Those Two Snakes…

Belittling encounters with medical professionals could probably spin out into a story as long as War and Peace. 

The symbol for the medical profession is the caduceus, featuring two snakes winding around a winged staff. And despite the many caring medical professionals I’ve encountered over the years, I sometimes fear that those snakes are uncannily accurate!

This struck me forcefully a few days ago when a friend called for advice on behalf of her sister. She wanted to know if I thought (as she did) that her sibling should make some type of complaint regarding the treatment she’d just received at the hands of a specialist, a pain management doctor to whom she’d been referred. All three of us were well aware that pain management is a tricky subject these days due to the opioid epidemic; even more so for a patient being treated for long-term depression and emotional issues, as the sister admittedly is. But she’d also been enduring untreated chronic pain for months, and had waited patiently for weeks to see the specialist…only to leave his office in tears, not one  whit closer to being out of pain, and having been demeaned, insulted, misinterpreted, and shunted aside.

I commiserated with my friend and we determined a course of action for her sister to take. But the event brought clearly to mind the many times I and others of my acquaintance had endured reprehensible behavior from someone in the medical profession.

cauduceusI vividly recall my shock and dismay when, years ago, having seen my doctor regarding symptoms suggestive of an underactive thyroid, I received his verdict. Although my thyroid activity was on the “low end” of normal, he explained, “What you really need is an aerobics course. Or a psychologist.”  Just as my friend’s sister had done, I left the medical office in tears. Ignoring the doctor’s assessment, I researched and found a natural solution to my problem: two herbs that I continue to take to take to this day, since whenever I neglect them my symptoms return. But I’ve thought about that doctor’s words many times in the intervening years, as I’ve participated in many forms of exercise and mental health counseling that did nothing for my “low normal” thyroid.

Then there was the anesthesiologist who treated me during a breast biopsy. To say that I was frightened the day of that surgery would be the understatement of the decade, and my way of handling emotional discomfort often is to joke. So when the anesthesiologist saw me prior to the procedure, asking about allergies, I said laughingly, “Mostly, I’m allergic to my whole planet of origin.” Her face darkened and her lips twisted into a snarl as she snapped out that she needed accurate information. Chastened, I quickly recounted my precise allergies. But conflict terrifies me, so I was still trembling as they wheeled me in for surgery

I’ve wondered since if that anesthesiologist trained alongside the tech who handled the anesthetic for my emergency c-section.  During that procedure, despite trying my best to remain still as the needle was inserted into my spine, I jumped slightly. The anesthesiologist smacked me across the upper arm and growled, “I said DON’T MOVE!”

Another friend recounted her miserable experience with a doctor whom she saw for knee problems. Although my friend never denies that she is overweight, she was shaken and humiliated when the specialist genuinely threw up his hands. Threw his hands into the air and declaimed that there was nothing he could do, owing to her weight. She continued her story of medical mistreatment, explaining to me that,  many years earlier, when she’d first begun to gain weight, she’d visited another specialist.  She’d described to him a breathing problem she was experiencing that was limiting her activity and contributing to her weight gain. Prior to developing this breathing problem, she explained, she’d weighed only 127 pounds.  Later, as she dressed following the examination, she overheard the doctor dictating his notes regarding her case: “Patient claims to have previously weighed 127 pounds. Frankly, I find that hard to believe.”

I could probably recount a dozen or more such unpleasant, degrading incidents, both mine and others. I feel certain almost everyone has such a story. Many are far worse than those I’ve already related here: the breast cancer patient who was slammed into the radiation therapy machine by an angry tech; the woman who was told of her 102°F temperature, “That isn’t a high fever!” Belittling encounters with medical professionals could probably spin out into a story as long as War and Peace. And still I recognize that there are always two sides to every coin: During my daughter’s long labor and eventual c-section, I was thoroughly impressed by the kindness and quality behavior of the two anesthesiologists who treated her pain.

Nevertheless, thinking over so many disagreeable experiences, both my own and those of others, I persist in believing there is a genuine reason for those two sidewinding snakes on the caduceus.

Growing a Spine

I am one who avoids conflict at all costs, sometimes—often–to my own detriment. Early experiences taught me that it was safest to be a pleaser; to be cautious, to maneuver or manipulate, rather than confront.  The direct approach is rarely my chosen route; I am ever a pacifist.  Consequently, it’s been an on-going challenge throughout my life to be able to tackle opponents head-on.  Instead, I often go in through the back door of confrontation by writing—letters, reviews, e-mails–rather than speaking my truth aloud.

For that reason, following surgery last winter, I refused to answer the automated Patient Experience phone call a few weeks later. I had a lot to say, but I was NOT going to spend 20 minutes pressing 10 for “Very Likely” or 1 for “Worst Experience EVER”, and receive perhaps two minutes at the end of the call to speak my piece.  Instead, I looked up the address for the Patient Experience division and wrote a letter—a real, true paper letter.  A long letter.  I provided detailed descriptions of both the good and bad aspects of my pre- and post-surgical experience.

It’s probably notable that a few weeks after sending my letter, I received a call from a genuine human being. The call from an unknown number went to voice mail, and I declined to return it; I had said all I wanted to say in my usual non-threatening manner.

But I am also very much of the “do as I say, not as I do” mindset. Just because I’m rarely willing to speak up for myself doesn’t mean that I don’t recognize when those around me are doing the same thing—again, to their own detriment.  This was never made more clear to me than once when, at a party, I listened a woman discussing the mother-in-law who had browbeaten her for years.

Mother-in-law lived out of town, and had made it her habit to simply call and announce when she would be arriving to stay for any length of time—a night, a weekend, a holiday, or longer, with no consideration for any plans already made by her son’s family. That was bad enough, her victim explained bitterly, but this high-handed woman’s expectations went much further.  She would demand that certain other people, relatives and friends, be invited for dinner or parties during her stay, and would even specify what was to be served at those functions (food for which the mother-in-law paid nothing, her long-suffering daughter-in-law noted).  When the gatherings were held, the mother-in-law failed to lift a finger either for preparation or cleanup.  In fact, during each of her stays she expected to be waited on hand and foot.

As this angry woman expounded ever more bitterly upon her mother-in-law’s outrageous behavior, it crossed my mind to wonder why, since his wife was so compliant, her husband never put his foot down to refuse his mother’s demands. However, it’s often that “like marries like”,  I realized, and the husband was probably just as docile as his subservient wife.

One would think the breaking point would have been reached when, as the victim explained, she’d just endured major surgery when mom-in-law announced her latest visit—a visit which was to include inviting the husband’s sister and all her family for a dinner party, as well as several outings. Apparently, at this point her submissive daughter-in-law finally protested, explaining that she needed bed rest for her recovery.  Her protests were dismissed as her mother-in-law declared that that getting up (and apparently working her fingers to the bone) was the best thing for her daughter-in-law’s recovery.

At this point in the woman’s narrative, I finally spoke up myself. “This is HIS mother, and your husband didn’t stand up for you while you were ill?!” I spluttered.  She merely shrugged with her hands splayed upward.  “Well, I would have told her to shove it in a sock and just stayed in bed!” I pronounced, was horrified when she said that “was impossible”.

As non-confrontational as I am, I could not comprehend this woman’s inability to grow a spine. I’d have suspected that she was exaggerating her situation, but later, after she’d left, others at the party—all of them just as mystified as I was about her passivity–confirmed her description of events.

Growing a spine is harder than hell. As I say, I go in the back door by writing, but at least I take some type of action to stand up for myself.  This woman’s submissiveness, and that of her husband, was totally incomprehensible to me.

I think about that woman’s story sometimes, especially when remembering my refusal to take the phone call after the hospital received my letter. I told myself that I’d said all I wanted to say, but was that really the truth? Or was my own spinal pliability the real reason?

Hmmmm. Maybe I’ll send “Patient Experience” a copy of a couple of my blogs from that time.

Soup and Sympathy

Over the years, I’ve made many an effort to assist when friends and family members were going through hospital stays or illness. I’ve rushed to emergency rooms, waited anxiously through surgeries, and made visits to those confined for a long hospital stay. I’ve put together personalized “get well” baskets stuffed with puzzles and videos and tea and snacks.  I’ve cleaned homes and baked pot pies and casseroles and muffins, and brought take-out for lunchtime visits.  I’ve sent get-well cards and checking-up-on-you texts, or shopped for and delivered groceries. I’ve cleaned cat litters, and brought fuzzy, warm socks to a friend suffering icy feet following a surgery.  In perhaps the saddest situation ever, I drove through a heavy snowfall early one morning to assist a friend, immobile with a broken leg, whose pet cat had just died unexpectedly. I brought a blanket and a box, laid the little fellow to rest, and then did my best to comfort her.

Throughout time, all of this has, I suppose, amounted to a considerable effort. Yet, spaced out as the events have occurred – spanning perhaps 40 or more years–it hasn’t seemed to amount to all that much.

So it was with very ill grace that I received the ministrations of family members and friends when the tables were turned I myself became seriously ill and was then incapable of self-care following surgery. These people were giving up their time—sometimes productive working time, as well as their free time—to look after me when I was incapacitated.  And I didn’t deserve it.  Of that I felt sure.

I didn’t deserve the errands they ran for me, the nights they spent looking after me—including the several nights one relative spent just sitting with me, watching endless reruns of Downtown Abbey, as I dealt with the reality of my cancer diagnosis. I certainly wasn’t worthy of all the hours they spent schlepping me to and from appointments and taking notes on everything the doctor was telling us—words that mostly went right over my head, as I sat there in a contained bundle of frantic nerves.

When I came home from the hospital and they prepared meals and served me foods, I tried to recall all those pot pies and casseroles and muffins made for others, but I felt like a total fraud, especially as I could barely eat more than a few mouthfuls of their carefully-prepared food. And though I wrote thank-you notes and handed out small gifts to each person who came to my aid, I still felt as if I was running some despicable scam.

Looking at all this through the lens of perspective, I finally understand how dreadfully hard it is for some of us to be the recipient of others’ ministrations.   But that reaction has nothing to do with a lack of gratitude, not at all.  It’s due to a loss of our sense of independence, coupled with a feeling of unworthiness.

Oh, I’m sure there exist those people who bask and glory in the singular attention of others: the work done on their behalf, the care taken of them. In fact, I’ve known such individuals. I’m sure everyone has.  And tending to them has been, frankly, a royal pain in the ass.  But, for most of us, to have to put others to the inconvenience of caring for us is not a situation that we willingly adopt.

When I’m next called upon to bring soup and sympathy to a companion in need, I am going to remember the experience of my own reaction in that same situation; to remember that they are likely squirming under the necessity of having others come to their aid. I’ll remember that as they seem grouchy or ungrateful, or when they appear to wish I’d just get the hell out of their home.  Because I’ve finally walked a mile in their moccasins, and at last I understand the blisters that journey leaves on the (pun intended) soul.

Twenty Hours After Surgery….

Following currently acceptable medical practice, after a serious surgery I was tossed out of the hospital just twenty hours after being wheeled out of the operating room. This was what I got for being a cooperative patient. (And to that, let me just say: Never Again.)

Overjoyed for a reason to have the catheter removed, I’d gotten up to walk the corridors with the nurse’s help, willingly choosing the “long route”, pushing my IV beside me, just twelve hours after the operation. Pleased to have the IV taken out of my aching hand, I’d cooperatively  slogged down water like the beverage was the latest trendy invention.  I trotted myself to the restroom multiple times (to the horror of the night tech, who hadn’t explained that I wasn’t permitted to do this on my own, without accompaniment).  I ate a small dinner and a big breakfast.  Everything that I was asked to do by the hospital staff, I did, in fact, do.  And my reward for this was to “get” to go home, pain prescription in hand, the following day, to endure possibly the worst night of my life. Undermedicated for pain; unable to walk up the stairwell to sleep in my own bed; barely able to rise from my couch to stumble to the bathroom, I felt as if every inch of my body had been beaten with baseball bats.

Let there be no mistake: hospitals are not fun places. IV alarms ring constantly.  Just when one has fallen into a sound sleep at last, in wheels the night tech, waking the patient to check vitals or administer a dose of some med or another.  People laugh, talk, argue and rush in corridors.  Noisy carts are pushed through halls.  Janitorial staff pop by to empty trashcans.  The sounds of people crying—or crying out in pain—filter through the walls.  One is poked, prodded, examined and stuck with needles.  Tape is pulled from sensitive parts of the body, leaving behind welts and rashes.  Responding to other, more urgent emergencies, no one answers the call bell.

But there are also advantages to lying in that hospital bed, not the least of which is the bed itself, which is adjustable and can be arranged into the best position for the comfort of the individual occupying it or trying to clamber in and out of it. Toilets are only a few steps away—not up a staircase or across the house—and showers are the walk-in variety.  Pain medications can be given by injection or IV, without waiting for the oral med to finally dissolve and work its way into the bloodstream.  But, most important of all, is the opportunity to ask someone knowledgeable, “Is this normal?  Should I be experiencing this?  Will this last?  Has something gone wrong?”

But, as mentioned, the cooperative patient is launched homeward as quickly as possible, to a place where there are no adjustable beds, where bathrooms are a long walk away and the only shower or bed may be up a flight of steps, where pain medications are oral, and where relatives and friends who’ve come to help are just as clueless as the patient. Preparing to leave the hospital that morning, I could not help but laugh when, as I fumbled to button my blouse, the nurse asked, “Do you have help at home?”  I am a divorced woman; I’ve lived alone for years. I wondered for a moment what she would have done had I answered, “No.”

Fortunately for me, family and friends stepped up to the plate, so that for the first two days and nights following surgery I was never left alone for a minute. I ignored the post-operative paperwork which stated that I was not to climb stairs for two weeks after my surgery and clambered, slowly and laboriously, up the stairwell to my shower on just my second day home.  That would certainly have been easier had I still been hospitalized, but the question, “Do you have a ground-floor bathroom?” was definitely never broached.

I suspect now that those unasked or belatedly asked questions were intentional. Negative answers would have meant red tape—a battle with the insurance company to cover another day, or even two, to ensure a safe recovery.  Medical staff are weary of the fight, and so cave to reality rather than the responsibility of protecting patients’ post-surgical health. Out of sight, out of mind, and the well-meant lie is uttered, “You’ll be more comfortable in your own home”.

There may be no place like home, but for the recovering patient, that just isn’t quite true. But the insurance companies and the almighty dollar, rather than common sense and medical safety, rule recovery in the modern health environment.