Doctors Divorced From Your Reality

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Why this? Because it applies to many medical situations we face, I believe.
Why poetry? Because in poetry, word carry more freight.

This is from Garrison Keillor. He’s the Prairie Home Companion person. It’s a daily, free email. I subscribe to the paid version – and I think the free one is worthy of donation. He does more than poetry, in these, but this struck me as relevant.

The Writer's Almanac for Sunday, August 15, 2021

A Slip of Paper
by Louise Gluck

Today I went to the doctor—
the doctor said I was dying,
not in those words, but when I said it
she didn't deny it—

What have you done to your body, her silence says.
We gave it to you and look what you did to it,
how you abused it.
I’m not talking only of cigarettes, she says,
but also of poor diet, of drink.

She's a young woman; the stiff white coat disguises her body.
Her hair's pulled back, the little female wisps
suppressed by a dark band. She's not at ease here,

behind her desk, with her diploma over her head,
reading a list of numbers in columns,
some flagged for her attention.
Her spine's straight also, showing no feeling.

No one taught me how to care for my body.
You grow up watched by your mother or grandmother.
Once you're free of them, your wife takes over, but she's nervous,
she doesn't go too far. So this body I have,
that the doctor blames me for—it's always been supervised by women,
and let me tell you, they left a lot out.

The doctor looks at me—
between us, a stack of books and folders.
Except for us, the clinic's empty.

There's a trap-door here, and through that door,
the country of the dead. And the living push you through,
they want you there first, ahead of them.

The doctor knows this. She has her books,
I have my cigarettes. Finally
she writes something on a slip of paper.
This will help your blood pressure, she says.

And I pocket it, a sign to go.
And once I'm outside, I tear it up, like a ticket to the other world.

She was crazy to come here,
a place where she knows no one.
She's alone; she has no wedding ring.
She goes home alone, to her place outside the village.
And she has her one glass of wine a day,
her dinner that isn't a dinner.

And she takes off that white coat
between that coat and her body,
there's just a thin layer of cotton.
And at some point, that comes off too.

To get born, your body makes a pact with death,
and from that moment, all it tries to do is cheat—

You get into bed alone. Maybe you sleep, maybe you never wake up.
But for a long time you hear every sound.
It's a night like any summer night; the dark never comes.

Louise Gluck, “A Slip of Paper” from Poems 1962-2012. Copyright © 2013 Farrar, Straus, Giroux.
 
That is really telling it like it is!!! And if I were her patient, nowhere near ready to cash in my chips and call it quits, I would go to another doctor for a second opinion!!!
 
How absolutely achingly poignant.
We are born cheaters, let us remain so until we count all our fingers and toes, caress the crepe wrapper of skin like paper. Blow our nose, wipe away the tear...
Of someone else before we shutter the building and slip into that summer night.
 
AlasSouth said:
Why this? Because it applies to many medical situations we face, I believe.
Why poetry? Because in poetry, word carry more freight.

This is from Garrison Keillor. He’s the Prairie Home Companion person. It’s a daily, free email. I subscribe to the paid version – and I think the free one is worthy of donation. He does more than poetry, in these, but this struck me as relevant.

The Writer's Almanac for Sunday, August 15, 2021

A Slip of Paper
by Louise Gluck

Today I went to the doctor—
the doctor said I was dying,
not in those words, but when I said it
she didn't deny it—

What have you done to your body, her silence says.
We gave it to you and look what you did to it,
how you abused it.
I’m not talking only of cigarettes, she says,
but also of poor diet, of drink.

She's a young woman; the stiff white coat disguises her body.
Her hair's pulled back, the little female wisps
suppressed by a dark band. She's not at ease here,

behind her desk, with her diploma over her head,
reading a list of numbers in columns,
some flagged for her attention.
Her spine's straight also, showing no feeling.

No one taught me how to care for my body.
You grow up watched by your mother or grandmother.
Once you're free of them, your wife takes over, but she's nervous,
she doesn't go too far. So this body I have,
that the doctor blames me for—it's always been supervised by women,
and let me tell you, they left a lot out.

The doctor looks at me—
between us, a stack of books and folders.
Except for us, the clinic's empty.

There's a trap-door here, and through that door,
the country of the dead. And the living push you through,
they want you there first, ahead of them.

The doctor knows this. She has her books,
I have my cigarettes. Finally
she writes something on a slip of paper.
This will help your blood pressure, she says.

And I pocket it, a sign to go.
And once I'm outside, I tear it up, like a ticket to the other world.

She was crazy to come here,
a place where she knows no one.
She's alone; she has no wedding ring.
She goes home alone, to her place outside the village.
And she has her one glass of wine a day,
her dinner that isn't a dinner.

And she takes off that white coat
between that coat and her body,
there's just a thin layer of cotton.
And at some point, that comes off too.

To get born, your body makes a pact with death,
and from that moment, all it tries to do is cheat—

You get into bed alone. Maybe you sleep, maybe you never wake up.
But for a long time you hear every sound.
It's a night like any summer night; the dark never comes.

Louise Gluck, “A Slip of Paper” from Poems 1962-2012. Copyright © 2013 Farrar, Straus, Giroux.
 
Hi @AlasSouth, I like that picture of the seaplane. Is that a Grumman?? It's kind of hard to tell with the size of the picture. And do you have a connection (or an interesting story) with that type of plane???
 
This is very thoughtful but depressing, we need to be more upbeat. yes we are all trying to be cheaters, the main problem in my humble opinion in that those in the white coats take this as a job without too much compassion anymore. There are no more Dr. Marcus Webley's. In a way I can understand, it it too much of an emotional toll of them otherwise. One has to remind distant as much as one can yet still do their job. God bless -off to do some errands today.
 
Hi @BarbaraDrabek, Unfortunately Marcus Welby and all like him have left the building!!! They went the way of Elvis, milkmen and '57 Chevies!
I remember way back when your friendly local doctor came out to the house if you had an illness like chicken pox or mumps, or even just a bad case of the flu. He may even take out your tonsils while you lie on the kitchen table and he pours ether onto a handkerchief over a tea strainer. Well admittedly that was well before my time, but a doctor actually carrying a bag with medicines and stethoscope and coming up to your front door did happen---once upon a time!!
But sadly that would not be a practical use of the doctor's time, because driving is a great time-waster and a quick way to have many minutes of non-productive time!!! And that's true especially in Florida with the way traffic is, and we do know that! Keeping that in mind, a doctor would be lucky to be able to get around to see four patients a day!!! So we all take up our day to go see the doctor instead! Burt you're right, doctors do have to distance themselves from their emotions with the patient or else they would end up a wreck themselves!!!!
 
@billliveshere

As a matter of fact I had a doctor just like that from 1946 until about 1955. He had a black Cadillac and a chauffer too. Most of the time my mom took me to his office, but if I had something like chicken pox he actually came to our home, and he had that little black bag too. We were working class people, but medicine just wasn't as expensive as it is today. Most office visits were cash directly to the doctor.

Doctors had much less overhead back then. For example, my doctor only had one assistant. She took care of making appointments from the waiting room, but she rarely came into his office. And his office was large with a big, fancy wooden desk. Chairs were covered in leather, and the walls were covered in solid wood panels. He obviously made a much better living than the doctors of today.

These days I have to check-in with one person. Then someone else escorts me to a room and takes my "vital signs". Another person comes in to get my current medications and ask other questions. Finally the doctor comes in. After the doctor visit I usually have to go to the lab to draw blood or get an x-ray, etc. Finally, I go to yet a different desk to schedule my next appointment.

Then there is the back-office staff. For example, when I was a child insurance was mostly for hospitals, so he didn't need a skilled staff to deal with insurance issues like they do today. There were no expensive electronics and computers to support.

I think things started going downhill for healthcare workers with the advent of managed healthcare systems, lawsuits, and government bureaucracies. There was no such thing as welfare or Medicare or Medicaid back then.

Don't get me wrong - I'm not saying that doctors are going hungry, but they don't do as well as they used to. If things keep going like they are I am concerned that the day will come when we won't have enough people willing to become doctors and nurses.
 
Billliveshere: I agree. I'm old enough to remember a doctor coming to our apartment. Somehow, they made a living, and not a bad one. They didn't get "rich". Neither did they financially break my parents. Traffic wasn't as bad in the late 40s, early 50s. I was fascinated with those bags.
So what changed? Specialization, to some extent. Equipment like xray & ultra sound and MRI, etc. Drugs expanded beyond what those black bags could carry. Liability and advances caused the need for anestesiologists, etc. One person can't do everything, now. At least on the lower levels of care. Big hospitals/clinics have teams on you. One or two are strictly the paperwork people, at least one deals with the Insurance companies & Medicare, and that's all they have time for. (Ugg!)
But the big one was the development of Big Medicine, Big Pharma, Insurance profits, even Medicare. Business realized just how much profit they could make, if they controlled health care, so they did it. They dictate a doctor's time. 20 minutes is all they are supposed to have with a patient. So, a big hospital needs 2 or 3 Urology rooms so the patients don't share the room & the Doc can go from room to room for all the patients' 20 minutes! Bureaucrats dictate medical matters - which is practicing medicine without a license. Oh, they have a loophole, but that's what it is.
That's why, when you see the urologist for that first full exam for incontinence, you see the doctor briefly, and the nurse and the technologists mostly.
With all the anti-vaxxers and denialers actually threatening nurses, and doctors, the s*** an ICU nurse goes through after a horrendous day of 12-hour shifts with Covid patients and all he deaths, some are quitting already.
There is something wrong with all that. I think. Now, what would it be?
 
Hi @billiveshare-I agree with you 100%, I am old enough to remember when my Mom was very sick, I was in 5rd grade the doctor came to our house. My older sister was a senior in high school and missed her first day of high school. I think it was the only day she missed. She missed out on the perfect attendance award during her graduation class. My Mom latter was diagnosed with cancer about 10 years after. so who knows. Dr. Brunswick did come to the house in the 1963. My sister graduated high school in 1963 -so it was probably then, I was 11 years old. She is 7 years older than me. I just remembered this now. This is not practical today nor necessary. We have a lots of urgent care places and emergency's rooms all around us. I just miss the closeness of living then where everyone knew everyone and helped each other. Those days are gone for all of us. The Mom stayed home to raise the family and take care of the house. The Father made enough money to pay the basic bills. This does not happen anymore. I think listening to the news over the weekend was very depressing for me. I have so many things wrong with me now, it is hard to figure out what to do next. I decided to call my workmen's comp doctor today to make an appointment to try to get an MRI done of my jaw on the left side. Medicare I think does not pay for this stuff. When the dentist put in the replacement implant because the old one was compromised from my fall; being was loose, painful, sore, etc. He had to pull out the old one. We had to go through hoops and write stuff up for workmen comp to accept it as a condition which they did eventually. I went back once in March where he checked on it where he had to give me a numbing shot to do this, he said it was not loose. told me to come back in a few months, by then I was scheduled for rotator cuff and bicep surgery. because my arm was becoming much worse. I went though Medicare because the workmen comp guy said I did not complain soon enough, about my arm. I never thought in a million years I had torn the rotator cuff from the fall. I had the left one done in 2007 where it was much worse. I had the meningomia brain tumor then. I am just sick of being sick. I had some pain free years and want them back. I need to stay positive to make this happen. In addition to fixing my tooth, I was working on getting my TMJ and tooth accepted that it was almost impossible for me to get the arm accepted. The first time I talked to the case manager he was very nasty to me over the phone which shut down pretty much. I spent 32 years in a marriage being mentally and emotionally abused, it does not go away at all like this. Being injured and in pain bought a lot of crap back into my life. I cannot deal with this anymore. The case manager told me that people are always trying to get away with something. Like what am I trying to get away with. I had a part-time job which ended one week after my trip and fall. So I received a little bit more money and that was it. I was a census taker. It was fun and convinced me that apple phones are hard to used. My android is much less work and less expensive. Besides my arm and knee were not that bad then right after the trauma. it started to hurt more as time went on. I should have stopped all lower body exercise. I was so afraid and still am of getting real weak again, I had a few accidents already. I was sick for over 20 years -here it was the brain tumor. I had to stopped playing bridge due to my brain tumor. I could not remember the cards on the table anymore with a bad back. This was cause from me lifting a pool table which my ex MR. Wonderful told me to do for his daughter's bridal shower. I should have never given for her. No one is grateful for anything and no one takes any responsibility for anything either. We were raised you do what your husband tells your to do. The thing is, what to do when they don't respect you. HE hid it from me while we were dating. I should have walked away, low self esteem. I know better now. MY right wrist was broken as well as the forearm was very swollen and damaged. After the injury on Sept. 24,2020 I had to wear soft brace for 6-8 weeks. The therapist coming to the home told me she did not think it was broken. The occupational therapist started me on my lower body exercises to try to keep my core from getting weak so I wouldn't start having a whole bunch of accidents again. I was and still am so afraid of what happened. I have two rental units which I depend on for my livelihood. I feel they will both end up being a great investment. One is an RV lot which is not any work anymore. The other one was bought as it, it is a one bedroom and one bath. I should have made it into an RV lot also next store to me. I had company during the summer-friend from high school who stayed there with her 41 year old autistic son for a week. He has a part time job but he has issues reading, he has dyslexia as well. He functions pretty much at a 1st grade level. He knows he has education issues and is very accepting of it most of the time. HE has issues when things are changed. Well we all know this is life as well, everything changes everyday. Debbie is my age, we were friends in high school. I got a scholarship and went on to college, ended up getting my MBA. We all had a great time together. They went back to get ready to go back to work. She is a massage therapist. She gives great massages. She gave me two while she was here and cut my hair as well.
The exercises by the occupational therapist ended up making my left knee worse I think. When I had my first appointment with the P.A. I could not talked to her about anything which was not on the list. this came out of her mouth to me. My right arm was getting worse so I went to my orthopedic though Medicare. I called Medicare and they told me they would pay for the surgery but if workmen comp ever accepted it they want their money back. Well workmen comp will never accept it.
IN addition I developed painful (I think) tendinitis in left knee, why it is so sore.
Now when the dentist gave me the numbing shot in my mouth last week, the implant which he replaced was still very sore-it was so so sore-he could not work with it at all. He put me on 10 days of antibiotics and lets us hope this helps. I did not follow though right away in getting the cap put on because of my upcoming surgery for my rotator cuff and right bicep. This is getting better. The office manager at the dentist told me last week when someone has a lot of things wrong with them, the body can only do so much. I don't know if it is an infection or my jaw is hurting from all the implant teeth I have. I don't know. I need an MRI to fine out. My left ear is sore as well. So something is going on there. When I was a kid, I wore braces because I had too many teeth for my small mouth. They pulled like 4 of them and then moved my teeth around. They don't do this anymore. They found the teeth have a memory and they always want to go back to the original place where they were. My left knee is still real sore from the fall as well. So here we are. It is hard dealing with this stuff especially when you live alone. I am not a good sleeper and have been forcing myself to go back to sleep in the morning to get my 8 hours in. I did this today and am very very tired today. This is my story so far. Had a bunch of errands which I was able to complete. Going to therapy tomorrow-going to go into the pool for my knee finally. I took a hot bath last night. It made my knee hurt more. Will have to think about doing that again, if I do. Thanks for listening we all have our issues sometimes. Blessings-remember nothing if forever-it is all temporary.
 
Anytime bureaucrats get involved with medical needs is seems like things go wrong. The lady that was my social services person back in Florida was an angel. She pushed very hard to get me everything that I need without care for how it was going to be paid for.

She really did save my life.

I have seen just how bad things can get first hand. It upsets me every time I see someone else have to beg to just get basic needs covered.

Some of the parents that I follow on Instagram point out how long they have to wait to get things like wheelchairs approved.

Today doctors only seem to care about keeping you alive.

In the Patch Adams movie with Robin Williams there is a few quotes doctors need to learn.

From Patch Adams movie...

"Our job is improving the quality of life, not just delaying death."

"You treat a disease, you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome."

Sadly most doctors Hospitals/insurance companies only care about keeping the money flowing.
 
Thanks, @ThatFLGuy, you are absolutely correct on this one. It is all about money so we can pay the CEO's millions of dollars. This is so so wrong. It is ok to make money but not to break people.
 
Hi everyone responding to my posts here: In a nutshell big business taking over medical care is the main reason that the medical care industry is what it is.... and industry!!! And also responsible is the development of more and better ways to diagnose and treat you, although in itself that is a wonderful thing. It's good that there are so many more things available to diagnose and treat you, compared to a generation ago. But that has a big price and we all know it!
And here come the insurance companies and regulations and Medicare and Medicaid all mixed into the pot. And it used to be the doctor took all the time he needed to look after you, including of course driving to your house and back and now the time the doctor spends with you at the clinic is something like 15 or 20 minutes. Then it's "I'll see whoever is next." Any more than 15 or 20 minutes and everything gets backlogged and it's harder for the doctor to meet today's quota. Unfortunately that's the way it is. And the operating word here is "what's our bottom line? Are we making a profit or a loss?"
There was a time when doctors ran their own hospitals or were in a select group that had a say in what goes on in their hospital. Now of course it's corporations running them and the administrator is not a doctor or a nurse (they used to be hospital administrators) but an MBA from Harvard.
The one parallel that comes to mind are airlines. Virtually every one of them with a history of more than 20 years was started by a pilot of a small group of them. Delta started as a crop dusting outfit and Pan Am started as an outfit that flew a float plane between Miami and Havana. And the pioneering pilots had a say in how their airline was supposed to be run.
Now the typical big airline is run by another bunch of Harvard MBAs who couldn't tell you what a "taildragger" is to save their lives!!!
 
My experience is England is that the main problem is that they don't actually listen to you. I was misdiagnosed with various things and it was actually a therapist I'd been seeing long term who picked up on some major autistic traits and it was that which led me to get an ASD diagnosis. It's like they have a pre-set questionnaire they have to rattle through. Ironically, often my private physio/osteo and I spend less time talking about my issues precisely because he allows me to speak and so he can assess what's going on.

Found out there was no mention of my mobility issues on my medical records in spite of the fact that I was admitted to hospital last year predominantly because I was struggling to walk! Saw a brilliant nurse who had been asked to do a standing/sitting exercise test who was a) astounded they actually wanted me to do it (turns out I physically couldn't) and b) shocked there was no mention of it in my records and c) alarmed that no one was monitoring me and that I'd had no guidance/advice re daily living.
 
so so sorry Sci_Fi_Fan, bunch of bullshit-medicine here in the states is so about making money that no one really cares any more. IT is all about money here. IF you have money then you may get some attention. Like the people in Afghanistan that were promise evacuation. bull-they were left a lot to them, Biden has the authority to cut threw the red tape and didn't. HE is out to lunch for sure. He promised the mon the news I saw it they they would all be taken care of, well why not?
 
Yep! @BarbaraDrabek, it's all about making money and he who has the most toys when he dies wins!!!
And @Sci_Fi_Fan, it is strange that your medical records did not mention mobility issues although you were admitted to the hospital because you were struggling to walk. But it usually does take a nurse to recognize when something is actively amiss, not the doctors! They just care about turning in their paperwork on time and that all the "i's" are dotted and the "t's" are crossed. When you come right down to it, it's the nurses who actually look out for the patients. If it were just up to the docs to look after the patients, there would be no patients left surviving!!! And your nurses are you day-in, day-out heroes!!!!
 
Unless the Doctor is brand new, there is no interest on his part to read all the crap which is going on. Take care, going to put some ice on my knee and rest tonight. Tired.
 
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