What I Look For in a Doctor

I read this article in the New York Times this morning and I loved it, so, naturally, it's the story I'm going with today. It's all about how a doctor can and should become a partner rather than a dictator when it comes to medicine, should be letting the patient call the real shots and, rather than demanding compliance, the doctor should be educating the patient so that the patient can make the best decision.

Now, I'm not a doctor. I don't doubt that it's likely not that easy and that any number of patients aren't going to do the right thing no matter how carefully their educated. But I understand and encourage this concept anyway.

Let me tell you one reason why. People in my family get weird stuff. We get shingles when we're children. We get mold that grows in one's lungs. We get meningitis that attacks heart valves instead of the brain, drastically delaying diagnosis. We are weird. When I got married the second time, I married into a family that, oddly enough, had the same sort of unusual diversity - just different problems.

I've learned the hard way that I better be an informed patient, question doctors, insist on knowing what they're suggesting and why and objecting if I know better. Why? Because they can't know my family history, my history as well as I do. Because, in the end, I'm still responsible for what happens to me. Because my children can pay the price if I'm not careful.

I have dozens of stories (I suspect most of you do, too). Like when my cousin almost died from an infection after an in-grown toenail operation and my aunt insisted on taking him to the hospital when his doctor said NO (he had a fever over 106). She'd been trying to get the doctor's attention for two days and the poor kid was on IV antibiotics for six months afterwards.

But there's something more as well. There's something empowering in being part of the decision, to being listened to. Now, you're part of your recovery, your treatment. That's certainly part of it. More, though, you don't sacrifice your humanity, your dignity. That may sound like a small thing, but I think it's a big thing.

There's a favorite movie of mine starring the ever-charming Carey Grant called People Will Talk. It wasn't just that he played the kind of doctor referred to in the article I linked, it's that he never forgot these were living breathing people with minds as well as body needing nurturing. A little bit of dignity can go a long way. Let me give you an example.

My husband's great grandmother was diabetic and blind, a remarkable woman. With eleven children (ten of them girls), she worked as a seamstress and managed to take care of all of them even after her husband shot himself to death when they were teenagers. Books were her great pleasure. So the blindness was kind of a double blow. As it was described to me, most of her daughters went into nursing and, for the last decade or so of her life, she was passed from daughter to daughter, told what to eat and what to do, managed and coddled as if she were a child. Her brain worked fine, mind you, but she was glad to go, I think, when she left. She was quite a woman, but all of her capable children dismissed her as if she were incapable of thinking for herself.

Counter that with my aunt Sue and my grandparents. My grandfather died of asbestosis five years ago or so. Before he died, he couldn't walk to the door without his oxygen, but my aunt reworked the house so it would have ramps, got him a scooter and a portable oxygen tank. When issues for the house or anything else came up, she talked to him. She let him look through the mail first. His brain worked fine and she made sure he knew she knew it. He never lost his dignity. My grandmother, who's brain hasn't faired quite so well, is still listened to, is still cherished, is still given choices and control. One thing she asked Sue is never to go to another hospital and Sue has moved heaven and earth to get her the medical care she needs without going to a hospital. I find it particularly interesting that there's no bitterness at the restrictions and extra work for Sue. She's happy my grandmother is still there to be loved and cherished.

Sue would have made one hell of a doctor.