Patient As Doctor

Two days as an inpatient recently reinforced my opinion that the medical system paternalistically infantilizes patients -- a symbolic reflection of how the System itself systematically disempowers people.

A 103 degree fever led me to ER. Soon I was hooked to an IV that pumped something into my blood. They didn’t tell me what it was, give me a drug information sheet about it, seek my consent, or ask me about allergies. Some time later someone dropped a pill into my mouth without telling me what it was. I think it was Tylenol. Then someone stuck a cue tip into my nose without telling me what they wanted to do or why. It was to test for flu, which proved positive. I was also wired up for an EKG. No one told me why or asked for my consent. Later I was taken for an x-ray, which I happened to know was to test for pneumonia, but if I had not known that, I would have been clueless. They also, without telling me why, pumped oxygen into my lungs with a device inserted in my nose and attached a monitor to my finger to read the oxygen level in my blood. It wasn’t until the next afternoon that I learned why or the meaning of various levels of oxygen by doing research with my smartphone. When I asked for a list of all the drugs they were giving me for my various ailments, which included constipation and a urinary tract infection, the list did not explain which drug was for what.

Then the physical and occupational therapists swarmed on me. After chatting some and walking around the ward, the physical therapist told me she wanted to refer me to two weeks at a rehab center. “Ok?” she said. I thought that was ridiculous and remained silent. She repeated, “OK?” I replied, “I understand what you’re saying but I disagree.” I felt like she saw a wounded fish and was trying to reel me in to boost the case for her agency’s budget.

Later I told one of my medical students about that encounter. He said the whole team would discuss it. As he was leaving, he said, “Sometimes the patient is their own best doctor.” After he left, I broke down crying. Hopefully that student bodes well for the future of medicine.

I could continue. There are more stories. But I think I’ve made my point: Society should serve to empower everyone, everywhere, but we fall far short.

Fortunately, however, the drugs cured my fever and I’m recuperating at home, not some rehab center.

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Yesterday I met with my primary care doctor for the first time since discharge and learned that I had pneumonia (a fact no one at the hospital told me!). At the end of our session, I showed her this essay and asked her if she believed I was being fair with my criticism. Before posting it, I wanted her opinion.

Not only did she say the essay makes sense. She asked my permission to photograph it and post it to her Twitter feed!

I often feel like a lonely voice crying out in the wilderness. As I see it, we need to apply holistic principles to every institution, not just health care. If we did, we would “transform the System.” But the world descends into ever more tribalism, materialism, and militarism.

Lately, short of breath, I’ve been discouraged. But my doctor’s response heartens me.

We must nurture a deep commitment to the common good of the Earth Community and find others who share that goal so we can build the critical mass needed to change course. Humanity’s future depends on it.