When did (some) doctors go from thinking of themselves as demigods to being wimps refusing to be decisive and accountable?
It’s quite possible that my medical oncologist is intimidated by me. (I expressly put that in the passive form.) Maybe he’s not used to dealing with knowledgeable, independent thinkers and straightforward speakers like me as patients.
Maybe I’m reading him wrong. We’re both wearing masks and face shields that cut out so much of the important body language.
We engaged in another prickly dialog today before my second chemo (Paclitaxel) infusion. Found myself having to explain the world of doctor-patient relations according to me.
It started when he told me again that the risk of neuropathy (numbing of extremities through nerve damage) was the key side-effect we had to monitor in me. We were discussing whether I should start taking a B-complex. I informed him that I have an over-sensitivity to B6 that can easily lead to toxic levels in my body and, in fact, it has before. He didn’t know what else to offer. Didn’t say he’d look into it.
He just said, “We’ll do what you want.”
Well, I must admit, I jumped on that. I quickly retorted with, “No, we’ll not do what I want. I don’t want to be here. We’ll do what is best for my body and we’ll do so together.”
I continued, “Our overarching goal, our objective, is to get my body in a shape that discourages cell division and cancer-cell proliferation. To do that, we must be a team.
I depend wholly on your expertise. You know the general protocols in these cases, yet we both know that there is a science and an art to this. So, I depend on you to be both the scientist and the artist, to modify the protocols into a customized, individual treatment program for me, my body.”
“You’re the canvas,” he interjected. Okay, whew, yes, that landed all right.
“Right,” I said. “I’m the expert on my body. That means you listen to me for what I tell you about my responses and concerns. That’s how we are a team.”
Again, I continued: “I want you to understand that my personal objective is to put as little medication as possible into my body. Each drug has potential unwanted side-effects. I want to take just enough to do the main job. If a preventive drug is to avert a 5% risk of something, I want to know about that, and then we decide together whether to go with it or not, with you having the final say.”
The best doctor gives the least medicine.Benjamin Franklin
We went on to discuss my unpleasant reaction to the Dexamethazone I had taken in pill form this morning. This medication was prescribed to me as an anti-inflammatory to stave off allergic reaction to the chemo. With a new understanding of my objectives, the doctor was able to remove that drug from my now short list of extra oral medication, and add a lower dose to the cocktail before the chemo infusion. Let’s see how that works.
In the end I asked him with my smile hidden under my mask and face shield, “Do you find me to be a problem patient?”
“No, I wouldn’t say problem.” We both laughed.
“Maybe just a bit makulit.” (A lovely Tagalog word that I poorly translate as persistent to the point of annoyance.)
It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.Sir William Osler
I would happily settle for a competent professional who has the confidence and ability to actively listen to me.
And I’m curious how this doctor-patient relationship will develop over time.
Do you challenge your doctor(s)? Do you know and explain clearly your expectations?
Or do they intimidate you?
Or maybe you think I was too hard on my medical oncologist today?
PS. Note to self: don’t wear pants with buttons to an infusion session… hard to open/close with one hand when visiting the toilet together with the infusion stand. LOL! #minilesson