Friday, November 21, 2008

Yes, I'm Going There

Here's an idea that will stop the gay marriage debate:

Take marriage out of the state all together and make it strictly religious. Civil unions would be recognized by the state, with registered domestic partners enjoying all the same rights as those who were previously married under state law were given.

Of course, this could mean that those whose marriages were performed in a civil ceremony rather than religious could lose their "married" label. But hey, it's just a label, right? Civil unions are exactly the same, with the exact same civil and constitutional rights. Quit your whining. It's just a matter of nomenclature.

What, you want to get married but you have to settle for a civil union? Why can't you get married? Ohhhh... your religion isn't too cool with you hooking up with husband number three*. Yes, well, I can see where that might be an issue in some denominations.

It isn't fair? You should be able to get married too? Please, do tell me what makes your third marriage more valid and committed than the marriage of the gay couple who have been together for twenty-plus years, who were finally able to get married, and whose marriage is now in danger of being invalidated by the passing of California's Proposition 8.

Get back to me on that when you have an answer.

*Full disclosure: I'm twice divorced, folks, and in a committed relationship with an eventual eye toward marriage, so this scenario would nuke me specifically -- I'm not razzing on anyone who's had bad luck in marriage. But seriously... like we straights have all done so well with it? The sanctity of marriage ultimately is not defined by gender, but instead by the caring, compassion, and committment of the partners.

Thursday, November 13, 2008

Reflections

Oish, what a couple of days I've had. I've been mulling over the situation with my former doctor in the post below since it happened, and in addition I had a bit of a verbal spat with my ex (resolved, I think), AND the freaking IRS appears to have lost the bloody tax check I mailed in. They'd like a new one by November 27th, thanks, even though my bank shows they already cashed the blasted thing. Arrrgh!!!

Some weeks it just doesn't pay to get out of bed, yanno?

Ah well, anyway...

I think I've come up with part of what might have precipitated the doctor's outburst. Prior to my appointment there was a woman in the waiting room ahead of me. Accompanying her was her very rude, loud, boor of a husband. He'd been creating a ruckus out in the main reception area, continued to create more problems in the GYN waiting area, and proceeded to loudly grouse his way back in to the exam and appointment area with his wife. Something about "You gave them $140 for nothing!!" with his wife desperately trying to shush him.

It's highly possible that this was the patient my doctor was dealing with right before me; if so, I'd say that it's also a pretty safe bet that he used up any and all reserves of understanding and courtesy while dealing with his patient's asshat of a husband.

So he finally escapes from that lunatic and enters my room, where in his perspective I first gripe about the wait time, and then I deny information that, again in his perspective, I certainly had been given.

So he lost it. Ouch.

And while thinking about the doctor situation, I've also been reviewing my own actions both during the event and leading up to it. In the course of that particular navel-gazing exercise, I flashed on a couple of entries Dr. Rob put up in August: Getting Along, Part 1 - Doctor Rules, and Getting Along, Part 2 - Patient Rules. So, as evidenced by those links, I went back to those posts and re-read them, most specifically the Patient Rules post.

In brief, the rules:
1. Your doctor can't do it alone.
2. Be honest.
3. [Your doctor doesn't] play favorites.
4. Don't mess with the staff.
5. If you don't trust, leave.
6. No news might be bad news.

For more detail, please see Dr. Rob's original post in its entirety.

The doctor in question appeared to believe I broke Rule 4, although the nurse to whom this refers agreed with me that I didn't accuse her of lying. Now she and I might disagree about what I was told vs. what I heard, i.e., she is certain she read his remarks verbatim whereas I'm positive that I would have heard it if I'd been told I had a hormonal imbalance, since I was convinced my problem was, in fact, hormonal and I remember being flatly disgusted that it wasn't. But in light of the fact that everything else I was told does indicate that the problem was indeed hormonal, there is a possibility that I misheard her. I can't understand how I could have missed it, especially as I was convinced the testing would finally show some hormonal cause to the 22-day-period-from-hell; but I must admit, since I can't replay what she said, the possibility is there.

My culpability in this situation, overall, lies in the fact that I totally hosed it on following Rule 5. I've re-read my posts about my health issues last spring, and it was clear from what I wrote as the testing progressed that I wasn't happy with my care or my doctor's communication. I also was afraid to call his office to seek clarification on anything, for fear I'd annoy him or cause him to talk to me harshly. He had that reputation with his office staff prior to his practice moving, to the point that one of the nurses who was assigned to another doctor in the building told me they all held their breaths when he arrived in the morning until they knew what kind of mood he was in.

Gee, I had others telling me he was difficult and I was experiencing some of the same thing as well as fear of worse. Why in the world did I remain under his care?

Simple... and stupid: I was afraid of offending him and/ or hurting his feelings.

Like I said... stupid. Unbelievably, ridiculously stupid, especially in light of what happened since I didn't listen to my gut and find another doctor.

Any offense or hurt feelings on his part couldn't possibly have compared to what I was subjected to this past Tuesday. And unless the man is an irredeemable jerk (which I'll admit that I suspect, but in all fairness I also know him to be capable of wonderful professional caring and concern from one of my friends who has seen him), he's also disturbed by what went on.

So to all three of you who are still reading this blog with my sporadic posting and all, please-oh-please, if you have any doubts about your doctor, if you just aren't feeling comfortable, if you have some niggling worry, find another physician. No one, doctor or patient, can thrive in a relationship without trust. And the damage done by leaving a doctor's care is much less than the damage that can result from continuing to see a doctor about whom you feel in any way uneasy.

Believe me.

Now all that said, I certainly don't feel any of this excuses the doctor's treatment of me. It explains it -- doctors are people too, and all of us screw up at times -- but doesn't excuse it.

It isn't appropriate to accuse patients of acts they didn't commit.

It isn't appropriate to attempt to deliberately embarass patients.

It isn't appropriate to badger, belittle, and verbally batter patients to gain false confessions of actions they didn't commit.

It isn't appropriate to talk over patients as they try to explain something and raise your voice to them.

It isn't appropriate to continue to continue to harrangue patients who are obviously in great distress, manifesting physically as well as emotionally.

It isn't appropriate to threaten and intimidate patients with the implication that you will harm their ability to receive decent medical care in the future.

Oh, and if there is some sort of discussion that must take place due to a difference of opinion, I personally feel that patients should be permitted to get dressed and the discussion be moved to a more neutral location rather than carrying on an argument while the patient is stuck in a vulnerable position on an exam table dressed in a backless gown with a paper drape, and nothing else.

So on breaking Rule 5? Totally my fault. But as to my former doctor's treatment of me? Utterly unacceptable.

Tuesday, November 11, 2008

My GYN (Revisited)

Sigh.

I almost had my annual GYN appointment today. Almost. Yes, with the same doctor I was griping about back in this post.

I really should listen to myself when I think I should find another doctor, but I'm one of those folks who not just dislikes the annual "spread 'em and grin" appointment, I loathe it. I feel violated by it, I feel literally sick to my stomach over it.

So basically, because I didn't want to get used to yet ANOTHER doctor with his hands somewhere I feel at my core they shouldn't be, and because I fear dying from some preventable disease that could have been detected by this appointment even more than I fear the appointment, I scheduled this year's with him again.

Late, I'll grant you, but I scheduled it.

The man is a ... well... words can't describe. Let me give you the story.

I had an appointment at 3PM my time this afternoon. The doctor finally entered the exam room after I'd been parked on the table, as I was told, in the gown and sheet with nothing else, for nearly 45 minutes. To top it off, I was in no small amount of pain.

He asked how I was doing in a monotone without looking at me, and I responded that I'd been doing better before I'd been sitting on the table for 30 minutes and the bursitis in my hip flared up. I wasn't nasty, just stating the facts... even had a half-smile on my face which he'd have noticed if he'd freaking looked at me. He didn't apologize, nothing. Just said he'd been with a patient. I said that was okay, things happened. And they do. I get that, even though it was now over an hour past my appointment time, I get that.

If I hadn't made that comment likely things wouldn't have gone downhill the way they did, but I fully believe that his response and treatment of me was inexcusable. And I apologized.

He then got, to my mind, very confrontational. He went back to the last time I was in in April of '07 and mentioned that I'd been told of a hormonal imbalance, and had failed to get their recommended treatment, to which I responded I'd NEVER heard I'd had a hormonal imbalance. I was shocked, because this was the exact opposite of what I'd heard (check back in the linked post above and it will state that the nurse said the problem was NON-hormonal in nature).

That really set him off. saying he knew the nurse who called me would have told me this. I told him that I'd been blogging about it and had blogged the resport of the test results right after they happened and if he had internet access I would happily locate that for him. He said he didn't and he called the nurse in who had called me with the test results (I'd had an endometrial biopsy). He then said in front of the nurse that I had accused her of lying to me, which I had NOT. I told him what I had been told, which does NOT mean I called her a liar. Good grief. And anyone who's dealt with patients or people for that matter knows that a person CAN miss something they're told, if indeed I did.

Really, I don't think she told me because I would have grabbed onto "hormonal imbalance" as at least SOME sort of diagnosis. And as I recommended to y'all above, I checked my blog to verify that I heard I was told that my results said the bleeding issues I had were NOT hormonal in nature.

I will admit it's possible I misunderstood. But that in no way excuses the doctor of saying I said the nurse was a liar (what a freaking JERK), or for him RAISING HIS VOICE AT ME. There I was, in the stupid gown with the stupid paper wrapper, in about the most vulnerable position you can get into, and he's yelling at me.

It was around that point, when he was being very nasty with me that I mentioned going somewhere else. He agreed, and said he would likely dismiss me as a patient which I told him was his right of course.

I am so upset. You simply don't treat people that way no matter what, and when you're a DOCTOR you most DEFINITELY do not talk to a patient who is visibly upset in that fashion. I even showed him that my hand was shaking and he made zero attempt to try to calm himself or to diffuse the situation. Nope, I was the one doing that. Why? Because I'm always the one who tried to calm the loud situations.

After he yelled, I mentioned that I'd just gotten out of ten years of a verbally abusive marriage and I would not be talked to in that fashion again. That likely made him more angry... but I can't take it. I simply can't be talked to that way. It's impolite, it's unprofessional, and I feel even more sick now than I did when I went in.

His nurse was very nice to me after he left -- yeah, the one he accused me of calling a liar. And I'll be happy to see another doctor than him, believe me, but now I'm terrified he'll put his "letter of dismissal" in my file and say awful things about me in it and I won't even know and it will become impossible for me to get another GYN which is devastating because if I had known there really WAS a problem, gee, I would have been in to see the doctor quite some time back. And I'd like to get in to see one, so I really REALLY am terrified he's going to do something to screw that up.

God I hate this.