Showing posts with label diagnostic tests. Show all posts
Showing posts with label diagnostic tests. Show all posts

Friday, November 16, 2012

The waiting list for the waiting list (or: I have a drug for that)




I don’t remember where I heard this – maybe in Moscow on the Hudson, one of Robin Williams’ earlier films, where he had not yet calcified into the parody of himself he is now. But it was a reference to being “in the lineup to wait for the lineup”. Do we think this only applies to the fucked-up Soviet system of inefficient callousness?

Substitute “medical” for “Soviet”, and you’re almost there.




I’ve been waiting to hear back from my doctor. I went in three weeks ago to address some alarming symptoms, the kind of thing that medical articles and TV doctors say you should follow up on immediately. I need a certain nasty-sounding test. It’s an up-the-ass sort of test that I don’t look forward to, a Roto-Rooter boring into my colon. I bailed on one of these tests a year or so ago, just couldn’t make it. This time there’s a serious reason for taking it, and I’m hearing nothing.


Maybe three weeks on the waiting list for the waiting list isn’t long, who knows. I have phoned twice to check up on it, and both times was hand-pattingly gotten rid of. In the nicest, we-know-who-you-are-you-hypochondriacal-old-bat way.


I didn’t think I had quite reached old-battitude yet, but I guess it’s a matter of degree. I don’t think of myself as a hypochondriac, but I once was told I was a “psycho-chondriac” because I dared to complain about clinical depression. Nowadays, they’d get down my neck if I didn’t complain. Don’t you know that’s a serious condition? Don’t you care about your health?


You don’t dare listen to medical specialists, especially not on TV where the more ludicrous the claim the better, because it “makes good television”. Soon the theory will be completely discarded, and of course anyone who goes to their doctor to have it checked out (as the medical “expert” never fails to insist that you should do) is looked at with that blank, incredulous, “what-the-fuck-are-you-talking-about-anyway” look.


And doctors also say “whatever you do, DON’T go on the internet about this.” I can see why, I really can. Lots of internet sites about health verge on black magic. Wave a dead cat over your head at midnight, and you’ll never have a heart attack again. Eat certain things, ingest herbs, roots, whatever they have for sale at an outrageous price, and your cancer will vanish and never come back.


But why can’t we get some basic information in this information age? Are the doctors, overloaded and harried and eager to install a revolving door in the office so they can yell “NEXT” every five minutes or so, any more useful for our enlightenment? Especially since they all have different philosophies and insist that theirs is the One True Religion.


I’ve noticed something else. My husband collapsed on the floor about a year and a half ago, and no one knew why. It was alarming to see him surrounded by police and ambulance attendants and paramedics. I had to stand back, way back, while they worked on my grey-looking life partner. Then came the barrage of tests. I don’t know how many tests, but he had to see many specialists, each of whom took a different part of the body and studied it.


Reminds me of that old story about the blind men and the elephant. It's a big piece of leather. No, it’s a thing like a hunk of rope. No, it’s a big chunk of ivory. No, it’s a – look out! It’s about to charge!


. . . PHHHHHHHHHHHHHHT!!



I do have a point. None of these specialists ever talk to each other or even send reports to one another. It is as if Bill had a separate heart, nervous system, brain, bladder, prostate, etc., component parts that were assembled like Lego or an old Meccano set. They weren’t parts of a person because these specialists are not concerned with a “person”. They are concerned with a piece of tissue, a hunk of organ. Never is the circulatory system connected to the heart, that’s insane! Nor is brain function tied to the nervous system. How absurd. They’re separate systems.


Frightening, is what it is. There is no consultation between experts, just conclusions, usually that everything is just fine and the patient is full of shit and whining for nothing.



Sometimes I want to bring back the days of the family doctor, like the wheezing old guy who carried a black bag into our house when I had the measles or the whooping cough. For a while after my first grandchild was born, there were three generations of my family seeing one physician. I’d had my doctor for nearly 15 years and recommended her to my daughter, who took her on, then started taking her infant daughter in to see her. It was an interesting throwback to a different time that is now completely obsolete.


Then she retired, and that was over and done. A child nowadays would have to go to a “pediatric specialist”, and if she was acting up a bit and stamping her foot and not paying much attention to parental commands, she’d be diagnosed autistic. ADD is now old-fashioned and has been pretty much phased out, like personality disorders in adults. The autism “spectrum” is the thing now, you see.  And by the way: I have a drug for that.


Oh, don’t get me going on psychiatric stuff, the way fads and fashions seem to dictate everything. Depressed women used to be given Valium, a highly addictive tranquillizer, which was about as sensible as taking a crowbar to someone with a concussion. Gay men were sick. They couldn’t help it, they were “immature” and their mothers were too dominant and their fathers were too weak. If they tried really hard, they might pass for hetero. But for the most part homosexuality was seen as a permanent mental illness, a serious one that disrupted the chance for a “normal” life.


For every action, there is an equal and opposite reaction. Simple physics. So now gay people – especially gay men in drag – prance around in pride parades, flaunting their “outness”. And we all smile, some of us a bit tightly, not daring to say we find the whole thing a bit silly, if not extreme. “Why aren’t there any heterosexual pride parades?” one unfortunate local politician once muttered, only to have so many bricks thrown at her that she never spoke again.



I’m not for going back to the barbaric model of “diagnosing” sexual orientation. But I don’t see psychiatric patients prancing around in parades celebrating the fact that they’re “out”.  They’re afraid, that’s why. Their condition is still very much medicalized, marginalized and stigmatized. There is no flexibility here, no individual definition of “normal”. You’re either a fuckup or you’re not. And if you’re not readily diagnosable, if you don’t fit any of the known (or should I say current/trendy) psychiatric categories, there will be hell to pay. You may even be told you’re untreatable and your condition is hopeless.


Do I sound a bit cynical about medicine? I wouldn’t go back to the days when no one even spoke the word cancer, or people in psychiatric distress were “put away”, often for life. (By the way, are you wondering now why I even mention psychiatric illness, when it obviously has nothing to do with “real” illness, “physical” illness that takes place in the body? Psychiatric illness takes place three feet above your head in a little white cloud with a nasty little man in it who spits on you every so often.)  I wouldn’t go back, but I couldn’t anyway, could I? There is no going back.



So I wait. If I do have cancer, which is extremely unlikely, then it is bubbling and festering away inside me even as we speak. It may be half a year before they can even tell, because I am waiting to see how long I will be waiting.


I’d like to see a horse doctor, please. If a horse has colic, they shove a big rubber hose into its rectum and blow a stream of warm water in it until the obstruction pops out. Sounds like a good idea to me.




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Thursday, October 25, 2012

I hate the doctor, and I don't want to go



The title sums it all up. I hate doctors. When have they done anything good for me? Every time I go, it turns out to be "nothing".

So should I conclude that it will always be "nothing"? The "it hasn't happened up to now, so it won't happen in the future" philosophy sucks rocks because it's illogical. It simply isn't true.

I am at the age - God, I hate that word - where I maybe need to worry. This is the time people are told to have screening tests like colonoscopies (which I always call colostomies by mistake - I freaked out a friend once by telling her I was supposed to have one) which scare me half to death because I've been told they can be agonizingly painful. One health forum had a comment from someone who said she would take her chances with serious disease rather than go through that again.




My husband collapsed on the floor about a year ago, and paramedics and police rushed over. Made me wonder why everyone ignores me when I have a medical problem, but then, he's male and considerably older than me. It might be heart disease, after all (because we all know women don't have heart attacks!). In the hospital they put him through a meat grinder, doing every possible diagnostic test on him. The follow-up was even more rigorous, cardiac, neurological, urological, bowel and guts and everything else they could ream out.

The result was exactly nothing.

So I don't want to go to the doctor. I don't want to go to the doctor because I've had some symptoms lately that are probably nothing, but at the same time scare the hell out of me.




It's funny, because Bill and I have talked about how we can't afford to live as long as our parents did (all four them were well over 90). In fact, we may have trouble affording our 70s. We've joked that if we make it to 80, we'll kill each other, kind of like a duel where we both shoot at once. But what if he misses, and I don't? Will I be charged with murder, or merely self-defense?

It doesn't sound good.

I think about cancer, everyone does, or do they? I don't know, I don't interview everyone in the world, or on the street. The thing is, people with cancer are usually seen as heroes, brave souls who keep smiling no matter how much it hurts. In contrast, don't ever get a psychiatric problem or you will be more or less seen as a fuckup. No one will visit you in the hospital with flowers and balloons because it's your own freaking fault you're there. Their ancient, deeply-buried dread of demonic possession will keep them away. But cancer, now! There's a great opportunity for bravery, for heroism, for stoicism in the face of pain, and lots and lots of warm get-well wishes.




Do I sound just a little bit cynical? I have my reasons.

I don't think I have cancer. So why go? I have this niggling worry. Shouldn't I ignore it? Do I want to be called a hypochondriac? But how can you be a hypochondriac if you hate doctors and stay away for years at a time?

There is something cold and frightening about the medical assembly line, the way you come out the other end feeling like dressed meat ready for the oven. There is a "NEXT!" feeling that only seems to get worse over the years. Too many patients, not enough time, because the equipment is absurdly expensive, the tests take forever and suck up resources, and it's usually for nothing. After all, somebody important might come in.

But we are stuck with it. In the past, if you had cancer, you just died. Probably horribly, because there wasn't even a good way to manage pain. Unlike today, when it's the banner illness that has spawned a million fundraising walks in every color of the rainbow, it was heavily stigmatized: people didn't even say the name. Probably this was fear, a dread that "something" had taken you over, colonized your body and was eating away at you beyond your control. This "something" would suck out the marrow from your bones, cause you to waste away to a skeleton, and probably drive away all but the most loyal family members who probably prayed that it would all be over soon.




All kinds of stuff has been written about illness, its social and emotional significance, etc. Usually the sufferer is blamed for not having it all together emotionally, for having "unresolved issues" (as if everyone doesn't have those). I wonder now if it isn't just bloody bad luck. Have you noticed how unevenly luck and blessings are distributed in life? Ain't it a bitch, and don't you wish it was different? People still get sick and die, in spite of all that fancy equipment. I've had five friends die in the last few years, and three of them were only in their mid-50s. One who was exactly my age at the time pulled his truck over, opened the door, and fell to the ground dead. Perhaps his fate was better than the woman who battled breast cancer for years, or Glen, one of the most beautiful men I have ever known, who escaped from a psych ward, swallowed a bottle of pills, and was found frozen to death beside the railroad tracks.



Oh, and that's another thing: the war imagery we use, especially for cancer. She "battled" breast cancer, she "waged a valiant struggle", and sometimes she "triumped" or scored a "victory" over it. I wonder why we do this. No one questions it, and when no one questions something I just get furious because we are PEOPLE, not cattle! My feeling has always been that you should question everything, especially loony social trends. The war imagery not only renders the sufferer especially valuable for being a "good soldier" (and we still think the military is special, no matter what anyone says), it places the whole thing at a safe, fictionalized distance, as if we're watching a World War II movie on TV or going to the Cenotaph for 45 minutes to watch old men stand in the rain.

Ah, the stoicism, the smiling in the face of doom. I wonder why people feel they have to do this, why it has become such a cultural imperative. If I had cancer, I think I'd raise bloody hell and be so hard to get along with, NO ONE would come visit me (a situation I should be used to by now). Then again, maybe I'd be terrified. I know I would not be stoical. I'd be shit-scared and probably miserable from all the clinical attention, the being fed through machines with no one talking to you.




I've heard it said that quite often, when you get your diagnosis, the doctor comes in the room, says to the patient "you have cancer", then turns and leaves. If I don't go, I won't hear that, will I? These guys are sons-of-bitches, aren't they? Are there any good ones? Well, OK, my brother-in-law, he's a Gunning man and as far as I'm concerned they're all great, but he lives all the way across the country.

If I don't go, I don't need to hear any of that shit. But if I don't go, this little scritchy-scrabbly feeling in my gut may not stop for a long time. If ever.