KATY CHANCE: Why the medical world is fast losing its patients
IN ABOUT 1990, I decided I had better get a degree if I wanted to be anything other than a secretary so I wandered into Wits University, found the right room and picked up a pamphlet on the linguistics syllabus. I then asked a senior staff member behind the counter who I should speak to for more information. The woman stared at me, the cogs turning in her brain almost audible; her response was considered and carefully given: "I don't know who you have to speak to," she said. "But I do know they are not here today." I left and never returned.
It was to be 20 years before I was on the stupid end of another similarly Monty Python-esque dialogue. A specialist physician asked me if I experienced a lot of pins and needles. "I'm not sure," I answered. "What is the 'normal' amount?" The doctor beamed at me. "We don't know!" he declared triumphantly. "We don't have a baseline figure!"
The major difference between these two utterly inane exchanges is that the first one was free; the second cost me the best part of R1000.
In the interests of transparency I need to declare I am fed up with most doctors and their seeming complete inability to listen to what you say without interrupting; or to never write anything down (or anything I deem relevant) so if I see them a second time they castigate me for not telling them before; and, in this country particularly, to sometimes get away with, if not murder, certainly grievous bodily harm.
I have a sort of family member who is blind in a home in Cape Town because of a big but fairly routine operation for which the outcome was given as "you'll be back at work in three weeks". Three years later, that she's still hanging in there is remarkable. The sad punchline of her life will be "he operated on the wrong vertebra".
Before you start baying for blood, I acknowledge that South Africa's medical men and women are among the world's best, but that doesn't make them infallible or above rank stupidity, rudeness or ignoring that I have lived in my body for a long time and only I understand and am aware of its every internal nuance.
I have unfortunately had reason to "interface" with a number of medical personnel in the past few years and I am tired of, especially, two things: the word "idiopathic" and shrugs. Idiopathic means "how the hell should I know what's wrong with you, you're the only person who's ever shown these symptoms!" and the second, nonverbal response means "I really couldn't care and I have other patients waiting".
Three gastroenterologists have shrugged at me in the past five years. One told me to "try wearing a corset". Another said with a sly sneer that perhaps my mother had given me a certain medication as a child. It was such a bizarre comment I was speechless. He had nothing to base it on, my mother and her early mothering formed no part of our consultation (nor are they part of my memory), and she died when I was 10, a fact he hadn't bothered to establish.
Fortunately, I am not alone in my frustration with the medical world. There are enough people in the States misdiagnosed for so long there is a show about them. Mystery Diagnosis (TLC) is in its 10th season, which means some very sick people are given the runaround for a very long time.
With episodes such as The 13-Year Stomach Ache and The Boy Who Fell Through the Cracks, it makes me even less trusting of the medical world at large. In one episode parents had to wait nine years for the correct diagnosis of their child. She couldn't run properly, couldn't get up off the floor, coughed continually and had trouble swallowing, yet "rounds of doctors" and a "series of specialists" all said she was just growing at her own pace or was "within the normal range". She wasn't - she has Pompe Disease, a neuromuscular genetic disorder.
A woman was told she had "one of the most aggressive lymphomas the doctor had ever seen". She and her family were already picking out coffins when a different diagnosis came in; she lives yet to sort of laugh about it. In almost all cases it was only when the desperate families or patients decided to "do their own research" that the correct diagnosis was unearthed. Dr Google will see you now.
So for me it is no mystery that doctors often diagnose whatever will make their day easier, accompanied with shrugs or suggestions so off the mark as to be offensive. Or, to be fair, perhaps they are just suffering from that medical get-out-of-jail-free card, "stress", and need a holiday. Either way, the long-term prognosis does not strike me as particularly positive.
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