Monday, April 12, 2010

The Beauty of a Competent, Caring Physician

My kids have heard me say many times, "Never underestimate the power of your smile.  It may be the one nice thing someone receives today."

To physicians, I say "Never underestimate the power of your intentional listening.  It may be the relief your patient needs when there is no cure for what ails them."

I recently had two such pleasant experiences in one week with doctors I had not met before.  After 20 days of a Behcet's ulcer that was proving to be more resilient than its host (me), I got an emergency appointment with Dr. Giardina, a gynecologist with Kaiser Permanente who was kind and sympathetic.  He admitted he hadn't seen a Behcet's case before, but he was familiar with the disease (that it is an auto-immune disease and very rare).   He provided some pain relieving creme and antibiotic ointment to tide me over until my appointment with a rheumatologist two days later.  It's the same "good stuff" they use on baby boys when they are circumcised.

That Thursday, I met with Dr. Andres Salazar, a rheumatologist with Kaiser Permanente.  Fortunately, he is familiar with Behcet's Disease and reviewed my case before he entered the exam room. 
[side note:  This was an important visit for me because not only was it my first appointment with him, but my family was leaving for a Spring Break holiday the next day.  My husband and I weren't sure if I would be able to make the long trip comfortably since the Behcet's wasn't healing.  I was prepared to venture on, but dear hubby wanted the doc's opinion.]

I took prednisone daily for the first year to manage the flare-ups, but the side effects proved hazardous to my physical, emotional, mental, and marital health.  Since I stopped taking the prednisone in January, the flares have been more frequent and take longer to heal.  This, he says, further confirms the Behcet's diagnosis.  In addition, I now have arthritis in my hands, hips, and ankles.  All I need is the dowager hump and I'll be walking like Quasimodo!

Dr. Salazar also explained that the meds that are most effective for Behcet's also affect the bone marrow.  Since the Polycythemia Vera is a bone marrow malignancy, we need to tread lightly on this.  He is going to confer with Dr. Kondapaneni, my hem/onc about the next course of treatment.  

I am just one year into the disease, so there is still a good deal to learn about which of my systems are affected by Behcet's.  He ordered a lot more blood work and we'll reconvene in a few weeks.   I've also got to go to an ophthalmalogist to be checked out for uveitis;  while I doubt there is any involvement in the eyes,  I do have some vision issues, so we need to check it out.

Did either of these doctors solve my problem?  No.  But they listened to my concerns (I felt heard), recognized the illness (I'm not crazy, making this up), acknowledged and treated the pain (they understood this hurts like hell), and continued probing for more information by asking me questions and doing more lab work (willing to gather more information to determine next course of treatment).

I left my appointment with Dr. Salazar feeling better than I had felt in weeks simply because he displayed competence and thoughtfulness during my appointment.  

Living with chronic illnesses can be a part-time or full-time job (depending on the type and severity).  We get to live with the symptoms, manage multiple medications & their side effects, endure the funky things the illnesses throw our way, go to doctor's appointments, lab visits, deal with insurance companies, etc.
When we are fortunate to find physicians who treat the patient and his/her illness with attentiveness and compassion, it's amazing how much better we feel.

In my daily practice of gratitude, I am thankful for medical professionals who remember that their patients are people -- with names, lives, families, histories, hopes, and desires.  It's challenging, I'm sure.  Doctors don't see us patients when we are at our best.  And they have a host of pressures outside their 15-20 minute appointment with each patient.

When you work with physicians or other medical professionals who are competent and kind, let them know you appreciate them.  Don't we all like to feel the love?

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