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.

Nephrologist: say it three times, backwards

The surprising thing about being, so help me, 57 years old (as of yesterday: happy birthday to me!), is that your insides age just like your outsides. Or maybe a bit more.

You can't see in there, and if you're not having any obvious problems, you can (wrongly) conclude that everything is chugging away normally.

I seemed to be chugging away normally, except that my doctor (not the one I complained about a few posts ago) noticed an elevation in something called creatinine. Oh dear. Creatinine isn't a good thing if it's elevated. It was, in fact, elevated just a tiny bit, but this particular doctor, being a specialist and a nitpicker, decided to refer me to another specialist who turned out to be an even bigger nitpicker.

This was Dr. Schachter, the nephrologist.

Nowadays, instead of doctoring the whole person, most docs choose one part of the body and study it furiously. There are advantages and disadvantages to this approach.

The advantage is, these guys really know their stuff. Though I didn't know Dr. Schachter and didn't at all know what to expect, I was amazed at how thorough the exam was: far more thorough than the cursory open-the-mouth-and-look-at-the-horse's-teeth thing I have come to expect once a year from my family doctor.

The not-so-good thing is that, in focusing on only one body part, you can forget about all the rest, or not put it in the context of the whole person.

This guy, the nephrologist, had done a dizzying battery of tests on my blood and urine, stuff I'd never even heard of, but that didn't matter because he knew what it was. And he knew all the right questions to ask. He asked a lot of them. This might have got my back up, since some of it was pretty personal (I'm kind of attached to my kidneys), but for some reason it didn't.

Maybe it was bedside manner, a kind of professional concern that is missing from most medical care these days. It's as if doctors are afraid their patients will get attached to them or, even worse, trust them. This is why I often have that shoo'ed-out feeling with certain of my doctors. When you're feeling anxious about something and have it brushed off as hypochondria or sheer foolishness, it hurts.

When you hear horror stories of blatant misdiagnosis or doctors who overlook serious disease completely, it makes your hair stand on end.

This guy, however, well, for some reason I felt completely comfortable, and who knows why. For one thing, he was very (very very very) young. I swear these guys get younger every year. It could be that med schools are finally telling these guys and dolls to please, please consider the whole person while you're focusing so fiercely on those kidney-shaped organs on either side of the torso.

I noticed several other things about my visit. One was that the office, almost brand new, had been built so close to the exit of the Skytrain station that I blew right past it and couldn't find it. The hidden message seemed to be: don't rely on your cars so much, folks, it ain't healthy. Or maybe the property was cheaper, I don't know

Another thing: the waiting room was full, and the average age of the patients must have ranged from 85 - 90. Most of them looked in rough shape, as if they spent most of their time in waiting rooms. One very elderly woman had one of those oxygen thingies on a pole, and she had to wheel it around with her.

I was the blushing young flower of the group at 57. It was strange. Yet, in spite of how ill everyone looked, there was lots of joking and laughing going on, mostly about the indignities of the procedures. I saw this as a form of valour, of not just enduring serious illness but finding a way to transcend it.

After poking, prodding, listening to this and that, and tapping me all over, Dr. Schacter talked to me about my kidneys. They were in pretty good shape at this point, but pretty good didn't mean perfect. I was surprised to learn my blood pressure is somewhat elevated. Ye gods! My body is ageing. So what's happening to this piece of meat inside my skull?

Looks like I will be returning to this oddly-located office at intervals, but I don't mind. Dr. S. is a real sweetheart, the kind of person who makes older women proudly exclaim, "My son, the doctor!".

And the place has one other advantage. It makes me feel so young.

Why won't my doctor listen?

Is this too inflammatory to write about?

We're all so dependent on the medical profession, especially as we age (and we're all doing that). We find we're developing symptoms, some of them mild and some of them alarming. And we don't know what they mean, and we don't know why they won't go away.

We're lucky if they go away. If they don't, we may have to step onto a dizzying merry-go-round (or awful-go-round) of baffling "treatment" that seems to be getting more and more removed from simple human attention.

It's easy to send someone away to the lab for a CAT scan or a blood test or for a consultation with a "specialist" who sees the world through the narrow lens of only one body part. When it all comes up negative, and if we try to speak up and say something like, no, that's not good enough, suddenly we're a "nuisance patient" with psychosomatic disorders (or maybe a hidden drug problem).

It gets worse. If we really have something wrong with us, it can be misdiagnosed and misdiagnosed for years, even decades, sometimes radically changing with every doctor you see. (Don't ask me how I know.) It can be mismedicated, overmedicated, or not medicated at all (though the former is more likely).

When your doctor packs you off to a "specialist", batten down the hatches and bring with you (along with a quart of your urine and an ultrasound of your kidneys) a medical dictionary, so you can try to keep up. You won't be able to. Doctors are taught to speak in this language, and it keeps them distant from all these needy people. These people who seem to want something totally unreasonable (care).

They used to call it care. It's rare now. Getting through medical school is a meat grinder, and only the strong survive. It's easier to send someone off to the lab than to try to figure out what is really going on within the context of the patient's individual life.

There is no solution to this. We're stuck with doctors, and with trying to deal with them and translate what they really mean. About a hundred years ago I went through an excruciating period in my life, didn't feel listened to at all (because I wasn't), and went through four doctors in the space of a year. I was labelled, if not branded, a hopeless hypochondriac who was "unstable" (and whatever you do, don't get labelled THAT).

When I finally found a good doctor, which I did, I stayed with her for fifteen years, until she finally retired. What happened to the diagnosis of hypochondriac? Were "they" wrong, did "they" misread a crisis situation and assume that I was that way all the time, throughout my entire life?

Yes!

That's called disrespect, and it's rife in the medical field. We're lab rats, folks, and finding real care is as rare as the dodo. "It's not that I'm calling you a malingerer," one doctor said to me. But who brought the subject up? I wanted to say back to him, but didn't dare, "It's not that I'm calling you a quack."

But I was. And he was. We are too often trapped by very limited options, and by the Byzantine labyrinth of professional bafflegab and passing the buck. But if we complain - oh, if we complain. . .

So I'm complaining, right now. I know this won't do any good. But I'm going to say to the medical profession what a doctor once said to me.

Shape up.