As I started to draft this, it was about 9 pm, I had just gotten off the phone with my medical oncologist, and yet again he managed to push my hot button. (Yes, again.)
I’ll say off the bat that I’m impressed he offered to call right after I had placed questions to him in our Viber chat. Kudos to him for that.
If you’re not a current or past patient with gripes in your doctor-patient relationship, this may be a good post to skip. It may get a bit detailed and mundane.
Or not. I’ve visited enough doctors of all kinds over my decades to know this one doctor is not in any way unique. So, unless you’ve had the immense good fortune of never having to go to a doctor of any kind (or maybe even another professional like a lawyer or accountant), you may have (or have had) a similar experience to what I am about to describe to share insights to it as well.
Here’s the context: I had my fourth session at Makati Medical Center yesterday. It was for infusions of paclitaxel chemo and herceptin, back to back, 90 minutes each, preceded by the cocktail of side-effect reducers.
Again, other than my oncologist obviously glancing at his watch several times during our pre-session chat (that message is obvious, yes?), this was a relatively no-drama infusion session. I was glad to be given a bed (instead of the usual recliner chair) so I could snooze in comfort and the kindest oncology nurse I had the first session.
So, what’s my problem this time?
To make this short, let me list how this transpired:
- Assistant doctor comes in to tell me my new dose of herceptin is 480 mg (no explanation/options given)
- After paying the bill, the billing clerk tells me they missed to add one vial of herceptin, so I pay a second bill
- When I get home, I see I was charged for a total of four vials of 150 mg, with each vial costing US$650 (total $2,600)
- They used only 30 mg of the last 150 mg vial, meaning I paid an extra $520 for wasted medicine
I hope you see my blip here!
So, the questions I had sent to the oncologist was: How much herceptin did I receive today? I had understood from your assistant doctor that I was administered 3×150 vials + 1×30? Is that correct?
He called and explained the formula for how the figure 480 mg is arrived at. No problem with that so far.
Then I told him about being charged for a fourth 150 mg vial when I needed only the extra 30 mg.
I didn’t mince my words, “That vial is worth more than gold! Don’t they have smaller dose vials, like the paclitaxel has?”
He didn’t think so. (If that’s correct, can I just say f*ck the pharmaceutical company? No doubt it knows the formula and that few patients would need exact multiples of 150.)
Looking for a rational way forward, I next asked, “Can the 120 excess be saved until my next session?”
“Probably not once the vial is opened,” he answered in brief.
“So what other options besides wasting 120 mg of gold do we have? While my first priority is my physical health, I’d rather not end up in the poor house at the end of this year!”
“Some patients want the exact amount needed. Others have opted to round off to the lower number, a multiple of 150. It’s up to you.”
There it is, button pushed!
We all have buttons that, when pressed, send us into survival mode.J.S. Wolfe
“How can it be up to me, how can I possibly make an informed decision, when I don’t know what the possible risks and outcomes are to reducing the protocol? What if taking the lower dose completely negates the year of these treatments I undergo and doesn’t do what we intend it to do?”
I got the lecture to be reminded that I was in early stage and my prognosis was excellent (“yes, my eye balls are focused on exactly that and making sure my body is primed for wellness!”). He followed that with his admission that the reported science wasn’t clear on my question. He only knows the recommended formula. So ultimately, I’d have to decide.
Weeeell… can you guess how that left me feeling?
Now I have three weeks to “think” about it, until the next herceptin session.
I decided to sleep on this for a night before posting this. Sure enough, I woke up with another, maybe deeper, question.
Why does his putting decisions in my court push my button?
I don’t have a full answer to that right now. It may have something to do with me not wanting to be, just for once, in the driver’s seat, in full control. Wanting an expert to do his thing and confidently make me all better. Allow me to be vulnerable, submit to his expertise, and to trust I will be taken care of. Is this wishful thinking?
Is life telling me I have to remain the hero always?
The good thing about having our buttons pushed is that we can no longer ignore the sensitive areas where we need to heal.Mary Buchan
My questions for you to think and share today:
- What is your reaction to all this, any thoughts/insights/advice to give me?
- Have you been in situations when a doctor/professional pushes the responsibility of making a decision on you when that decision requires expert knowledge you don’t have?
- What are your hot buttons and what do they tell you about yourself?
PS. More to be grateful for: Heather and my honey, who continue to drive me to and from the hospital. Being pampered by my honey. Feeling good enough to go for a walk around the subdivision. You, my readers, and other friends who support with their love and care.
PPS. Note to self: don’t put on an old pair of slip-on shoes that you haven’t worn for two years and save yourself the embarrassment of having the inners fall out on your bare feet when you take them off to get into the hospital bed.
PPPS. If you’re finding any value in my posts, please share them or the journal with others. And I invite you to sign up for an email notification each time I post by clicking on the hamburger (three horizontal lines) on the top right of every page.