Full disclosure: I hate going to doctors, but at least for half of my life, I did the "right" thing. What is the right thing? I got all the tests, got biopsies when necessary, and submitted to scales, blood pressure cuffs and gynecological exams. Then when my mental health went south, I didn't have the energy to pursue a never-ending stream of mammograms, colonoscopies and the like. I was like flat out unenthusiastic about filling my days with terrifying tests that would only upset my balance even more. What I needed were happy books, films, and lots of anti-depressant medications. Not mornings when all I might have to look forward to were stirrups, speculums, and a professional's finger up my ass.
Okay, so I gave up worrying and thinking about my health insofar as tests and doctor visits were concerned. I still took care of my health in a minimal way--I brushed my teeth, saw the dentist regularly, and showered when I had to wash or dye my hair. And I still went to my dermatologist because all she had to do was look over every visible pore on my body and tell me whether I had skin cancer. No invasive tests, just an embarrassing closeup investigation of every blemish on my body.And look she did, and when she found stuff, I submitted to biopsies, laser treatments, and surgery. So I wasn't totally reckless with my health. I did eat ok even though the psychotropic meds and the chronic depression often lowered my appetite or changed my taste. To put it bluntly, I loitered on the dessert aisle. I was fine with ice cream, pies, cakes, candy, and chips, but the really nutritionally rich stuff like meat, salads and veggies were a little harder to swallow (pun noted, read on).
Since I had been diagnosed as being hypothyroid, I had to take these little grey pills every day. I actually saw the reason in that since the Internet informed me that too little thyroid hormone and a whole host of horrors happened: weight gain, hair loss, and depression. That last side effect was the clincher. If I wanted to minimize my depression, the thyroid pill might do the trick. It was no problem at all except I needed a doctor to prescribe them. For some crazy reason, my psychiatrist or nurse practitioner refused to authorize them. I still can't figure out why, when they were already prescribing medications that could cause dizziness, fatigue, strained urination, suicidal ideation, and a host of other negative side effects. I think it was a conspiracy, and my shrinks just wanted me to go to a general practitioner so that if anything went wrong in my body--like if I died overnight or turned into a vampire--they could blame the GP for it. "It must have been the thyroid medication," I imagined hearing them say after the police tasered me for driving blindfolded on a one-way street. Responsibility is hard for anyone to take, but shrinks especially since they do see loads of suicidal people. The APA or AMA--one of those groups--allows one suicide per psychiatrist per year, but no more, so precautions are warranted, which is where the GP comes in.
After running out of thyroid supplements, I cried a little, then looked around for a patsy or anyone with a prescription pad. Anyone would do, I figured, as long as he or she would limit their medical intervention to pulse taking, bloodletting, and temperature taking. Of course I made the mistake of listening to my husband, who volunteered his internist. Now this was a guy who had helped my husband during a crisis caused by a malfunctioning prostate. It's complicated so I'm not going to go into it, but suffice it to say, I saw his doctor twice a day in the hospital where my husband was recuperating from acute kidney failure. I wasn't in the best of moods then because I was obsessed with wondering whether I would become a fairly young widow or my mate's lifeline to dialysis clinics. Either way, I figured I was screwed. I'd have to get a job that paid more than the subsistence wages I was making with freelance writing and get out on the dating scene again. I didn't know which scenario was worse. It was enough to aggravate my chronic depression into a full-scale catatonia.
To make a long story shorter, I decided to go to this MD pal of my husband for the thyroid supplement. Of course I didn't tell him I was just coming in for a blood test and a pat on the back for keeping an eye on one of my endocrine glands. So he presumed I was ready to jump on the medical bandstand and take every test and shot in his shop. It was after I got weighed and my blood pressure taken that my goals began to clash with his raison d'etre. After waiting and waiting and waiting for what seemed like the best years of my life in his reception room and then in one of his exam rooms, I began to observe and evaluate my surroundings. I noticed the decor--carpet, tile, and wall space. He had the de rigueur charts on the skeleton/body, some hygiene posters, and lots of brochures on the signs of and care of diabetes, congestive heart disease, osteoporosis, arthritis, and a heap of other maladies I had only heard about on Netflix ER shows where doctors found worms crawling around a woman's head and dislodged a man's penis from a beer bottle. But there were no brochures on my cause celebre: Valley Fever. I had been volunteering to publicize the dangers of Valley Fever, an incurable life threatening disease endemic to the Southwest and particularly Arizona, for the past five years, and I was passionate about Arizona not funding a cure or at least a preventive. I had heard so many stories about doctors who misdiagnosed Valley Fever as lung cancer or some harmless flu or cold that I was overly sensitized to any health professional whom I felt was shirking his or her duty by not telling patients of the commonness of Valley Fever. I just wanted doctors to have brochures out from the Valley Fever For Excellence that told the symptoms of valley fever. The idea was that patients who suspected they had these symptoms would inform their doctor and request a cocci test.
Well, picture this: I'm sitting quietly in an uncomfortable chair in the exam room chewing on the inside of my cheek (per normal) and waiting for the doctor to make an appearance. I've already been chit-chatting with an intern who seemed to know nothing about nothing. I figured bringing up valley fever to him wasn't a good idea. I'd only be disappointed in his attitude. Like he might say, What is valley fever? I've only been living in Phoenix for 15 years and my grandmother died from "pneumonia," but I've never heard about it."
So to minimize irritation on my part (since I'm already in a shit mood due to depression and poor self esteem) I postpone my inquiry about valley fever pamphlets until the doctor enters. In his immaculate white coat with a stethoscope hanging around his neck, there was no mistaking that this guy with the strained smile and whiter than white teeth was my doctor. In fact he was the quintessential doctor if you like them cheery and dogmatic. After a few pleasantries and his noting that my weight was "a little high," I knew I had to hit him with a valley fever plea in the next three minutes or he would be gone for good. As it was he glanced at his watch, which in his favor was not a Rolex, afterwhich he locked eyes with me.
"I notice you have a lot of brochures on diseases and conditions," I said in what I hoped was a pleasant though faked-up tone of voice, "but nothing on valley fever." I noticed the muscles of his face seemed to tense, and he appeared to be in shock. I had gone off-script. Patients were supposed to do nothing but yes their doctors and sign up for tests, but I had had the audacity to suggest he introduce his patients to the reality of valley fever. To his credit, the "shock and awe" face didn't linger for long. It was quickly replaced with a blank look that either meant "you are so right, and I'll get those brochures from the DHS as soon as possible" or "fuck you."
It didn't take me long to conclude that the second reaction was his honest feeling now revealed in all its truthfulness and tough love--he wasn't going to publicize valley Fever over his dead body or anyone's for that matter. Now anger took up residence in the exam room. He was angry at what he felt was an indecent accusation (you might have thought I was accusing him of sexual assault), and I was angry because my valley fever cause had again been discounted, written off as a stupid suggestion from a patient as dumb as a post. After that it was all downhill in our relationship. He quickly learned that I wasn't going to get a flu, pneumonia, or shingles shot, and I wasn't going to go for a colonoscopy, mammogram, or EKG. I could see by the fact that he hadn't written anything on his white pad in the last four minutes that I would be lucky to get out of that office with a prescription for thyroid meds. I was patient non grata.
Still, his next "chess move" surprised me. I was unprepared for total rejection. As a freelance writer, I had been rejected by good and bad editors and agents innumerable times. Rejection was something I was used to experiencing in my professional life, but rejection from a doctor? What had I done to cause such a downer? Did I not inhale and exhale correctly when he placed the stethoscope on my chest? Did I forget to use deodorant, and he took this as an affront to his masculinity? Did I have bad breath? Just what was the problem? I had only to look at him to know that again I had failed in a relationship with a man. My husband and father represented past failures, but I attributed them to a dysfunctional family, competition with a sister with OCS (only-child syndrome) and a husband who had no idea what he was getting into when he married me. But for a relationship to turn so bad with a service provider, I had hit an all-time record. Raised to be a "nice girl" who did what she was told by a bevy of authoritarian figures, I had jumped ship. I now could claim the title of Bad Patient.
Get out, my MD said not in so many words but by implication when he turned his back on me after tossing an ugly look in my direction. I could tell he needed a timeout, but I didn't think I was the person to tell him. Maybe the intern would, I thought.
"I'll fax you your file, and you can go somewhere else," he said in a calm and deliberate way. We are not compatible." I don't think he said compatible, but he meant it. He also meant that he considered my suggestion on valley fever flyers to be an act of defiance that he would not tolerate. Especially from a woman and not even a pretty woman.
So that's how I got fired by my GP. As further punishment for my crime of assertiveness, he would only give me three months' worth of thyroid pills, until, he said, I located another physician.
I'm curious what you think of this true anecdote and would like to hear your comments. Did I do something bad by suggesting an addition or change to his office educational library? Should I have apologized? Let's hear from you. Inquiring minds want to know, so keep those comments coming!
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