About Me

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Grew up in the San Francisco Bay Area. Richmond, El Cerrito, Berkeley, Oakland. My time now is mostly spent getting better at being a person, refining my time management skills, trying to read normal people books and articles, and learning how to be a force for good.

T1D Life in full effect. 

I will never stop learning, nor will I stop working to make a difference for someone.

Saturday, September 25, 2010

The first 'medicine from a patient's perspective'

Medicine in the United States is a complicated beast, mainly because of the differences in experience between professionals and patients. Not only that, but different professionals have different experiences within the context of working in medicine. (i.e. Nurses compared to practicing M.D.'s) That being said, I've decided to write this blog about medicine from the patient's perspective.

When you enter a hospital, say for a "routine appointment," you can never be sure you know what's going to happen. Also, having "routine appointments" assumes a great many things: you have health insurance or are substantially well off financially, you have a regular doctor to see that you like enough or trust enough to keep seeing, that you understand the potential consequences of not engaging in preventative medical care, ad infinitum. So with these things in mind, let's continue.

You've entered the hospital, and you're heading up to wherever your doctor's office is. There are sick people all over the place (which is appropriate given where you are) and medical pro's running around. Your heart rate starts creeping up, just with the almost palpable adrenaline levels creeping through the halls. You get to where you're going, and a receptionist more often than not says something like, "hi, welcome! Please sign in and we'll get to you as soon as we can." Most of the time, these folks are either professional receptionists, or nurses which kinda ticks me off because nurses have a ton of stuff to do already, but that's another post. You take a seat alongside the other waiting folks, and sometimes there are some sickies, sometimes you're practically alone. Depending on what kind of facility you're in, this could be consistent one way or the other.

Sometimes almost immediately you are called back, sometimes it takes an hour or less. The first nurse who leads you back into the shiny and band-aid scented exam area has you step on a scale emotionlessly, reads off your blood pressure, asks some general questions including, "why are you visiting us today?" Like 'visiting' really does it justice, but it can be comforting. You answer as best you can, and after a few minutes the nurse asks you to wait for the doc. This waiting period is terrible. You never know if the nurse is quickly meeting with said doc about how much you suck given your weight, blood pressure and habits you've briefly discussed with him/her, and whether they're planning to bust into the room shouting, "what the hell is wrong with you! You're gonna die!" Or perhaps the doctor is just finishing up with the two patients who went in before you did. Who knows, it's a mystery for the ages. There are only so many times you can re-read the "how to recognize suicide in yourself and your friends" pamphlet. Just saying, maybe some reading material in the treatment rooms?

The doc comes into the room. Usually they have an agenda based on their previous visit notes, and your current "situation," you know, the weight/bp/lifestyle stuff the nurse got outta you. The going assumption seems to be that docs don't care, but they have to have a game plan if they're going to get you to keep yourself alive, let alone get through the appointments and walk-ins they've had and will have during the day. The conversation is sometimes give-and-take, sometimes lecture (better take notes), and sometimes a mix of those two plus a visit from someone else on the team, say a dietician, or social worker. Then you're out, with a few pamphlets and some homework.

There are different places that do this in ways that feel better or worse than others. Some places are purely overloaded, and some places have a lot of money with which to actually hire enough medical and pro-staff. The differences can be striking. I've always been privileged to be able to find endocrinologist offices that actually serve as my primary source of medical care. I say this because when you're working full time and sometimes also part time, go to school and have a semblance of a life, there aren't enough hours in a business day to see more than one medical team. That's reality. It's also a very privileged and lucky reality and I know it. Here's where we find some disconnect: patient responsibility vs. medical responsibility.

Patients, we gotta do our part. There is no "wellness pill." There is no magical potion, no quick fix, no seemingly easy answer. You want that, go see an expensive and ultimately fucked up practioner of elective cosmetic surgical procedures. Not only will you be able to pay someone to look a certain way (assuming you have a ton of cash to burn), but you also will still die unhealthy. Good luck. We as patients have to do everything we can to keep ourselves together. It's a long process, and it's worth it as nurseXY is finding out and with good reason. (Keep up the good work bro.) And, the more you do for yourself, the better this doctor/nurse/patient relationship will be. Ask questions, no matter if you feel stupid. Get the information. Medical pro's can't know what you need unless you tell them, and it's impossible to always find the most important stuff online. Again, quick fixes can backfire big-time.

However, to all the medical pro's: we aren't all idiots. Some of us are, and I can't speak for them. They're jackasses, and they're suffering even as they suck. But some of us do care, not just about ourselves but about other people. Know that the intimidation we feel when our medical pro asks us, "any questions?" is real. We don't want to look stupid, even though you probably will be more than willing to either answer, tell us where to get the answer or have someone on the team help us. But it's not easy for many of us to feel comfortable. You're behind an opaque wall of mystery, and this means we're not always going to be willing to not only ask, but demand we be treated with respect and understanding.

This two-way street is remarkable in that there are so many twists, turns, and misunderstanding abound. And with medical care reform being not only futuristic, but incompatible with medicine as a business, we're in a perpetual state of denial about what our huge system really needs in order to function at a level that means we're successful on a broad scale.

The next installment will be 'the patients' perspective in a capitalistic medical market.' Hope y'all enjoy, or start talking.

-Street Philosopher

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