style="font-size:130%;"><br /></span><div style="text-align: justify;"><span style="font-size:130%;">You know, it's the prerogative to be a <a href="http://askanmd.blogspot.com/2009/08/why-are-doctors-such-jerks.html">heartless bastard</a> that really makes all those years of medical school worth it! </span></div><div style="text-align: center;"><span style="font-size:85%;"><span style="font-style: italic;"></span><blockquote><span style="font-style: italic;">Okay, so Doctor D isn't really that much of a jerk.</span><span style="font-style: italic;"><br /><br />In fact, he's starting a series on <a href="http://askanmd.blogspot.com/2010/08/how-to-get-straight-answer-from-md.html"><span style="font-weight: bold;">How To Get A Straight Answer From A Doctor</span></a>.<br /><br /></span><span style="font-style: italic;">Tune in <a href="http://askanmd.blogspot.com/2010/09/why-do-doctors-dodge-your-questions.html"><span style="font-weight: bold;">tomorrow</span></a> for the real answer!</span></blockquote><span style="font-style: italic;"></span><br /></span></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com0tag:blogger.com,1999:blog-344900867722860530.post-32203043343596230222010-08-26T10:35:00.012-04:002011-03-26T05:51:19.215-04:00I Hate Medicine!<span style="font-style: italic;">Last week <a href="http://journeysinmedicine.blogspot.com/">Ella the Med Student</a> wrote brilliant and thoughtful advice on how to be happy in medical school: <span style="font-weight: bold;"><a href="http://askanmd.blogspot.com/2010/08/will-medical-school-make-me-miserable.html">You need to love medicine.</a></span></span><br /><br />Now Doctor D has a confession to make:<br /><div style="text-align: justify;"><div style="text-align: center;"><span style="font-size:180%;"><blockquote><span style="font-weight: bold;">I hate medicine! </span> <span style="font-weight: bold;">Medical school was</span><span style="font-weight: bold;"> the worst 4 years of my life.</span></blockquote></span></div><span style="font-style: italic;">There, I said it!</span> It felt good to let it out.<br /><br />But before all of Dr. D’s medstudent fans rush to unfriend him on facebook they should know this: <span style="font-size:130%;"><span style="font-weight: bold;">Doctor D not just a good doctor. He is a frickin’ amazing doctor!</span></span><br /><br /><div style="text-align: left;"><span style="font-size:100%;"><span style="font-weight: bold;">How is this possible?<br /><br /></span></span><div style="text-align: center;"><span style="font-size:180%;"><span style="font-weight: bold;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyx1_us7x0sfVf_Jie7qTI5GZi7ZuBfi4Sbtihz7xQFFW5iuwPllOBzCCKDya_WLrpF0klx0HXmH8G6LlMBUwIl_iL3hBJnsrbpAcg3wNRUgC9Qb8fnJI5BvrpEtlXvNIATZiC4oIhotUF/s1600/Happy+to+be+in+a+Hospital.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 340px; height: 226px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyx1_us7x0sfVf_Jie7qTI5GZi7ZuBfi4Sbtihz7xQFFW5iuwPllOBzCCKDya_WLrpF0klx0HXmH8G6LlMBUwIl_iL3hBJnsrbpAcg3wNRUgC9Qb8fnJI5BvrpEtlXvNIATZiC4oIhotUF/s400/Happy+to+be+in+a+Hospital.png" alt="" id="BLOGGER_PHOTO_ID_5509739268773895330" border="0" /></a></span></span><span style="font-size:85%;"><span style="font-style: italic;">They look so pleased just to be in a hospital!<br />Doctor D isn't in any photos like this.</span><br /></span></div><span style="font-size:180%;"><span style="font-weight: bold;"><br /></span></span><span style="font-size:130%;"> </span><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">How I Learned to Stop Worrying and Hate Medicine:</span></span></div></div>Ella classified medical students based on their love for medicine with the <span style="font-style: italic; font-weight: bold;">“miserablites” </span>at the bottom. <span style="font-weight: bold; font-style: italic;">They are the ones in medicine with ulterior motives. </span> Therefore they hate school from the first cut on the cadaver. <span style="font-weight: bold;">They don’t fit in with other medical folks. They don’t like studying diseases or treatments. They can’t wait for medical school to be over.</span><br /><br /><span style="font-weight: bold; font-style: italic;">Yup, that pretty much describes D in medical school!</span><br /><br />Young D took one of those aptitude tests administered by the college career counselor. It said that his personality was an awful fit for doctoring. <span style="font-weight: bold;">He was warned.</span><br /><br /><div style="text-align: left;"><span style="font-weight: bold;">So why did he do it?</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Medical School With Ulterior Motives</span></span></div></div><span style="font-weight: bold;">Doctor D’s ulterior motive for studying medicine was that pesky humanitarian impulse. D loves people. </span> As a student young D worked in homeless shelters and volunteered in 3rd World countries—not to pad a resume for med school, but because he actually liked doing those things. Young D asked himself, <span style="font-style: italic;">“Self, what work should you choose that allows you to help suffering people?”</span> <span style="font-weight: bold;">Since D had the book smarts everybody suggested medicine.</span><br /><br /><span style="font-weight: bold;">On day one of medical school D realized he wasn’t in Kansas anymore.</span> He was surrounded by highly driven people who absolutely loved spending 18 hours a day studying pathophysiology and pharmacokinetics. Ella enjoys kicking back with Robbins Pathology while sipping her coffee in the morning. <span style="font-style: italic;">God bless her crazy ass!</span> <span style="font-weight: bold;">Doctor D’s trudge through Robbins was about as enjoyable as the Bataan Death March. </span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt1V4_TSoq9rDNezBIVK41ZiRfrbozkgMoflVX-VZsOHmLULXu7GCII__dZ-Yt-f3x3XeXP0EO2RKsCdfZDLjB8xIr-RJEiBDYAQTqtGeBv2KNDpb28R5j8TBBPUC0URTYT_5Fa8l88ajJ/s1600/Screw+you+Med+School%21.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 136px; height: 159px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt1V4_TSoq9rDNezBIVK41ZiRfrbozkgMoflVX-VZsOHmLULXu7GCII__dZ-Yt-f3x3XeXP0EO2RKsCdfZDLjB8xIr-RJEiBDYAQTqtGeBv2KNDpb28R5j8TBBPUC0URTYT_5Fa8l88ajJ/s320/Screw+you+Med+School%21.png" alt="" id="BLOGGER_PHOTO_ID_5509734739686844722" border="0" /></a><span style="font-weight: bold;">D’s secret fantasy in medical school was that one day he’d go in and give everyone the middle finger and drop out.</span> This thought was the only real pleasure he had for most of med school. <span style="font-weight: bold;">It kept him going when times got rough. </span> Every miserable day D told himself, <span style="font-style: italic;">“I’ll quit tomorrow.”</span> He came close to doing this about a hundred times, but never pulled the trigger.<br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Doctoring with Love and Hate</span></span><br /></div><span style="font-weight: bold;">So D became Doctor D, and lo and behold he was right:</span> All this dull medical science he forced himself to learn is useful—it helps sick people get well, and <span style="font-weight: bold;">D really enjoys his job!</span><br /><br /><span style="font-weight: bold;">The actual practice of medicine allows for amazing connection with other human beings.</span> A caring doctor during the worst and most painful day of your life is really useful. Doctor D always gets along well with patients. <span style="font-weight: bold;">One reason Dr. D connects so well with patients is that he never really did connect with other medical folks.</span><br /><br /><div style="text-align: center;"><div style="text-align: justify;">Some doctors love studying diseases and reading the latest medical trials—quite a few retired docs do this years after they’ve seen their last patient. <span style="font-style: italic;">That’s cool and all, but it ain’t me.</span> <span style="font-weight: bold;">If Doctor D lost his medical license tomorrow you can bet he wouldn’t read another sentence of medical literature again!</span><br /></div><span style="font-size:180%;"><span style="font-weight: bold;"><span><span style="font-size:180%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKrzXAd9JLhtPjn4AMThzRn3BTKa7daI0RzTdbLYiGouwRMnkwIpFVNXbrtc7TdJoupSyrZjbyuu6tadlVUx6hU9_ckej15aQm37Ig6ynzjpJ-i4t7UY77GyGRgbrVh532pha8m7o8D-ve/s1600/Injection.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 246px; height: 336px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiKrzXAd9JLhtPjn4AMThzRn3BTKa7daI0RzTdbLYiGouwRMnkwIpFVNXbrtc7TdJoupSyrZjbyuu6tadlVUx6hU9_ckej15aQm37Ig6ynzjpJ-i4t7UY77GyGRgbrVh532pha8m7o8D-ve/s400/Injection.png" alt="" id="BLOGGER_PHOTO_ID_5509742133162297234" border="0" /></a></span></span></span></span><span style="font-size:85%;"><span style="font-style: italic;">"Yeah, I don't like school either, but some things are worth the misery."</span></span><br /></div><br />But Doctor D <span style="font-style: italic;">does</span> keep up with all the info on the escalating arms race between diseases and medicine and he'll treat you with just as much skill as the next doctor. I<span style="font-weight: bold;">n some ways D sees himself as the purest form of doctor: </span><blockquote style="font-weight: bold;">Some doctors battle illness because they are fascinated with the weapons or with the battle strategy. Doctor D fights because he believes in the cause.</blockquote><span style="font-weight: bold;">So take courage you med school miserablites—you sad souls who don’t like biochemistry or fit in with your anal classmates—here is hope for you yet! </span> You may yet become a fine MD who loves this crazy job in a way those medical types could never imagine.<br /><blockquote><span style="font-weight: bold;">PS:</span> If any of you med students do decide to go out in a blaze of glory by telling "the man" to stick it up his rectum and burning your student ID please email Dr. D your story because he would love to live that moment vicariously!<br /></blockquote></div><div style="text-align: center; font-style: italic;"><span style="font-size:85%;"><span style="font-weight: bold;">An informal AskAnMD poll:</span><br /><br />How many of you medical people actually like medicine vs. those who use medicine for ulterior motives like Dr. D?<br /><br />How many of you patients would care if you doctor wasn’t actually fascinated with your disease and your medicines?<br /></span></div><span style="font-style: italic;font-size:85%;" > </span>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com51tag:blogger.com,1999:blog-344900867722860530.post-70637749335813478012010-08-18T18:50:00.020-04:002010-08-23T09:57:52.253-04:00Will Medical School Make Me Miserable?<div style="text-align: center;"><span style="font-weight: bold;">Part II of ongoing series: </span><a href="http://askanmd.blogspot.com/2008/08/should-i-become-doctor-series.html"><span style="font-weight: bold;">Should I Become A Doctor?</span><br /></a></div><span style="font-style: italic;"><br />Great question from a potential medical student:</span><br /><div style="font-weight: bold; text-align: justify;"><blockquote><span style="font-size:130%;">"I got accepted to med school for 2011, but I am scared to commit to this decision. Will medical school suck all life out of me, leaving me passionless, tired and with no ambitions?"</span></blockquote></div><div style="text-align: justify;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://journeysinmedicine.blogspot.com/"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 59px; height: 68px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsNQNP04iXsVmxRzXItde8Bu9bNKebgxi1O-C7jvjhJGEHijXL0upRobfOMqkNxneMYo3DvA8p3RHTfZpcsFm59NIFNMtpgQn0ua_WbzCy-FS_UCLuNEMGZGcZJ-LsTtUgvS4MxUM-9e0h/s200/Ella+the+Medical+Student.png" alt="" id="BLOGGER_PHOTO_ID_5507133470385974306" border="0" /></a><span style="font-style: italic;">For this question Doctor D called in a consult! <span style="font-weight: bold;">Doctor D recruited a real live medical student! </span></span><a style="font-style: italic;" href="http://journeysinmedicine.blogspot.com/"><span style="font-weight: bold;">Ella the Med Student</span></a><span style="font-style: italic;"> is a brilliant blogger and a winner of the coveted </span><a href="http://askanmd.blogspot.com/search/label/Big%20D%20Awards"><span style="font-weight: bold; font-style: italic;">Big D Award</span><span style="font-style: italic;">!</span></a></div><br /><div style="text-align: center; font-weight: bold;"><span style="font-size:130%;">Ella's Advice:</span></div><div style="text-align: justify;"><span style="font-weight: bold;">Medical school is difficult.</span> It takes tons of time. It's stressful. It is a huge commitment. It's competitive. <span style="font-weight: bold;">It is also a million other wonderful things.</span><br /><br /><span style="font-weight: bold;">Everyone in medical school has essentially the same experience,</span> the same course load, the same time schedule, etc. Yet, you will hear very different opinion from students about their medical school experience... ranging from <span style="font-style: italic;">"it was the </span><span style="font-style: italic;">worst time in my life"</span> to <span style="font-style: italic;">"this is so much fun!" </span><div style="text-align: center;"><blockquote><div style="text-align: justify;"><span style="font-weight: bold;font-size:130%;" >The MAJOR factor that contributes to the differences in student's experiences in medical school is why they are there.</span><br /></div></blockquote></div><div style="text-align: justify;"><span style="font-weight: bold;"><br /></span><div style="text-align: center;"><span style="font-weight: bold;"><span style="font-size:130%;"><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-zhv1Y9vzvUXv9NpQop7c-iS9yCPh02dqszjb93TUyByKc3axJ9uMG3Ntha8jBrZ-ELDrM0GpSpAjLaTxgMmH2dCnBXzWv-5pmCD4kApCpG60GyJ88V4ESEMExjPHZQhKhdQ7jAxOKBw8/s1600/Med+Student+Why+am+I+here%3F.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 272px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-zhv1Y9vzvUXv9NpQop7c-iS9yCPh02dqszjb93TUyByKc3axJ9uMG3Ntha8jBrZ-ELDrM0GpSpAjLaTxgMmH2dCnBXzWv-5pmCD4kApCpG60GyJ88V4ESEMExjPHZQhKhdQ7jAxOKBw8/s400/Med+Student+Why+am+I+here%3F.png" alt="" id="BLOGGER_PHOTO_ID_5507134809981217922" border="0" /></a></span></span><span style="font-size:85%;"><span style="font-style: italic;">"Why am I here?"</span></span><br /></div><br />Let me describe a pattern I have noticed among medical student. I think there are three main groups of student attitudes about medical school. I'll describe them here...<br /></div><blockquote><div style="text-align: center;"><span style="font-size:180%;"><span style="font-weight: bold;">Ella’s Taxonomy of Medical Students:</span><br /></span></div></blockquote><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The Good</span></span></div>The happiest students are those who are enjoying the journey. <span style="font-weight: bold;">They actually love medicine, love the material they are studying, love the lifestyle of continued learning and a high-paced academic environment.</span> Of course, many have other interests and families, but to them medical school is not an obstacle in the way of those things. <span style="font-weight: bold;">Med school is an awesome part of their life.</span><br /><br /><div style="text-align: center;"><span style="font-weight: bold; font-style: italic;font-size:85%;" ><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbBn0MD78CFIuTcijHYJUW0skI_87FovFqzZYAaQbiDEGfC2VtiUUhERHsg45hEHK-lIdxxDq0baKv_mysdZU9EwJAJPF3XR9iWTOzarN-u2VTIQMlxk9-8ORpNaPYbxzpY2w_DwtODpso/s1600/Happy+Medical+Student.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 280px; height: 272px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbBn0MD78CFIuTcijHYJUW0skI_87FovFqzZYAaQbiDEGfC2VtiUUhERHsg45hEHK-lIdxxDq0baKv_mysdZU9EwJAJPF3XR9iWTOzarN-u2VTIQMlxk9-8ORpNaPYbxzpY2w_DwtODpso/s400/Happy+Medical+Student.png" alt="" id="BLOGGER_PHOTO_ID_5507135560007634066" border="0" /></a></span><span style="font-size:85%;"><span style="font-style: italic;">"I'm happier than a pig in mud! Medical school is Awesome!"</span></span><br /><br /></div><span style="font-weight: bold;">Personally, I love reading my huge Robbins pathology book with a cup of coffee in the early morning. </span>I love going to lecture and participating in clinical problem solving. I feel a rush every time I am in the hospital, I talk to my patients for too long, and my brain is always coming up with ideas for projects and research. I look forward to residency and my future career, but I am in no way miserable in school. <span style="font-weight: bold;">I absolutely could NOT imagine being anything other than a physician...</span> it took me so much work to get here that I am actually in bliss all the time. <span style="font-style: italic;">I know this sounds weird... but I know a lot of other people like this. If you ask them about medical school, they will describe it just like I have.</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The (sort of) Bad </span></span></div><span style="font-weight: bold;">The second group of people are those that like medicine just fine, and it came to it as a reasonable choice.</span> They worked hard in undergrad, and are all around strong academic students. To them, medicine is more of <span style="font-style: italic;">"a good field to be in"</span> but not <span style="font-style: italic;">"the most amazing and only possible career on the planet."</span> They could have been attorneys or engineers or business entrepreneurs or stock brokers and would have been just as happy. <span style="font-weight: bold;">They do well academically, but are a bit blase about medicine... often eager to get home, eager to skip extra discussion about a disease or patient, and tend to be a bit frustrated with the rigmarole that comes with medicine.</span> This doesn't make them less of a physician, but they do not enjoy the ride of med school as much as the first group. <span style="font-style: italic;">They are "putting up" with med school... and looking forward to getting out so they can have a family, a paycheck and a steady schedule.</span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">The Ugly</span></span></div>The third group are the <span style="font-weight: bold;">Miserablites</span>. <span style="font-weight: bold;">They hate medical school.</span> They are barely hanging on by a thread academically, and they are socially and academically absent. They are caught up in the idea that that are in the wrong spot. <span style="font-weight: bold;">They've realized that medicine is a lifestyle that doesn't end after medical school... and they expect that stress and academic/hospital nonsense will be a theme in their lives forever.</span><br /><br /><span style="font-weight: bold;">S</span><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOmfm8A9pOWCOdZjiL9nZHZQgrEfGpDvTupeBgxYrnJoLH-A4zb-Kp_Q9IMOxUd-m5kH8kiM8SS1pqrvHJkHTTYPlQ8AGG-z2xMeWQDbE-6ocRuZrj1JSbq9grSYVCJHs8aJVbjf7l2y_B/s1600/Medical+Student+Just+shoot+me%21.png"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 183px; height: 149px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgOmfm8A9pOWCOdZjiL9nZHZQgrEfGpDvTupeBgxYrnJoLH-A4zb-Kp_Q9IMOxUd-m5kH8kiM8SS1pqrvHJkHTTYPlQ8AGG-z2xMeWQDbE-6ocRuZrj1JSbq9grSYVCJHs8aJVbjf7l2y_B/s320/Medical+Student+Just+shoot+me%21.png" alt="" id="BLOGGER_PHOTO_ID_5507140542708460866" border="0" /></a><span style="font-weight: bold;">ome miserablites ended up in medical school because of outside influences.</span> They felt pressured to do something <span style="font-style: italic;">"worthwhile.”</span> <span style="font-weight: bold;">Their heart wasn't in it...</span> but they either didn't have another readily identifiable passion, or they felt their other passion didn't hold enough weight.<br /><br /><span style="font-weight: bold;">Other miserablites came to medical school for the money or lifestyle, and quickly figured out that those reasons are not sufficient to motivate you through the insanity of medical school. </span> And they also figured out too late that being a doctor usually doesn't make you rich. 90% of doctors are not free of financial obligations. Student loans, malpractice insurance, etc. make the life less than glamorous.<br /><br />The miserablites are those who, as you say regard medical school as <span style="font-style: italic;">"sucking all life out of me, leaving me absolutely passionless, tired and with no ambitions."</span> <span style="font-weight: bold;">I can tell you I have NEVER even one day felt this way about medical school. </span><br /><br /><div style="text-align: center;"><span style="font-size:130%;"><span style="font-weight: bold;">Search Your Soul!</span></span><br /></div><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhA8Ho07xOhwYbP4JWez8G5xkyWpZ1i2cKGkyD9FpHk5zXsU_yGdBD3tf-D32P4LeV9IkVETsDmiXH7NZYvURbydAWo3871-LYsDmQm6mo-6UiMRflDL7qOfje2_4U91l2L_fuTf-ReIii8/s1600/Will+being+a+medical+student+make+me+happy%3F.png"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 165px; height: 173px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhA8Ho07xOhwYbP4JWez8G5xkyWpZ1i2cKGkyD9FpHk5zXsU_yGdBD3tf-D32P4LeV9IkVETsDmiXH7NZYvURbydAWo3871-LYsDmQm6mo-6UiMRflDL7qOfje2_4U91l2L_fuTf-ReIii8/s320/Will+being+a+medical+student+make+me+happy%3F.png" alt="" id="BLOGGER_PHOTO_ID_5507141419301639202" border="0" /></a><span style="font-weight: bold;">So, you have a lot of thinking to do. </span>I would really consider what this commitment means, and how it will effect your goals. You have already identified some gut feelings about whether this career is a good match for you. <span style="font-weight: bold;">I really think you owe yourself, your wallet, your future family, your happiness and your overall sanity some real hard soul-searching.</span><br /><blockquote style="font-weight: bold;">If you decide not to go into medicine, there is NO SHAME in that! </blockquote>There are a million other things you can do which are just as rewarding. <span style="font-weight: bold;">And if you do choose medicine as a career, choose it because it is best for you. It is indeed a wonderful life, but only if it is the life you really want.</span><br /><br />Good luck!<br /><span style="font-style: italic;"></span><div style="text-align: center;"><blockquote><span style="font-size:85%;"><span style="font-style: italic;">What do you think? Doctor D always loves hearing your thoughts in the comments.</span><br /><br /><span style="font-style: italic;"><span style="font-weight: bold;">Patients:</span> Would you care if your doctor enjoyed learning medicine?</span><br /><br /><span style="font-style: italic;"><span style="font-weight: bold;">Medical Students:</span> Where do you fit in Ella's Taxonomy? Any of your Miserablites want to explain themselves?</span><br /><br /><span style="font-style: italic;">Go on over to </span><a style="font-style: italic;" href="http://journeysinmedicine.blogspot.com/">Ella's blog</a><span style="font-style: italic;"> and admire how awesome she is!</span></span></blockquote></div></div>Doctor Dhttp://www.blogger.com/profile/15967600225173640437noreply@blogger.com33