Acknowledgements
This book has been in my head for many years, but bringing it to fruition has involved a number of other level-headed and talented people. Thanks to my nephew, James Lake; my partner, Andrew Mitchell; and Emily Seligman for their sharp-eyed reviews and editorial advice. Thanks to all the people at FastPencil for their assistance with the publishing of this book, and to Jim Caputo for his wonderful illustrations.
Note to the Reader
The characters in this book are entirely fictional (with the exception of the author himself in one story), and any resemblance to persons living or dead is purely coincidental. The stories and the advice which follows them are general in nature and may not apply to your particular situation. As always, consult with your own physicians regarding any specific questions or concerns about your health and medical care.
Introduction
“If you’ve got your health, you’ve got everything,” it’s been said, and we, as a nation, are eagerly seeking to fulfill that dictum. We join health clubs, take yoga classes, and buy vitamin supplements, at a yearly cost of billions of dollars, but we often overlook one of the most important links to good health: our relationships with our physicians. But improving these relationships can help us achieve better health–and there’s no additional office charge!
On average, we visit a physician nearly three times per year, for a whopping total of 800 million office visits per year. That might make you think that Americans love seeing their doctors–but it’s often a love-hate relationship. More and more people are voicing their dissatisfaction with the traditional medical system and turning to alternative therapies such as acupuncture, homeopathy, and chiropractic. Still, most medical care takes place in a traditional office setting, and patients themselves have the power to increase their level of satisfaction with their care providers–and their level of health–by following some simple suggestions on what to do (and not to do) in the doctor’s office.
We have bought millions of books to help us get along better with our spouses, children, and in-laws, and yet very little has been written about the doctor-patient relationship–the foundation for receiving good care–or the ingredients that are needed to make this relationship work. Relationships are largely abstract and emotional, but the behaviors they involve can be defined and illustrated. Bear in mind that the doctor-patient relationship involves two human beings–(yes, doctors are human, too)–and that getting what you want out of any relationship involves responsibilities and seeing the other person’s point of view.
We’ve learned that if we don’t treat our spouses well, we’re not even going to get to first base when it comes to getting the love we want; respect, openness, and affection will make us winners at home. Likewise, if we have difficulties in the way we deal with our doctors, those difficulties will become roadblocks to getting the care we deserve. The premise of this book is that you will be better served, happier, and healthier if you get along well with your doctor, perhaps more so than if you receive any particular test, drug, or treatment.
Using colorful vignettes drawn from my years of experience in primary care (but using fictional patients and physicians), this book illustrates many of the challenges that test the doctor-patient relationship. Each scene will be followed by an analysis and advice as to what could be done to improve the situation. By following these guidelines, you can become “your doctor’s favorite patient”–and get the care you deserve!
PERSONALITIES
Trekkies
Jayvon Jackson hardly looked up when the doctor walked into the room; he was too busy playing the computer game he got for Christmas to notice. Having just passed Level 4, he was waging “The Ultimate Battle” on Level 5. He had learned all the tricks to the weapons in his arsenal, and they had made him the all-powerful master of this cyber-planet.
But on Planet Earth, he wasn’t invulnerable. The previous week he had come to the doctor’s office after feeling dizzy for three days. Dr. Jenna Brooks examined him but wasn’t sure what was causing his symptoms. When the physician ordered a panel of blood tests, Jayvon was certain it would reveal the answer to his diagnostic dilemma. So, on his follow-up visit, he was more than a little surprised when the Dr. Brooks now told him, “Your tests are all normal–no clues there.”
“What? You still don’t know what’s wrong?” he asked incredulously. “How about doing a CT scan, or an MRI?”
“If your symptoms persist, we may need to consider that, but I doubt it would be helpful, considering your normal neurological exam.”
“You mean to tell me, with all the tests you guys can do nowadays, you can’t always figure out what’s goin’ on?”
“Yes,” said Dr. Brooks with a sigh, “I’m afraid so.”
“Oh, man. Guess I was born a century too early.”
“Hold still, and we’ll have the diagnosis in 2.7 seconds!”
Science fiction is fascinating–a tantalizing look at what our future might someday hold–but it is still a fiction. We’ve all been enthralled by the Star Wars and Star Trek movies and television programs, and in a universe of intergalactic travel, it seems that anything is possible. But you don’t have to look too closely to see that those characters who conquer worlds can’t seem to conquer their own wrinkles or baldness.
To someone born a hundred years ago, the medical world of today might seem as fantastic as those movies. Medical technology, like computer, aviation, and other technologies, is doing things that once were only a dream. Sometimes all the new hardware gives us a false sense of security and shields us from the hard fact that people get sick and die–eventually. This isn’t to say that we shouldn’t use technology to our advantage, but that like any other resource, we need to recognize its limits, conserve it, and use it when appropriate.
Do expect your physician to order blood tests or imaging studies in evaluating unusual symptoms; sometimes they can help to pinpoint the diagnosis.
Don’t expect technology to provide the diagnosis and treatment. Medicine is still as much of an art as it is a science, and there still are humans behind the machines.
Don’t demand extensive testing as part of a routine check-up. Only a very few tests (such as cholesterol) have proven to be worthwhile for screening purposes.
Do ask for a second opinion if the testing goes on and on. A different human may find out more than the MRI machine.
Don’t smoke or engage in other unhealthy behaviors on the assumption that there will be a cure for lung cancer and other diseases twenty years from now—you may not live to see it!
The Social Caller
“Dr. Diogenes! Hello, my dear, how are you? I haven’t seen you for ages!” exclaimed Mrs. Maureen O’Leary, the 63-year-old president of the Knoxtown Women’s Auxiliary. “What have you been up to?” Anyone would think that the reason for her visit had nothing to do with any concern over her health, but rather a fascination with the whereabouts of her physician.
“Well, mostly I’ve been here at the office and the hospital,” he replied. “And the little bit of time I have left I try to spend with my family.”
“Oh, but I hope you and Jo won’t be too busy to come to the Community Cabaret. It’s going to be wonderful. I’m going to open the show–everyone simply insisted–with my version of ‘Everything’s Coming Up Roses.’ People say I sound just like Ethel Merman. But of course you’ll be there! I almost forgot your son Cody is appearing in West Side Story. Don’t you wish our juvenile delinquents nowadays were still that tame?”
“Ah,