We give way too much power to our healthcare providers. Here are a few stories about why that's costly
Is it safe to assume your doctor is always right?
That depends, doesn't it?
It isn't just that even the very best of doctors are limited strictly by the profit-hungry insurance companies to mere minutes no matter how complex your condition may be. It's that thoughtless comments, recommendations driven by greed vs. true care for the individual can cripple us even more than the condition we're asking them to treat.
My friend Melissa called me this week, a week where I got carted to the ER for what turned out to be pure, unadulterated stress. She told me a story which made me jump for joy. Her journey wasn't particularly easy, however.
Melissa's a few years younger than I am. She's been working with an eye doctor and an eye surgeon for a while. The optometrist would only look in one eye, telling Melissa that her eyesight in the other was so bad that she would never EVER have 20/20 vision again, even with vision aids.
Melissa, like so many of us of an age, bought that. She had gone through Lasik surgery and has had contacts for years.
Long story short, she needed cataract surgery in The Eye That Would Never See 20/20 Again. An arrogant but very competent surgeon took care of her, and she reported her recovery as good. She wasn't expecting much.
After all, her eye doctor had told her that this eye wouldn't improve much after cataract surgery.
She went back for a checkup with the surgeon. Turns out the eye that would always be a problem, which would never ever see normally again, was already back at 20/25.
With glasses, the doc said, she would see 20/20.
Would Melissa mind glasses?
Would you like to be handed a million bucks?
She shelled out a chunk for new frames that same day.
And told me what she was going to send an email to the woman doctor who flatly told her that her other eye was essentially useless. She was going to be blunt, but kind: that doctor had effectively lied to her.
Happily Melissa got better doctors. And with new glasses, she will be seeing 20/20. She was still in a kind of shock. She said today that she had seen, with some wonder, that a rose is made up of many, many different colors.
This article speaks to the effect of placebos and nocebos, the latter of which is what Melissa got from her doctor:
A doctor is all too often imbued with great power, when their job is educate us on our bodies. Unless they know us intimately, which these days is not likely, they can't possibly tell us whether or not we will heal well, heal at all, or bypass all expectations and achieve the impossible.
What is true, however, is that if we give them far too much agency, their words can condemn us to being crippled for life in one way or another. They are, as we all are, relating from their own experience, prejudices and limitations. Their problems. Not ours. But when they visit their issues and -isms on us, the cost could be terrible.
I've written often about what our family doctor, Willy Steele, told me in no uncertain terms back in 1972 when I had severed my Achilles' tendon and was smoking five packs a day.
As he removed the cast from my leg, Steele, who was a fellow chimney, intoned with all the seriousness of Moses on the Mountain that I would always limp and I would never be able to quit smoking.
The next morning I was on the 600-yard track at my old middle school, running, limping, spitting, coughing, bleeding, crying and in horrible pain. The next day I did it again. And again. I kept at it. Three weeks later I didn't cough OR limp. Never did again, either.
That taught me something indelible. No matter how well-schooled or skilled, doctors really don't know as much as we think they do. They know the body but they don't know OUR body. Most importantly they don't know US. That's the magic ingredient here.
Willy Steele, MD couldn't quit smoking. That had not a damned thing to do with me.
My buddy Orvel Ray broke his back, hand and many other body parts when he went sliding off a high roof at his neighbor's house back in 2008. From his hospital bed, he considered suicide by inhaling all his pain pills. His speaking business was gone. He was in a terrible depression.
Worse, his great love, being a drummer in a big band, playing 1940s swing music, was over. His doctor told him that he would never, ever pick up a drumstick again.
Like Moses on the Mountain, GOD SPEAKS.
While Orvel Ray was walloped and down just like I had been, this is not a guy you keep down for long. As soon as he could he was doing PT, yoga, and every single thing he could to get back in shape.
It's fair to sat he did an excellent job.
That's my lifelong friend Orvel Ray on the drums, doing precisely what the self-appointed expert of all things had told him he would never do.
And he's working as a top-notch coach, fulfilling another long-held dream.
Doctors are achingly human, as are we. They are just as susceptible to foolishness, arrogance, graft and greed as are we, and they all too often buy wholesale into the notion that they alone are God. Therefore what THEY think about our bodies is cast in stone, and there is no other truth.
Which is why some doctors are subject to being ignorant and viciously unkind about things like obesity (move more and eat less, right). They can make sweeping, patently-wrong statements which can end a career or break a heart right in their offices.
They can get invested in being right rather than being invested in learning more about what could be going on. Misdiagnoses kill, please see the article, bottom.
Even the very very best can get exhausted, strung out and pressured, and they are prone to mistakes no matter how good or well-meaning they are.
And we believe them, which is the greater crime.
Jim Stutsman reminds me regularly that when he is allowed his carefully-controlled very few seconds with his Primary Care Provider, she tells him (correctly, as for all doctors) that he most likely knows more about nutrition than she does. That goes for both of us and for many others, too, who take the time to read, experiment, work with a nutritionist to find the diet which works for us where we are.
My parents grew up in an era where the family doctor came to your house when the kids got worms or had a bad stomach. They would spend enough time with you, get to know everyone, notice the conditions of the house and the food supply and have the kind of knowledge of the context of our lives, including the emotional issues, that today's doctors don't have.
I doubt we will ever see that again. If anything, AI will likely invade the doctor's office and replace any kind of bothersome interpersonal communication. But that is, for now, at least a few weeks away.
The human spirit is a wonderful thing. We need it in doctoring, which has gone the way of greed, high tech and high doses of pills we have no business taking if we want any kind of quality of life.
Happily a great many docs are, indeed, great.
There are so many stories of people whose doctors have given them a death sentence. They went on not only to survive but also thrive. Like my buddy Orvel Ray.
Pills and procedures cannot do what will, grit, perseverance and determination can do.
My friend Zack Childers spent his very early childhood in braces, using a walker and wearing a helmet. Saddled with severe cerebral palsy and a mother who gave him up right after his diagnosis, Zack was told he would never walk.
This is Zack today:
Zack defied all the odds and continues to astound everyone. You would not know he had cerebral palsy until he speaks. His work to gain control of his damaged body is just that amazing.
Yet every day, some doctor is telling some kid, some grandmother, some husband, some athlete, some teen, that their dreams are over. You're done. NEVER AGAIN.
Melissa couldn't exercise her eyes in the same way I could run on that track. However she can exercise her Goddess-given right to not believe her doctor. She's moving on with her 20/20 vision and new glasses.
Years ago I had a new opthamologist/eye surgeon inform me that I needed punctum plugs for dry eye, and I needed cataract surgery.
I took that news home, did some research and made these changes: I took the space heater away from my feet, installed two humidifiers and used Systane eye drops. Problem solved.
Punctum plugs are not a permanent solution but they can permanently change your tear ducts. Not on your life .
I also took that information to my trusted optometrist who laughed both off. He said that most of his sixty-year-old patients would kill for my eyesight. I was ten years away from cataract surgery.
I'm seventy and I STILL don't need cataract surgery. Diet, exercise and regular care, along with lutein.
Key word? Trusted.
I fired the new opthamologist who was hot to trot on all kinds of surgeries I simply did not need.
How do you know when to fire a doctor?
When they have a big screen in their waiting room pitching drugs, and there are drug brochures instead of magazines at every elbow.
WALK OUT FAST.
All you are is meat with a wallet.
Over the course of my life I've had some fantastic docs, several of which I have the pleasure of working with right now. In the past I've also had dangerously arrogant and ineffectual doctors who very nearly killed me off.
To that, I would invite this:
First, learn how to be your own advocate. If you're single, the medical system is against you from the get-go. Single people sometimes have to lie to get care, for the system functions under assumptions that died out in 1957. Facilities demand that you have a family member spend the night and no such thing exists, so you have to lie or lose the care.
You HAVE to learn your body, you must get competent about what ails you and what you can and can't do around your own home.
Second, and forgive me for banging this drum here, get in your best possible shape. That is the single best thing you can do, for when you are healthy you need medical care less. And you have the strength of body and clarity of mind to advocate for yourself with a doctor who may not have your best interests in mind.
Third, question and research every single medicine any doctor wants to prescribe. Demand to know why. Research the med, the side effects and know what interactions it may have with what you're already taking, including anything in your medicine cabinet.
Finally, get a second opinion when it's important. Why? Because doctors are overworked and stressed out and tired and pressured, and that means they can make a misdiagnosis. I will end with this (and kindly forgive that this is provided by a legal firm, the information is solid):
Above all, do NOT accept one doctor's opinion, especially if it's a really harsh one. Get another, and another if you need to.
Finally: bottom line, you and I are in charge of some 75% of our quality of life. We can and should fight for ourselves, our best lives. A doctor is after all, only human. Skilled, but flawed, as are we. It's our job to do everything to get healthy. It's our doc's job to help us return to that health when we are off the rails.
Our bodies, our lives, our rules. Fight for your health. Live your best life.
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