Wednesday, September 23, 2009

Doctor Of WHAT?

Watch out - Ranting and Raving ahead:

When I was in nursing school, I remember a few comments from people along the lines of,

"Why don't you already become a Doctor?"
"And then do you follow that with Medical School?"

I wanted to strangle these people.

Nursing is NOT a pre-requisite to becoming a Doctor. They are two very different jobs, with two very different functions.

ONE of the reasons I became a nurse, is because I hate Doctors. Doesn't make sense to you? You may be thinking, don't you have to work pleasantly alongside Doctor's as a nurse?

Here is the thing -

Nurses are patient advocates, Doctors are NOT.

Of course there are exceptions to this rule. There are some amazing Doctors out there. But try to find them, it's like trying to find that toe nail that flung away with the cut of the scissor and is wedged into tiny carpet fibers.

The good ones are highly sought and getting an appointment with them takes months. By the time you reach your appointment date, you might be dead.

There are also many nurse "Ratcheds" out there as well. They are nurses who are just mean and nasty and have forgotten what it means to be a nurse.

But in general, I stand by my previous statement. Nurses look out for the well being of the patient and most Doctors just look out for the well being of their bank account.

I have come to this conclusion, both as a patient and a nurse.

There are even specialty hierarchies of crappiness amongst Doctors.

In the nursing world, it is a known fact that Surgeons, specifically are the most arrogant of Doctors.

I once told my mother that ALL surgeons are arrogant, they have to be. Her reply was that they are confident, not arrogant.

My response was,
"NO! ALL surgeons are arrogant." They have to be arrogant to do what they do. A human being has to have arrogance in order to cut deep into the flesh of another human being. It is essential to being a good surgeon. They must think that they are impervious to ever making a mistake when cutting a chest cavity open (or other areas) and slicing through vessels and arteries and then reattaching minuscule blood vessels, etc...

Could you do that?
I could not.
I have no problem jamming a needle into your vein, but I could never take a scalpel in my hand and slice across your abdomen.

And, within this specialty hierarchy of arrogant Doctors, the most arrogant is the

How arrogant must one be, to saw off the skull and actually manipulate the human brain.

But there is one even higher on the arrogant totem pole,

the Pediatric Neurosurgeon.

Oh, wait - there is actually one even worse -

the NEONATAL Neurosurgeon.

When I was working in the Neonatal Intensive Care Unit, years back, there was one such Neonatal Neurosurgeon.
Sure, when he was in the OR, performing his surgeries on the tiniest of brains, he was GOOD at what he was doing. He was the best, in fact.
But outside of the OR, well there is no other way to say this -

He was an ASSHOLE.

Arrogant surgeons do not leave their arrogance in the Operating Room.

Each surgery he performed made him anywhere from 100, 000 - 250,000 dollars. Yes - EACH SURGERY.

Thankfully, I worked in a hospital and a unit where "Naughty" Doctors were reprimanded. If a Doctor was out of line with the nurses, he would lose OR privileges. Losing OR privileges = losing loads of money. This kept the pompous sons of b$@*&#* on their best behavior.

When, I moved to New Jersey, I had an interview in a very prominent hospital.

I remember specifically being asked,

"What was the Nurse/Doctor relationship in the hospital you previously worked at?"

"What do you mean?"

"Did you get along?"

"For the most part, I guess."

(I still was not sure what she was asking. Did she want to know if the Doctors and Nurses ware cavorting? Was she asking if our hospital was all "ER" and "Grey's Anatomy"? I mean, it might have been if we had a Clooney and McSteamy and McDreamy or any McHotties, but we were a real hospital, not a fictional one.)

"What I mean is, how do the nurses deal with Doctors who are not so nice?"

"Oh, the Doctors faced consequences for ill behavior (no pun intended)."

"Well, over here, if a Doctor is nasty, the nurse has to just grin and bear it. Bite your tongue. Deal with it... Can you handle that?"


wait... no. You mean to tell me, that in the year 2000, you feel the need to be subservient to asinine Doctors? You allow Doctors to get away with bad behavior? You force the nurses to deal with a hostile work environment? Why? How do frustrated nurses make for great health care providers. This stupid policy of yours seems quite counterproductive, don't you think?"

Well, needless to say, I did not get that job.

I guess that it was a good thing, I couldn't really say I was surprised. This was "New Jersey" after all.

But it was eye - opening to me.

As a patient, I had my share of doozies when it came to Doctors.

Remember when I took
Erythromicin ?

My stomach could not handle this sort of anti-biotic and I ended up in the hospital hooked up to an IV.

So years later, when I was having my employee physical in the New Jersey hospital that I actually did get a job at, I was asked a question,

"Do you have any allergies?"

"Well, I am highly allergic to fish and "INTOLERANT" to Erythromicin."
(notice my specific choice of words.)

"What happens when you have those things?"

"Well fish causes anaphylaxis and Erythromicin caused chronic vomiting and dehydration."

"Well vomiting is not an allergy."

(uh, Doctor - grow some ears, I said, I was "INTOLERANT" to Erythromicin).

"Anyway, nowadays we would give you Zythromax."

"Well my husband took that and it was highly concentrated and he had a reaction, so I would not take it as well."

"Well, that was your husband, not you."

"Yes, but it IS from the same family as Erythromicin, so I would think that my body would find it too concentrated as well."

"Well you should just do what your Doctor tells you."


You should do what your Doctor tells you to do???????????

See, that sentence actually came out of her mouth, at which point I realized a number of things,

1. I should not be surprised, she is from New Jersey.

2. What the hell did she do wrong that she is relegated to only practicing as a Doctor in an employee health clinic.

3. She is from New Jersey

4. She may be deaf and DUMB.

5. That sentence is the reason so many patients NEVER question their Doctors and take medications that are awful and undergo needless treatments, or do not take medications they need and do not get treatments that are helpful.

I can not stress this enough...


That is the arrogance of Doctors. They do not like when you come in and diagnose yourself. They want to be the one to prescribe the next course of action and when they can not figure out what is wrong with you, they will either tell you it is all in your head, or you are depressed, rather than tell you,

"I have exhausted all I can do, maybe you should find another Doctor who might benefit you more than I can."

When I moved back to Chicago, I needed a Doctor at some point. I had no time to search, so I just went to the Doctor my parents used. He was fine when it came to diagnosing strep or virus, but beyond that, an actual MORON.

I went to him one summer twelve times. I kept getting sinus infections, I was having many migraines.... and chronic fatigue. I also had chronic neck and upper back pain for years.

He kept telling me it was allergies, even though the allergy medicine did nothing but antibiotics finally did. He made no further suggestions when I kept coming back to him, at which time I asked,
"Shouldn't I go see an ENT at this point?"

to which he replied,

"You know what, you should probably see an ENT at this point."

Thanks, great SUGGESTION.

(The ENT, was a whole other story, won't get into.)

I was back at my general Practitioner with more head aches at which point he said, angrily, might I add,

"Well what do you want, a Cat Scan? Those things are expensive."

That was the last straw for me.

I now searched for a really GREAT doctor. I found her, and guess what - I waited 4 months for my first appointment. But she IS GREAT. And I still see her.

The first appointment, she asked,

"Have you ever had an MRI?"

"Uh, no..."

"Well, why not? It seems like the next logical step."

Yes, I like the way you think Doctor Greatness, "LOGICAL".

So I had an MRI, and guess what we found...

A cyst in my maxillary sinus cavity (NOT ALLERGIES ASSHOLE)
Stenosis of my spine
Some bulging discs in my neck
And muscle spasms in my upper back.

So apparently, my previous Doctor was ALMOST right, some of it
And the rest in my neck and upper back, and no I was not depressed, but how ironic that crappy Doctors probably cause depression in patients who feel helpless.

I have learned to question Doctors and the health care industry (not in Obama sort of way).

The health care industry HAS unfortunately become money making ventures, and they have lost sight of patients needs.

Hospitals - are businesses
Insurance companies - are businesses
Pharmaceutical companies, are BIG businesses.

First one out with a drug or vaccine makes the big bucks. So I don't trust that their drugs and vaccines are tested responsibly. Case and point, drugs like Vioxx which killed people because it was determined later that the amount of study was exaggerated leading to the removal of Vioxx from the market. This happened with other drugs as well.
Pfizer has been fined over and over again, among other reasons, for offering perks to Doctors for pushing their drugs. So your Doctor might prescribe something for you (like Zythromax which may cause you to wretch uncontrollably) because of the perks they get, and not because it is the best drug for you.

I am not one who is anti-vaccines, in general - but I do question the new ones and weigh the benefits against the risks. I am in NO way telling other parents what to do.

I do not give my kids the Chicken Pox vaccine, it was studied in Japan for 30 years before it came out, not in America. My DNA is not the same as that of a Japanese (trust me, it makes a difference).

When it first came out, only one shot was intended to be enough. Then it was realized they were wrong, and they added booster shots. I was supposed to give my oldest daughter her Varicella Vaccine when I just had my third child. The Vaccine CAN cause a mild contagious case to break out. Why would I give the vaccine to my daughter and then possibly expose my newborn (who can not get the vaccine) to a disease that would be more dangerous for him.

I do NOT give my children Flu vaccines. I am pretty sure that a new strain will pop up anyway. I teach my kids all the precautionary measures to take. My oldest daughter did get swine flu, that was verified. I am pretty sure my second daughter may have had it as well, that was not verified.

Yes - it is true, the flu CAN be deadly, especially for small children, elderly and infirmed. Getting in a car can be deadly as well. I will not keep pumping my kids full of EVERY chemically concocted vaccine that comes out one week and is on the market 3 weeks later. I just DO NOT trust the greedy money making Pharmaceutical companies enough to do so.

I have conversations with my Pediatrician about this all the time. We have a lot of mutual respect for one another. Although he CAN NOT tell me that it is ever okay to NOT get the vaccines, I can easily tell which vaccines he thinks are superfluous and which he thinks are imperative. And I will repeat, I DO give my kids many of the vaccines.

The problem I have, are the Doctors who do not let educated patients and parents question what is going into their or their child's body. It is surely okay to read about the medications, treatments and vaccines and ask questions before we.

The reason this post is written today, because this "Doctors are educated and must know what they are doing" concept, keeps coming to the surface.

A friend of mine told me last night that she keeps getting migraines and her medicines are not working anymore.

I told her to get an MRI.

She said,
"Well, the Doctor did not suggest that, I don't want to ASK for it."


This morning, I saw my SIL attempting to drop my niece off at the same school that Ate attends. My niece was really acting up and crying. I inquired from my SIL, if she was okay. My SIL then informed me that yesterday morning she took her to "walk in" at the Doctor and was told that she had a "minor ear infection", no need to do anything AND it was okay for her to go swimming yesterday.

So, as I noticed her acting up and touching her ear that my SIL confirmed was the ear in question, I asked,

"And, is this my lovely, adorable, good natured nieces temperament on a regular basis?"

"No, she is definitely not herself."

"I get why Doctor's are against antibiotics, it is definitely overused by overly anxious parents of kids with viruses, but I am against pain in children. Go back to the Doctor and get her antibiotics so her ear can heal."

My kids have seen the Doctor she had seen the day before. He is not our kids regular Doctor, but was the one on call for "walk ins".

I can not stand him. He is one of those, text book Doctor's who ONLY pays attention to the objective facts, ie. the throat is red, it is not red, the ear looks bad, it only slightly looks bad, it looks fine, as opposed to listening to the parent.

He likes to look in the throat and announce,
"It doesn't look like strep, she does not even have fever, just a virus probably - drink plenty of fluids."


Humor me, I know when her throat hurts, and I know when HER THROAT HURTS.
Take the culture.

What's that? It's strep you say?

I could go on and on with this topic. The bottom line is this -

As patients, each one of us has to take responsibility for our own care and health. We can not solely rely on a Doctor or his knowledge. I don't care how many years of schooling a Doctor has had, or how long he has been practicing - Doctor's DO make mistakes and do not always make the right choices for our benefit.

Do not feel guilty questioning a Doctor.
And if a Doctor ever makes you feel uncomfortable, stupid or guilty for questioning him,
and go find a new Doctor.

8 have shown Orah a little love: said...

I agree with this post on so many levels!

When I was a med-surg nurse, if I dared ask for tylenol for my pt, the docs were sure to order advil.

Which i guess was better than when grandma used to have to give up her chair at the nsg station for the docs.

In L&D I learned to be a ferocious pt advocate (we are known for that) I love to be sweet, but I can pull out a can of whoopass if I need to :)

As far as personally experience, well you've walked through my anaphyl. journey. How thankful I am to the awesome docs I had at the Mayo. The mayo doc told me if I had continued with the epi like I was, I would have ended up in heart failure...scary @%*&

Great post

Brie said...

awesome post! I agree with you! You have to be your own health advocate and do not EVER forget that doctors are just people and they too can make big mistakes.

Candice said...

Amen! Preach it!!

Anonymous said...

I will ask for that MRI and if he gives me a funny look (like u dont need one) what shall I do? Go to another Doc.? Last time, he assured me it wasn't a tumor (G-d forbid). Well, that comforting!

- Miss S.

Shira said...

Two things.
1) The other night, a Facebook friend of mine who is in medical school had the following status, "Ummm...what would happen if I just don't study". One of her friends responded, quite seriously (I think), "Well then you would just fail out and settle for being a nurse". I was horrified. SETTLE for being a nurse after FAILING medical school? How on earth is that logical?? Nurses KNOW patients. They have keen assessment skills and have intuitions when something is just not right.

2) I had a patient the other day who had many psych issues and just did not want to go home. She was completely fine, but was manipulating the system and was trying to convince the doctors that something was wrong with her. She had just had a baby and was waking up sweating through her clothes. The moronic resident asked me in the morning, "Can you take her morning vitals? Something is not right. She doesn't look good."

I said, "Okay. I'll take her vitals but she looks fine. She's been here for a month (antepartum) and she has never looked better".

He said, "Well, I think she might be septic and just hasn't spike a temp yet".

I took her vitals and she had a minor temp of 99.5. He ordered a superfluous amount of tests (CBC, blood cultures, influenza swab, urine tox screen, sputum culture) which added a lot of extra work for us nurses. This was at change of shift (of course) and I gave report to the next nurse. The next night, I came in to find that she had been discharged because guess what? She was fine. The attending doctor recognized that she was just being manipulative and booted her out. She was not SEPTIC or anything. She was hormonal and diuresing from pregnancy. I used to wake up sweating after I had my baby too. Gosh, that whole thing just bothered me so much. I will end my blog/comment now.

Bottom line, I agree. Trust your intuition.

Shira said...

Oh, in case I appeared to have handed off a lot of work for the next nurse, I did do all the things I could do like the sputum culture, urine tox, and called phelobotomy for the CBC and blood cultures. The flu swab the doctor had to do.

Heidi @ Tayterjaq's Rebels said...

Great post! It must have taken ages to write. I am pretty good with my kids Dr. and speak up when I think something is not as he is saying. I do have to say that I adore their Dr. and even though we have moved, still travel more than an hour each way just to continue seeing him. He is very receptive to my opinions and such.
I just don't go to the dr's (last visit 2 1/2 years ago) because I get sick even more rarely than the it's not really an issue for me.

Brie said...

way to cop out on writing your own blog post Shira!!