Vol. 12, No. 2,856W - The American Reporter - March 18, 2006


by Cindy Hasz
American Reporter Correspondent
San Diego, Calif.

SAN DIEGO -- The doctor stood in the waiting room doorway and waved = impatiently at us: Follow him. Before he disappeared out of sight down the = hall, I noticed he had a cruel mouth.

My patient, her caregiver and I had to find our way into his office= at the end of the hall. There was no room to get the wheelchair in as seve= ral chairs in front of his desk blocked our entrance. In retrospect an apt = metaphor for what was to come. I looked up to see if he was aware of the si= tuation, but his head was already buried in her chart.

Oh, brother, I thought, now I see what my patient meant when she t= old me she wasn't crazy about him. We cleared the chairs out of the way as = Dr. Oblivious kept reading. We had come to hear the results of an expensive= brain scan.

The patient was to my right and her caregiver to my le= ft. He and I were directly across from each other. As we sat down, he didn'= t acknowledge our presence. I broke the ice.

"Hi, I'm Cindy, her nurse ca= se manager. He looked up briefly and gave me a dull stare. What a complete = toad, I thought to myself.

He still did not acknowledge his patient = as he started typing on his laptop. Silence. Thirty seconds, then 45 -- fin= ally, he spoke. Looking at the caregiver, he began, "Well, the tests were e= quivocal for hydrocephalus, and I wish they weren't because then we could d= o something." How very kind of you doctor, I thought. My patient wouldn't k= now what "equivocal" meant, I realized.

He continued talking to the= caregiver and ignoring the patient. After a few minutes of neurological wo= rd salad I interupted him. " What exactly does all that mean for her?" Agai= n, he looked at me with a vacant expression.

I had my hand on the patien= t's shoulder, hoping to encourage him to speak to her directly. He mumbled = something about taking out spinal fluid or putting in a shunt. The patient = looked alarmed and confused.

"Do you understand what a shunt is?" I = asked, looking at her. "No," she said. We both turned to him. By that time= , he'd figured out he was going to have to talk to her. He explained what t= he purpose of the shunt is and what she should expect if she refused surger= y.

"You'd loose what little ability you have to walk, all bladder contro= l, and your brain function would deteriorate even faster than it already is= ," he declared.

We were all stunned by the shovelful of nasty reality thi= s bilious human being had just dumped on her, but more so by the callous wa= y he did it. I imagined his scrawny little body up on the table getting a s= pinal tap with a dull needle, or having a shunt placed -- preferably withou= t anesthesia.

He recommended that we follow up with the primary doct= or and the appointment was abruptly over. He dismissed us without even a go= odbye -- his head buried in paperwork before we left the room.

"= Philistine," I whispered under my breath. I wheeled her out of the office. = When we were alone, I told my patient that she never had to go back = to him and that I could find her another neurologist. She was greatly relie= ved but concerned about how to tell him the news. I assured her that I woul= d take care of that part of things. She may never know the pleasure I will = find in telling that small man with the shriveled heart that he was weighed= in the balances and found wanting.

Many people are surprised that t= hey have the right to not be treated as though they are chattel by the "cle= rgy" of modern medicine. The built-in power deficit of the patient-physicia= n dynamic is such that it can deteriorate badly if both people are not awar= e that healing is not just a project but a relationship. Their sharing of i= nformation in a context of human dignity should be non-negotiable.

I= am happy to say that it is my responsibilty to dismiss such cold-blooded c= retins in lab coats. There are too many good physicians out there to accept= such a degrading exchange. There are physicians who in spite of the renstr= ictions of "managed care" still manage to care and recognize that the best = medical results are achieved when there's trust based on good communication= and mutual respect.

Cindy Hasz is a nurse and writer based in San Die= go. She can be reached at cyn1113@aol.com

Copyright 2006 Joe Shea The American Reporter. All Rights Reserved.

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