Friday, March 7, 2008

A Patient's Perspective on a First Visit with a New Doctor

Some doctors know how to connect with a patient right from the start. They not only offer excellent care, but also hope. And, unfortunately, some don't........

The first pain management clinic I went to, in June 2000, in a major urban university affiliated teaching hospital, was overcrowded and dingy. The olive walls of the waiting area contrasted harshly with the orange plastic chairs that circled the room. The thick haze of pain coming from the crowd of patients made it hard to breathe. Everywhere I tried to rest my eyes I saw clenched jaws and jiggling feet and silent tears. The crescendo of pain in that room was still rising as I was called in to see my specialist.

Dr. S. was a small woman, dressed in a lab coat that reached below her knees. She radiated a harried efficiency. She acknowledged me with a brief flash of eye contact and an accompanying head nod and then asked her resident to describe my symptoms. As he spoke the words I had given him fifteen minutes earlier, she poked at me like a fish monger checking the freshness of a slab of salmon. All the while she concentrated more on instructing her resident than on connecting with me.

She was soon ready to declare that I had a neuropathic pain syndrome and to prescribe more medication. For me, calling my pain “neuropathic” was like my dermatologist naming a rash I once had on my arm “dermatitis.” She didn’t provide any real illumination; she merely described what was, in medical language.

I had many more questions to ask her, but she kept looking at her watch and telling me we could discuss them at the follow up appointment when we would be able to discern if the medications were helping. She kept edging toward the door. I tried to lasso her in place by tossing out more questions. With a final flourish of her watch she bolted through the exit. As a parting gesture, she explained that the department administration only allotted her fifteen minutes per patient, and she had already used up her quota and any reserve minutes.

For her, I was a petri dish to which she was adding some mold to see what might grow.


Dreaming again said...

and my husband wonders why I hesitate to go to a pain management specialist ............ .. .. .

Barbara Kivowitz said...

Actually, the second pain management specialist I went to was the one who helped me get my pain under control. In my first appointment with him, he spent two hours with me! He responded to my phone calls and email promptly. And he listened.

Keep searching. The next pain specialist (or neurologist or immunologist) may be the one you're looking for. Good luck.

Merelyme said...

i wonder why so many docs are lacking in just human compassion. i really love your blog and what you are doing well as the fact that you are an excellent writer. i will be sure to visit often.

Teresa Hartman said...

Oh, man - I have my first visit with a pain management clinic this week, and you have just described my nightmare. I will hold a hope that I will get a two-hour visit, but not holding my breath. Looking for alternative measures, but so many of them involve the head area -and that is where my pain is. Ah, well - thank you for your great writing!

jeisea said...

I don't think htere are too many of us who can not identify with your experience. Like you I was fortunate eventually to find someone who reaally listened to me.
Great post.

therapydoc said...

That wasn't fun. But I'm always wondering what's going on with those people. They have to be bigger than this.

Barbara Kivowitz said...

Merelyme - you raise a great question about docs and compassion. I wonder how many med schools teach compassion. Plus, I think pain , especially if the pain is complex (and whose isn't), can push doctors into their discomfort zone - where they feel helpless, and so they back away emotionally, and physically.

Teresa - I do hope your pain clinic visit is a positive experience. My husband would say to me - "There's always something more to try," which was both frustrating and encouraging. But I think he is right. We have to keep mixing and matching (and reading what our fellow bloggers have learned).

Jeisea - it can take time but it's worth the search to find a provider who can also be a partner in our care. We are both lucky in that. btw, I just read your interview on the How To Cope With Pain blog and have already learned a lot from you.

Good luck to all of us.

Barbara Kivowitz said...

Therapydoc -- Afterwards, I wonder too what's going on with them; but in the moment, they do yield such authority over patients in very vulnerable states. Even if they can't make us better, they can nourish us. What do you think gets in the way?

cory said...

Hi Barbara - can I ever relate to your post? I've had to fire a few pain specialists in order to find one that would work with me as my partner. But once I found one who is compassionate and is informed about pain - it made all the differnce in the world.

Sometimes by going to a local support group for chronic pain to to talk with others, you can learn which pain doctors to avoid to save your time, money, and frustrations.

Finding the right doctor can sometimes be such a taxing process.

For anyone looking for a supportive doctor, don't give up - remember the doctor works for you and is a member of your pain managment team.

May comfort be yours.