Wednesday, October 24, 2007

The Tidal Wave of Condescension You Get From Your Doctor When You've Researched Your Own Symptoms

God forbid I should intrude on their staggering expertise. How dare I presume to deign to even imagine that I might actually contribute something to the conversation. Shouldn't I just keep my mouth shut when I'm sitting up there on the crinkly paper? After all, only one of us went through half a dozen grueling years of list-memorization, followed by another half dozen years of taking urine samples on graveyard shift. So what could I possibly know about my back pain?

Plenty, I think. I could read a layman's primer about it on the internet - maybe go through one of those symptoms analysis websites - maybe ask a few questions on a few forums - and then maybe develop a highly reliable working understanding of the common causes of back pain. But is that going to impress my internist? What do you think?

Look, obviously the doctor has the real expertise. Obviously he's drawing from a much deeper well when he diagnoses me. But that doesn't mean I'm not going to do some cursory homework before I pay for the doctor visit. I typically don't go to the doctor until I've exhausted all possible over-the-counter type avenues and done as much internet research as I can. But if I tell the doctor something like "It's got all the signs of a slipped disc." then my friends you have never seen such drippingly hostile, barbed, venomous condescension.

It can take one of two general forms. One reaction is the pissy one. It's the "please don't waste my time with your amateur theories" exasperation. These doctors take it as a personal insult that you would even offer some kind of analysis of your own condition, because it implies that you don't view them as the incense-waving, all-knowing shaman that they want you to think they are. The second common reaction is the tidal wave of patronizing, infantilizing condescension. The doctor takes on the attitude of a man who finds his dog looking at a newspaper. "Awwwwww, who's reading the paper! Who's reading the paper! C'mere little guy - is the Dow up today! Who's my big boy!"

WTF? You wouldn't get this from any other kind of professional. If you told your mechanic the brakes were feeling a little sluggish, and that maybe it was a weak piston on the caliper, would he blow up in your face? Would he say "Hey, who's the mechanic here?" Would he say "Suuuuuuuure it's the piston on the caliper! What a bright young man you are! Do you want to be a real mechanic some day?" No, of course not. He'd say "Okay, I'll check it out."

I'm not telling the doctor what I think the problem is because I want a pat on the head, It's because a) I'm doing him a favor, and b) because I would like to be an active participant in the process. I'm trying to be the Robin to his Batman. The Igor to his Frankenstein. I am just... trying... to help.

What doctor ever tells you to study up on your condition and recommends a book? What doctor ever invites you to become more educated on the principles of diagnosis? They don't, do they? They enjoy your ignorance. They savor it. Not necessarily because they're panicky that you'll read a book and put them out of business. It's because they've been taught since day one that they will be the keepers of the sacred knowledge. That's the doctor's reward as he slogs through med school - he knows the exclusive club he's about to join. But it's not enough that he has this mastery. Everyone else has to be ignorant.

Again, compare it to almost any other scenario where the layman comes to the specialist and tries to demonstrate that he's read up on the specialist's work. The specialist would normally be flattered. At least, he'd feel a little warmth toward you that you had taken the time to learn something about what he does. There'd be no belittling sneer. No "You've read the holy book!?!" anger and venom.

Look, doctors - it's only natural as the internet matures we will see self-diagnosis websites that just get better and better. True, it's very hit and miss right now. But even now, I guarantee you for any weird symptom you can do a google search and find 5 people all complaining of the exact same problem, followed by the advice of doctors advising them what it might be about. In the future, trust me, Dr. Clippy will be running circles around you.

"Paging Dr. Clippy. Dr. Clippy, you're needed in surgery. Dr. Clippy."

Dr. Clippy will be able to upload your medical history, then ask you 100 questions, then narrow down the diagnosis possibilities with what I promise will be a ridiculously high batting average. You doctors need to understand that the vast chasm of highly specialized knowledge between you and the average Joe is about to become irrelevant. You doctors - you aren't particularly great geniuses. Your great skill was memorization. You're a bunch of walking medical encyclopedias. And Dr. Clippy, who's a much more reliable memorizer of facts, is about to be able to diagnose anything that you can, and there's not any reason to think he can't do it much better.

So when I come in with (gasp!) an opinion about my groin pain, maybe at the very least you should take it seriously, and lose the 'tude?

1 comment:

Mr. Gentlefinger said...

Look, you and I both know why you have groin pain. Have you ever considered that your doctor was embarrassed by stories that would make a prison guard wince?Your "internet sights" that gave you "groin pain" are not useful information to anyone other than a court-appointed psychiatrist. Put down the riding crop. Take off the Hitler moustache and nun's habit. Disconnect the internet. And let a medical professional heal your chaffing without embarrassment.