Archive for June 29, 2012

Good Medicine, Bad Medicine

Like many people, I owe my life to skilled medical practitioners.  Back before there was a quick-fix for the Rh factor issue, I was born fighting for survival as antigens forming within me battled to reject my own blood supply.  Even after a total transfusion, I required an emergency response team at least once before my parents could take me home from the newborn ward.

My husband Jack is similarly indebted to the researchers who discovered insulin as a treatment for Type I diabetes.   We are both extremely grateful for the reprieves we’ve been granted. 

But medicine is like any other field:  It produces competent, caring professionals as well as some less admirable types.  And because of its unparalleled potential to affect our quality of life, society holds the health care industry to the highest standards.  (A miscalculation in surgery certainly trumps a slip-up in toilet installation.)  

Some failures to meet these standards are dismissible as human error, of course.  The ones that cause fear and trembling are rooted in greed, insensitivity, ineptness, or narrow-mindedness – traits one would hope might be sifted out through the arduous process of education and training.  So, while most health care providers serve us well, some others, perhaps, could do better.  I am sure you have stories of your own.  Here are a few of ours. 

We had the same family doctor for our first ten years of marriage.  Dr. Good.  Really.  And was he ever.   He treated my stepchildren with respect; he listened, and applied common sense; he took a conservative approach to minor problems and acted quickly on the major ones.  He was a doctor, not a clinic – as his business card read.  When you called his office, a human being actually answered the telephone. 

By the time Dr. Good was approaching retirement age, he was forced to take on shifts at the emergency room in order to stay afloat.  The giant machine of government programs and mega-clinics and mammoth insurance conglomerates nudged him right out of practice, no doubt earlier than he, or we, would have liked.  Since then its been a kaleidoscope of changing clinics and M.D.s for us. 

There was the megalomaniacal endocrinologist who wanted to micro-manage my husband’s life with no regard for how sending him to the local E.R. for weekly blood checks would disrupt his work schedule and his insulin routine.  There he would sit for an hour or longer, waiting for the staff to get to him as a non-emergency, until his blood sugar had dropped to an comfortable low, throwing his readings off for days.   And this doc insisted on monthly office visits, versus the twice-a year check-ups most of his colleagues recommended. 

When the patient decided he could no longer comply with this overzealous tyrant, the doctor sought revenge on him by giving a bad report to the State License Bureau.  Jack had to renew his driver’s license every six months for many years as a result.  Perhaps Dr. X. could have done better. 

Several years later, at my desperation-inspired insistence, we starting tooling 20 miles across town at least twice a month to an institute that advertised itself as solely committed to diabetes care.  They were right there on the cutting edge; this was all they did and they did it well.  They said so themselves.  A few non-informative meetings with an overweight dietician who couldn’t tell me how many grams of carbohydrates there are in a potato should have been a warning bell.  Unfortunately, the worst was yet to come. 

Visit number one to a staff a specialist yielded a prescription for a new type of insulin.  For decades, my husband had taken the same two insulins, one dose of long-lasting morning and evening, for continuous “background” blood sugar control, and a dose of fast-acting before each meal.  Before breakfast, he would combine both insulins in the same syringe.  This was recommended  procedure; it was safe, effective, saved syringes, and meant only one injection instead of two.  Sweet and neat.  

Shortly after he started seeing the experts at the internationally acclaimed diabetes center, he was driving to an appointment with his eye specialist and I was along for the ride.  Half-way there, he started acting strangely.  I had seen this only once, a few weeks earlier at Taco Bell, when he had a blood sugar dip so radical and so sudden that he couldn’t speak, couldn’t even navigate out of his chair.  It had never happened before.  I thought it was a one-time fluke.  

Yet this day, here we are, barreling 65 miles an hour down the freeway, when my husband begins to act as if he doesn’t know where he is, (more…)

June 29, 2012 at 11:27 pm 1 comment

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