Now, I have a serious question. Please tell me if you have an answer. And please take a look at the new survey.
What do doctors do? Do they ever actually diagnose anyone? With anything? I mean, if a person shows up in a doctor's office with unusual symptoms, but without already knowing what the diagnosis is, do they ever leave knowing what the problem really is?
We did have one good doctor. Once. Years ago. His name was Dr. Cosgrove and he was a pediatrician in Salt Lake City. No matter why we were in his office-- ear aches, Legos in the nose, or heart failure-- he would pull out his little note pad that was preprinted with a checklist of things for him to examine, note, and tell us. "Heart and lungs are clear, pulses are strong, ears show no sign of redness, eyes look good..." etc. etc. It took only a couple of minutes, but occasionally he caught something during this. "Did you know Joshua's right eardrum is about to break?" As Joshua is climbing over the doctor to get a look out the window, grinning from one infected ear to another, yelling, "Truck! Truck!" at a passing dump truck. No. I didn't know that. We came in for something else totally unrelated.
And then there was Dr.Cosgrove's unorthodox idea that mothers were the best judges of how sick their children were. Shocking! He once told me, "My diagnosis needs to match the mother's anxiety level. If I find a mild ear infection, and the mother's concern level is a 9 out of 10, I've missed something. On the other hand, if I find something very serious, and the mother's concern level is low, something is wrong-- either with my diagnosis or at home."
How unusual is that? How ingenious? How revolutionary it could be if others adopted the same idea!
But, Dr.Cosgrove aside, my question remains. What do doctors do? I mean, other than say, "I don't know," and remind you to fork over your co-payment as you leave.
Last year Peter was in the ER. He had a fever of 104 that wouldn't go down even with Tylenol and ibuprofen together and cold compresses. He wasn't drinking, and hadn't been for about a day. I knew he needed IV fluids, so I took him in.
The doctor ran a couple of tests, didn't find anything, and came to give us our discharge papers-- all without any IV fluids. I was aghast! I pointed out that his fever had not gone down, his eyes were dry, he was not totally coherent, and I would like him to get some fluids!
The doctor brought Peter a cup of water and told me to prop him up so he could drink it, which I did. The doctor said, "See? He's taking fluids. If he has trouble keeping them down, bring him back in." Peter promptly threw up the water all over the doctor's pants and shoes. I just about shouted, "Bravo, Peter!" But I refrained. The doctor looked down at himself and said, "Here are his discharge papers. Sign here."
My mother had a very good idea, later, for what I should have done at that point. I should have said, "If you'll sign a paper stating that you refused IV fluids when I though that was what he needed, we'll leave."
But I didn't think of that. So I took Peter home. We found out in the next couple of days that he had pneumonia in both lungs, influenza type A, and mono. All three. At the same time. And I now am quite certain he had kidney stones that day, too. But the doctor couldn't be bothered to find any of that out.
Check you in, check a couple of tests, check you out, check the box. Check please! Next patient.
The reason this comes up right now is that I took Elizabeth to the doctor yesterday to get the results of her (second) sleep study. The doctor is a pulmonologist who specializes in sleep problems. She had ordered the sleep study because Elizabeth has been so tired for the last couple of years that she's having a hard time functioning. The sleep study showed that Elizabeth woke up (micro-arousals) 25 times an hour. That's a lot. Even for someone who has wires glued on their head and is sleeping in a hospital. Her sleep stages were not normal, and there were extra waves of a certain type in stage two sleep. The doctor said E's oxygen and CO2 levels were fine, though. So she had no idea what was wrong. Something. But she doesn't know what. So good-bye!
Two sleep studies have now confirmed that Elizabeth is Really tired. Wonderful. We already knew that. But no doctors involved feel any responsibility to find out why?
Just like Rachel's muscle problems (constant jerking), Bethany's toe problem (it turns white with apparently no circulation sometimes), my heart problem (LBBB-- the electrical system apparently quit functioning properly recently), Peter's fever and dehydration problem, any of my kids fainting (which Naomi did this week-- but I'm not taking her in-- and Josh and Elizabeth have done in the past) and many of my siblings problems (medical =) I mean).
Does anyone ever go into a doctor and walk away with more info than they brought with them? Do doctors ever find out what's wrong? Why on Earth do we pay these people? Couldn't there be a system as I've heard China used to have? You pay the doctor regularly when you are well. If you become sick, you quit paying your doctor until you are well again. I think it's a brilliant plan. That would be the best health care reform of all. Perhaps I'll see if some politician will go for it.
In the mean time, I think I'm just done with doctors for a while. The seriously toxic prescription the neurologist handed Rachel, with assurances that the only possible side effect would be some weight gain (liar), combined with the complete lack of useful information all around, lead me to believe we should just say home and try to figure things out ourselves.
Rebecca
who will post about the wonderful book she's reading soon! =)
2 comments:
You're beginning to sound like one of the hippie/psychic healer types ;)
I've decided that 90% or more of everyone in every profession is incompetent and lazy. Or at least lazy and generally unwilling to break out of their routine. For doctors the routine includes diagnosing certain sets of symptoms, and the laziness is mental, not physical. Every doctor SHOULD be aware of -- and test for -- potentially serious problems associated with common sets of symptoms, but 90% of everyone is lazy and incompetent.
It goes without saying, of course, that you and I (and anyone else reading this) are in the minority ;)
Tell Bethany Happy Birthday from me and let her know that I have a small present for her in the form of a set of programming challenges.
Two more things. First of all, why are you awake at almost 4 am. Second, there is a P.A. here at Ft. Eustis who (though busy) is actually pretty good. Not only is he thorough about diagnosing things, but he knows the military system pretty well and anticipates roadblocks to getting real treatment. For example, when I went in with weird blisters on my hands (dishydrotic eczema, easily prevented by changing my brand of soap) he said "I know this isn't syphilis, but I'm going to test for it anyway because it can cause blisters on your hands and if I don't test for it the dermatologist will send you back."
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