Friday, September 17, 2010

Dear Doctor

Dear Doc B,

I'm writing this in the hope that you remember me. I think that you might; you considered me a thorn in your side for a while.

I want you to know that I don't hold anything against you personally. You're probably a very nice person to interact with outside of the doctor/patient relationship. My issue is with your professionalism. Not your skill as a physician, exactly, but your listening skills.

I have a lot of respect for the education you've received. My hat's off to anyone who can make it through medical school and residency. Nursing school opened my eyes to the kind of rigors physicians are put through; those of you who make the grade do so because you're tough. My issue isn't with your level of intelligence, however; it's with your listening skills. Your HEARING skills, to be more precise.

Doc, you may have thought that you listened to me, but I don't think you HEARD me. You didn't take me seriously. You wrote me off, you told me that you didn't know why I was so ill intermittently but that I should just learn to live with it. You labelled me - not only in your own mind, but to other providers, too - as a hystrionic hypochondriac and also as a drug seeker. It didn't seem to matter to you that I wasn't asking for narcotics and that I made myself ill taking NSAIDs, you ignored the fact that I came to you asking for a medically managed withdrawl from narcotics after a car accident and subsequent surgery, you just saw me coming in complaining of pain and you made up your mind that that's what I was after. You even wrote it in my medical records. You ignored the times when I refused narcotic medications from yourself and from other providers, you ignored that I asked for you every single time I was seen because I wanted continuity of ignored those things and you got a tunnel vision. Do you know how difficult it is to have something like that written in your chart, Doc? Every physician I've seen since you wrote that has initially looked at me with suspicion.

You're probably wondering why I'm writing to you now, years after we last met. I'll tell you why: I have Crohn's disease. I've HAD Crohn's disease for years, even way back when I was your patient. It's not only attacked my gut, it's attacked my joints and my kidneys, too. All that joint pain I kept complaining about? It was real. The belly pain and constant diarrhea I came to you with? That was real. The fatigue, the hair loss and weight loss and the depression that came and went? The recurring kidney stones and reflux, the gall stones and billiary colic? ALL OF IT WAS REAL AND HAD AN ORGANIC CAUSE.

It wasn't all in my head. It wasn't something I was making up. It was real, doc, and had you not been so determined to prove that there was nothing wrong with me, you might have seen the signs and symptoms that, according to my gastroenterologist, were 'blaringly obvious to anyone who cared to look' and you might have ordered the right tests and come up with a diagnosis.

I consider myself incredibly lucky to have found a physician who was able to put aside the bias you placed in my chart (based on a falsehood, I might add) and see me as a sick person desperate for help. Instead of taking the preliminary negative results of a colonoscopy and endoscopy as a firm indictation that nothing was wrong, he decided to investigate further. "There's another 1/3 of your gut that I haven't seen yet" he said. "Don't worry, we'll figure this out" he said. Those words were like a ray of light in the darkness, and they made me cry. It felt like finally, someone was validating the way I was feeling.

He took me at my word, Doc. He went and looked further, and he saw that the 1/3 of my gut he hadn't seen yet was eroded and ulcerated. He looked at the abnormal blood tests, at my lack of renal function, at my swollen and painful joints, at my weight loss, at my malnutrition. He took the time to figure it out instead of dismissing me the way you did. He took the time, and he got an answer.

I'm not saying that he is a better physician than you, or even a better person than you. I'm simply saying that you might want to re-think your bias; that you may want to try to put aside your cynicism a little more often when confronted with a patient who keeps coming back with the same symptoms, telling you that something is wrong. Perhaps if you had done that with me, I'd have better renal function than I do now and I wouldn't have been as ill as I was...I wouldn't have thought I was dying. I can't say with any certainty that your lack of concern led to my kidneys only working at roughly 30% of their original capacity, but I can say that they're damaged because of the effects of undiagnosed Crohn's disease that I had for YEARS. I can say that had you NOT insisted on seeing me as the pain in the ass patient you might have been able to help me.

I know how easy it is to become cynical when confronted with patients; I've experienced it first-hand. I've also had the cynicism come back to bite me in the ass. I hope that this letter and my diagnosis is YOUR bite in the ass, Doc. I hope that you don't just blow this off as sour grapes on my part; I hope that you take it seriously and that you use it as an opportunity to reassess the way you look at patients. I don't want anyone else to go through what I went through, and I don't want you to treat anyone else the way you treated me.

Now that I have a diagnosis and am being treated adequately for this disease, I'm doing really quite well. It wasn't until I started to feel better that I realized just how awful I had been feeling for so long. I know that it may not seem like it, but I harbor no animosity towards you. If you were still practicing in my area I wouldn't be telling other patients that you're a horrible physician, and I won't be campaigning for the AMA to revoke your license or penalize you. I simply want my case, my illness, to be a wake up call for you. I want you to learn from it, to learn from me.

Much love and many regards,


Saturday, September 4, 2010


Thursday, 5pm. There's a knock at the door; Hubs answers it and standing on the other side of the screen door is D, the little boy who lives in the other half of the duplex we inhabit.

Hubs: Hey, D! What's up, Buddy?

D: Mister F, I'm real sorry but my brother threw his ball in your yard. Can I please have it back?

Hubs: Of course you can. The dogs are inside, so just go on in and grab it. And D? Thank you for asking.

- - - - - - - - - -

Saturday, 5pm

Our house sits almost at the end of a cul-de-sac. There's about 15' of grass between the duplex we share with the neighbors and the house preceeding ours - where the family that likes to party a lot lives. I don't know how many children live there exactly, but today there are 7 of them outside. To the front are my flower beds, our driveway and a patch of grass that we call out 'front yard'. It's not fenced in, but it's our responsibility to maintain. I worked hard on my flower beds this summer; I have roses, azeleas, rhododendrons and a lilac bush, pansies, alyssum, violas and snapdragons. The centerpiece is a Queen Elizabeth rose I planted in memory of my dad, a lush, spicy smelling rose with red petals and dark green leathery foliage. To the back of our houses are baseball diamonds and soccer pitches, big wide open spaces of grass for kids to run and play on.

But they don't play there. At least, the ones that live next door to me don't. They choose instead to play on the strip of grass that separates the houses and they choose to play in my front yard. They're playing soccer there this afternoon, and I tried not to mind the ball hitting the side of the house; I tried not to mind them traipsing all over my lawn. I tried to ignore the ball landing in my flower beds three, four and five times, and I tried even harder to not mind them walking over my bedding plants to fetch it - without even asking or letting me know that's what they were going to do.

When they hit my dad's rose, though...that's when I couldn't ignore it any more. I opened the screen door and told them they needed to take their game elsewhere now. They all stood still, all seven of them, stared at me with open mouths. They didn't say anything - not a single word. I know better than to expect an apology, so I closed the door and came back inside.

I give it half an hour before they're back out there with their ball in my flower beds again. I also expect there to be some retribution from their parents; there will likely be snide comments made in my direction or loud music played until the wee hours of tomorrow morning.

It's quite a contrast.

Taking it back from whom, and to when?

The Tea Party wants 'America back'. The problem that I have with that statement is that it wasn't ever theirs - white, conservative Christians - to begin with. Unless I have my history all screwed up, Native America peoples were here long before us caucasian Europeans came and took their land from them (which much force and great celebration, I might add). How can you 'take back' something that never really belonged to you in the first place?

Exactly what do they want back, anyway? What era is so attractive to them that they feel we need to turn back the clock? How many years? 4 years - back to when we had a President who wasn't a Democrat and a person of color and we were sending our young men and women to Iraq to die for a cause that was tantamount to a lie? How about 20 years, to the grand old era of Reganomics when cocaine from Latin America was king? Do they want to go back the era of McCarthy-ism, when the threat of Communism caused such paranoia in the country that we actually had an 'Un-American Activities' committee? How about the 30's, before the New Deal, where everyone had to fend for themselves their entire lives and if you were too old/ill to work, you starved or died? What time do they want to go back to, and what exactly are they trying to regain?

The Tea Party also wants you to believe that illegal immigrants are the source of all the problems in America today. Those dang Mexicans are sneaking across our border in the middle of the night, taking jobs away from hardworking Americans, getting free healthcare, dropping 'anchor babies' willy nilly and generally using up all kinds of resources whilst contributing very little to the community. Tea Party members seem to forget that unless they're Native American, they're descended from immigrants, too.

Then again, perhaps they don't. Perhaps they don't forget that; perhaps it's not so much about immigration as it is skin color, language and different culture. It's easier to use someone who looks very different from yourself as a scapegoat (which is why organizations such as the Arayan Brotherhood and KKK have lasted so long) than it is to turn against someone who's caucasian, just like you.

I'm an immigrant. I'm a Permanent Resident Alien in this grand melting pot of States. I've dropped three anchor babies here. I've worked here, gained an education here, used resources here....I have done all of the things that the Tea Party members are complaining about. However, I have blonde hair and blue eyes and fair skin and I speak English with an American accent. I'm not so obvious; I don't stand out in a crowd.

I can't say for sure that this is about race or skin color or religion or culture because I'm not a member of the Tea Party and I don't know what's going on inside their heads. From an outsider's perspective, though, it sure seems like it.