TONGUE - TIED IN THE HOSPITAL

When a doctor writes about an experience in the hospital as a patient, I love it. Somebody understands how the patient feels!  And yet my heart may go out to him, especially because his illness and treatment may be a lot worse than my experience.

But when he writes that he let the hospital go ahead without questioning a test he thought was wrong, premature, or dangerous for himself ( or for a relative he was taking care of) that really scares me.   

When a doctor does speak up, does refuse a test, does ask why or why now he or she sets an example for the rest of us.  An example we  may need when we're hesitant or afraid or too sick and tired to say No.

But when it's my experience, wouldn't it be fun to imagine a certain unpleasant doctor in the hospital as a patient?  My inner three-year-old would say, "See!  It's not so funny, is it?  How do you like it!"  Instead I imagine myself reading the riot act to that doctor or unseen administrator.  

I'm not a doctor, my professional relationships aren't damaged if I speak up, ask questions, insist on an explanation, or just plain refuse.  In fact, in the first spine hospital, I flatly refused an MRI until my own doctor okayed it.  But in the next hospital, I didn't refuse the pain pill the physical therapist insisted on, even though I knew it would make me nauseous.

Why am I telling this now?  Because maybe you, too, ignored one of those patient feedback questionnaires like the one teetering on top of my files, postponed, but not quite forgotten.

Some of the questions on this one are tough. I've read that some feedback can result in the wrong person being punished, and I don't want the responsibility. I could suggest instead of shooting from the hip. But I need to speak. A doctor may be an expert but still leave me feeling alone--that nobody has my back. A doctor may be revered by his colleagues but never warn me of what's coming, may not have the experience to prepare a patient for what seems a small thing, and might be a small thing to a different patient. 

I don't have to fill out the little circles, I can write down what I think (in block letters like a criminal)  Remember, the doctor won't see it. 

I will do it today.  And try to leave my unpleasant memories in the mailbox with it.



















See the file Ask a patient, which has a sample bill

AN ONCOLOGIST--On how to talk with us, and how to think about us. . from Dr. Salwitz

Once in a while, my California doctor would do a procedure on me in his office.  One day I went in with a lump right below my nose, in the spot where one had been removed decades ago.  I told him that two other lumps had come and gone since surgery, but I felt uneasy about the latest one.

Getting ready to remove it, he said:  You seem to put yourself into a zen-like state.  I told him it was just pure trust. 

My uneasiness about the lump was justified--it was a basal cell carcinoma.

So yes, I trusted him.  But what I always tell friends about him is:  He trusted me.  He always listened to what I thought was going on with me.  When I was right, he said so.

Don't we all deserve this trust from our doctors?  Dr. James Salwitz seems to think so.


This came by e-mail,  From Sunrise Rounds Tuesday the 25th

"I will need to understand his incentives, goals and how he makes decisions.  Otherwise, I am afraid his health will suffer because of mistakes, by him or me, born of poor communication.  

Curing his cancer requires not only that he understand me,

 but that I trust him."