Thursday, January 25, 2007

A Short Diatribe on Certain Doctors

My brother is sick. What he has most people do not recover from. My sisters and my other brother intend that he will survive. He has one doctor who is a real mensch. When we leave his office we feel really good. He doesn't surgarcoat. But he doesn't stand aloof and 'pronounce' either.

Recently he advised my brother to see a surgeon. The surgeon he recommended did not take the right insurance so we went with a colleague. Esteemed, the right letters after his name, big deal at a very well-known teaching hospital -- it was hellish. He kept us waiting, didn't apologize, then proceeded, coldly, to insist surgery would not happen: would never happen. It was too late. He kept stressing that anything he would do would NOT be curative. He mentioned the phrase "quality of life" maybe 35 times. He said that PET scans were not perfect and there was much still present they couldn't pick up. Then, when tiring of our questions, he got up and went to the door.

Talking with my sister later, she blurted out "They don't want to look bad if the patient dies, so they purposely talk as if he will. If he dies, they didn't do anything wrong. If he lives, they're heroes. They can't stand not being able to fix it so they protect themselves from failure."

Yeah, I can understand that. Nobody wants to fail someone who is so sick. But we're not stupid. We've looked at statistics. We know what could happen.

But when the yang impulse to protect is thwarted by a situation that cannot be helped, it's the wrong move to put it on the person who is sick, by saying, in essence: you're gonna die, and I can't really help you, and anything I do will be to make you comfortable, but it's not going to cure you. What a message: You make me feel inadequate by being sick, by having something I can't cure. I don't like feeling inadequate. I am powerful. I AM A SURGEON.

And they act it out, by being cold and peremptory. Instead of putting the patient's feelings first, they protect their own feelings of importance. No-one can ever say they didn't tell the truth. There were no false promises made. No hope was allowed to interfere with their prognostications. It's almost childish. Strutting, self-important people with truly fragile inner selves, this is how they protect their power.

Want to have real power? BE HUMBLE and BE COMPASSIONATE. That's real strength.


Stewart Dean said...

Our culture holds up really worthless, demeaning, disempowering role models for both men and women.
/I/ had the good and bad fortune to grow up in a family where my mother was nearly completely paralyzed and who showed, day by day, what grit and courage can be, for thirty years, while my father, a surgeon, and my brother and I were there giving care and loving back. My parents had a ferocious love that just wouldn't give up. It was difficult, it warped my childhood in some ways, enriched it in others. It taught me to serve, to give, to pay attention, to do things right in an age where those who do can be used and sneered at.
But, as Bujold says:
Reputation is what other people know about you. Honor is what you know about yourself.

Li said...

Please write more about the inhumanity patients face during treatment (or lack thereof) when faced with life - threatening, spirit - breaking illnesses. They need a voice. Doctors must learn how to be healers, humanitarians, and teachers; and they need permission to FEEL.