Got to see Chao in person today, and boy did I lay in to him.
I doubt I got through to him, but he sure as fuck got a piece of my mind today.
And I am quite proud of myself for that. I was not a dithering and uncertain doormat who instinctively does what will make the other person happy today.
No, I was an angry and demanding prick. And on my own behalf too.
In fact, the very first thing I said to him today after “Hi, Doctor Chao!” was, “So, what’s your plan for figuring out what’s wrong with my legs?”.
And we were off and running.
That took him aback, and he of course said that he THOUGHT we were going to be talking about my blood pressure today
Of course he did. Because that’s a way easier thing for him to deal with because dizziness upon rising is a well known thing and he has presumably treated it dozens of times over the years and knows it inside and out.
Whereas whatever the fuck is happening to my legs and my other muscles is murky and complicated and mysterious and might actually require an ongoing effort where he stays on top of the issue and thinks really hard about what it might be.
And that’s not in the cards. Homie don’t play that.
Then he tried to get away with offhandedly saying, “Well, you’re diabetic, so it’s probably diabetic neuropathy” like that was an actual diagnosis.
But it isn’t. It’s a fucking guess. He hasn’t run any tests. He doesn’t have a report from a neurologist saying that is definitely diabetic neuropathy. He doesn’t have anything.
It’s a lazy diagnosis formulated by a lazy doctor who just took one thing he knew about me – insufficiently controlled diabetes – and said, “Eh, it’s probably that, then.”
But it’s worse than that because that’s not even true any more. The Jardiance has my blood sugar under control. My last A1C test came back almost normal.
Plus, diabetic neuropathy affects small muscle groups, not big ones, because it affects small capillaries and small nerve clusters.
So it’s a rotten diagnosis all around.
I told him I thought he was lazy. I told him I would go to the College [1] if he didn’t come up with a real diagnosis. I told him I wasn’t happy that here we were, a year after my hospital stay, and I still had no idea what the fuck is up with my legs.
And he did the thing where he says, “I COULD end this right here and refuse to see you again. I’m not GOING to. But I COULD. ”
Which is like pulling out a gun and putting on the table and saying, “I am NOT going to shoot you. But I could. ”
He even pulled the classic martyr trick of pulling up the College’s website and showing me the “make a complaint” button.
Big deal. I brought up the College first.
In the end, I let him fob me off on some neurologist.
But when that person finds nothing, I will be back.
And I will be pissed.
More after the break.
[[1}} College of Surgeons and Physicians., the governing and regulating body for all doctors here in BC. [[1]]
What I wish I had said
Time for some l’esprit d’escalier.
In no particular order :
I wish I had asked him, straight out, what HIS theory as to why I have gone a year without a diagnosis is. Because I’m dying to here that.
Go ahead, you feckless twit. Explain to me, the jury, and the audience back home why there has been no progress on my case for at least six months. I can’t wait to see you try to tap-dance out of this one.
Because we both know that the real answer is that you forgot. We tried some things – spine, brain, heart – and when it wasn’t any of those,. you did the same thing they do at RGH : you shrugged and moved on.
It did not even occur to you that you needed to keep trying because you still didn’t know the fucking answer.
Imagine playing Clue with this guy.
“I know it’s not Colonel Mustard, Professor Plum, or Miss Scarlett. Game over!”
“But you don’t know who the killer is yet!”
“Oh, um….. I guess it’s Mrs. White because she has diabetes. ”
The truth. Doctor Chao, and I say this with great reluctance, is that you can’t handle my case. It’s too weird and mysterious for your usual “here’s a piece of paper, now leave” approach to medicine. It is going to require a long term commitment of mental resources and effort where you stay on top of the case and you keep investigating until you actually have a diagnosis for me.
This seems pretty basic to me. But you’re the doctor. Odd that I have to tell you this.
I also wish I had asked him directly what he thought was wrong with my legs. And when he told me diabetic neuropathy, I would follow up with, “And you know this because…?”
And he would have had to admit that he didn’t actually know that to be the case, it’s just a theory he pulled out of his lazy ass when I was grilling him.
Get this – he had the gall to say that because diabetic neuropathy affects teeny tiny capillaries, it is “impossible” to test for it.
Bullshit, you mealy mouthed motherfucker. The tunneling electron microscope has been around since the late 60’s, and it can visualize individual atoms.
They totally could find small capillary damage if you could be bothered to look for it.
God, how stupid are most of your patients if you routinely get away with this bullshit?
Well I am not your average patient. I am, in fact. incredibly intelligent, and that means your facile bullshit doesn’t work on me.
So trust me, you ARE going to find a diagnosis for me.
Because if you don’t, you’ll find yourself hauled in by the College.
I will talk to you nice people again tomorrow.