Long, possibly boring... Five Examples
Iatrogenic? Ahhh, Tessxyz, you scare me with your big Greek words! I had to go to the internet to be sure of its meaning. An interesting word, first coined in 1924 and not in common use. It was what I thought you meant, but I like to make sure. (Being a good consumer, I check my sources.) As it happens, I am already aware of which hospitals in my area are considered "good" and which are "iffy." Even the best can have bad days, however. I was reading about the medicalisation of life today and found this little quote in the BMJ, said to come from George Bernard Shaw:
"Make it compulsory for a doctor using a brass plate to have inscribed on it, in addition to the letters indicating his qualifications, the words
`Remember that I too am mortal.'"
As for choosing non-iatrogenic surgeons, my doctor gives me the recommendations, of course. She'll point out two or three on the list to whom SHE would go. She knows that I prefer women and immigrants since they, in my mind, try harder. In almost every case, I will make the final choice and call their office.
You asked for my sources... I look at websites from the NIH and its Medline, the CDC and sometimes, the Mayo Clinic. I may even check my Merck manual, although it is slightly out of date, but handy when I'm away from my computer.
And now I'll bore you a little with five examples:
It is from the CDC that I saw I should have some
innoculations before a trip last month. I called the doctor's office, spoke to her nurse (aptly named "Candy" as in candy-striper) and made arrangements to have a HepA and, while I expected just a tetanus booster, elected at Candy's advice to go with the new Tdap. Candy is amazing at giving innoculations -- like that Daoist butcher, Ding, whose knives never got dull, she also can find the "spaces in-between" and prides herself on painless shots. I did not see my physician.
Everyone (imo) has a lot more information about medicine than is realized. We don't go to the physician every day or even every month. We go WHEN WE THINK WE SHOULD. We have a list of symptoms in our heads that are: 1) necessary to be checked out, 2) can be doctored on our own, 3) that we just watch and see. As we age we collect symptoms which we may have experienced earlier in our lives. Doctors would be overwhelmed if they were called upon to make every decision about our health. An example for me is
labyrinthitis. The first time I had that, I rushed to my doctor... it seemed to come on suddenly, I was dizzy... signs of stroke. Ho-hum, says doc, with a quick test of having me lay back and turn my head suddenly. Take this, she says, it might make you sleepy (but you won't be dizzy). It makes me very sleepy and I hate it. Next time I have symptoms of labyrinthitis and no other stroke signs, I decide to live through it and not go to the MD. Have I prescribed for myself? I also have most of the pills left over from the last episode. The bottle says they are still potent. Should I take them?
I rupture my
Achilles tendon while playing soccer. It is found to be at least 99% separated (I cannot walk at all, there is a bulge in my leg, x-rays taken). The orthopaedic surgeon says, "I could repair this surgically OR I could splint it." He describes the two procedures and what I can expect. And then he says, "It is your choice."
Another example... I am having my first treadmill test during a physical. It seems rather short. I'm sent home. A minute after I get home I receive a call from the doctor's office. They'd like me to see a cardiologist. (Okay, says I.) Can I be there in half an hour? (Well, says I, I'd like to change out of these gym clothes.) No, they say. Not necessary to change, please go as fast as you can.... are you okay to drive? (!!!?!) I get to the cardio in 20 minutes wearing shorts and a teeshirt. I'm immediately ushered into the rarified air of the cardio's office. I note HE is dressed immaculately and wears beautiful shoes; he's from India and so new that he doesn't yet have his name on the Cardio Clinic stationery. He's already looked at the results of the treadmill test. You have two choices, says he. We can do a
cardiac catheterization or another, "more stressful" stress test. He tells me what each entails. And then he says, "It is your choice." [Later, on finding out from my MD that for women, those stress-tests are known to have 25% false-positive results, I might have made a different decision, but she errs on the side of caution.]
Last one... I am having my first baby. I've been struggling for twenty hours as she is, in a word, stuck. The Ob-Gyn says, "Well, I guess I'll go to lunch and if you aren't any further along, we'd better consider a
C-Section." Oh no, says I. Let's just go ahead and get that knife prepared... thank you very much. You can have your lunch after.
My baby is born before noon. (This doctor later leaves the profession under the dark cloud of too many lawsuits. Sad, I liked him, but I did make the right choice for myself as he waffled over what to do.)
I hope this "little dispute" has settled down and we can be friends. Truly, I am an admirable patient, respectful, even amenable, and my doctor likes me very much. Of course, I pay my bills. ;-)
Nice to know that about the generic drugs, I did not realize there are so many differences with the brand names. I read one article that says that if you start on a brand name for example, you are better off to remain on the same instead of switching to generic and back to brand name on and off, because the drug would not be so effective. From what you said, looks like it may be true.
