 |
 |
Dear Mary Ann, I wish I could report that my personal experiences with doctors were like the Norman Rockwell portrait physicians that you have known. I was diagnosed with PD by a doctor I was seeing for the very first time with my complaint being that I was experiencing some stiffness in the tendon of my left heal. After suddenly enfolding me in his arms (he smelled bad) and knocking me over (was he crossing some line here?), he bluntly announced that he thought it was parkinson's disease. He suggested I get an MRI and see a neurologist. I left his office in a state of shock and homophobia. Only later did I learn that the purpose of the MRI was to rule out a brain tumor. Fortunately, the stress that I experienced from the visit exacerbated my symptoms so that by the time I had the MRI and saw a neurologist, the neurologist was readily able to confirm the diagnosis. However, far from being the warm-hearted, compassionate physician that you have known, this man made me realize what an insect must experience while being examined by a scientist through a microscope. He sat in a very expensive powder blue suit behind his desk which was festooned with golf knick-knacks. Was it my imagination that he had a small wooden sign on his wall that playfully read, "I'd rather be golfing!" He studied me in a remote but vaguely curious look, as if he had played out this scene so many times before, telling a seemingly healthy person that they had an incurable, progressive disease, and wondering what defensive measures I would employ in my attempt to cope with the bad news. He offered no information. He dryly asked me if I had any questions. I had little framework to formulate and hang a question upon, knowing so little about parkinson's disease. I stuttered, "Will it effect any of the other organs of my body?" to which he answered, "No." We sat in silence, I feeling guilty that I was holding up a foursome on the 1st tee at the Westchester Country Club. I realized that I had not been medically well served, so I went to another neurologist. I have a problem when it comes to social situations. When people learn that I am a psychologist, they immediately think that I am analyzing them and get very weird, or they take the opportunity to unburdon themselves and tell me their problems. So, I was not completelly surprised that interlaced with this new neuroligist's routine examine: close your eyes, finger to nose, stand on your toes, hop on one foot, toe tap,... he filled me in on his marital problems. "Tap your left foot. My wife is ruining me with her credit card spending. Tap your right foot. She's spent $50,000 on one card alone. Close your eyes and touch your nose with your right forefinger. I'll never be able to retire. This can't go on. Now touch your nose with your left finger. Do you think that's fair? What is the matter with her? Walk up and down. Your walking is good. Now she wants to redecorate the house!" I gave him what verbal support I could muster and as I left he filled my arms with samples of Comtan, Requip, and Permax. The third neurologist I saw was like the first, although evidently, he didn't golf. However, he looked quite depressed. He didn't talk much, but just sat there looking at me ruefully. As I described my symptoms to him, he punched the keys on what looked like a little hand held calculator. He assured me that I could take up to 17 tablets of sinemet without harm. He dutifuly filled out the disability form from my insurance company. At the end of our session, he announced that this was our last session since he had decided to devote his practice exclusively to stroke victims. Had I said too much? I decided to go back to the neurologist with the marital problems. At least he talked! Here and there I hoped to get a word in edge-wise about my condition. But alas, it was not to be. It was one of his off days. There I learned that he was very angry at the Republican party, particularly John McCain. He was shouting so loudly that when I went out into the waiting room everyone looked at me as if I was a very difficult and dangerous patient. What had I said to the doctor to upset him so? But at least I had a fistful of Sinemet prescriptions! Since then I have been called out of the blue by a cheerful neurologist offering me Deep Brain Stimulation surgery, and did I want to come in for a workup? It only involved a hundred miles of traveling and a $100,000. I said I'd think it over, not wishing to be rude. He assured me it's the latest, greatest thing, as I hung up the phone. So, right now I am between doctors. Actually, I'm between wives since my wife invited her twenty year Arab old boyfriend to have Thanksgiving with me and the kids. Now there would be a Norman Rockwell painting! Regards, David >From: Mary Ann Ryan <[log in to unmask]> >Reply-To: Parkinson's Information Exchange Network ><[log in to unmask]> >To: [log in to unmask] >Subject: Re: Diagnosis >Date: Fri, 5 May 2006 08:53:29 -0400 > >David, thank you for your very well written expression of how the patient >and family view Parkinson's Disease. I would disagree with the 'Albatross' >reference. My husband is hardly that - even though he is severely impaired >now, he is a treasured member of our family. Our little three year old >grandson considers him especially precious. > >I have been with doctors many times when the diagnosis has been given and >explained. The wide majority of physicians care deeply about their >patients >and are empathetic when identifying a disease process (whatever it may be) >and it's effects. Most of the time I have been a witness to such >communication, the physician has asked me to come into the room so that >when >they leave, the patient will be able to ask the questions the shock of the >diagnosis silences. > >In my experience, patients deal far better with symptoms if they know the >cause. Regardless of how the members of this list view PD, most people who >receive the diagnosis are told about treatment options (hope) not the long, >arduous journey ahead. As we all know, everyone's PD path is different - >some progress only slightly while others crash and burn quickly. It is >best >for the patient to be allowed to hope. No one knows what the outcome will >eventually be, certainly not the doctor. > >I'm curious as to why a neurologist would be reluctant to tell a patient >that the diagnosis is PD. In my experience, that is one of the more benign >diseases a neurologist deals with. What would this doctor, who wrote PD on >a piece of paper, do if he had to tell a patient that they had a terminal >brain tumor - or ALS. I shiver to think. The guy should be fired. I'd >find another neuro in a heart beat. >---------- >God bless >Mary Ann (CG Jamie 66/26 with PD) > > I don't know how doctors do it. Parkinson's disease is not >>the worst disease. It gives you time to adjust to your gradual >>limitations. >> But I wouldn't want to tell someone they have Parkinson's disease. I >>wouldn't know how. There's the respect that takes all the fun out of >>playing doctor. >> >>David >> >>>Maybe patients should submit suggestions on ways to break bad news ? >>> >>>My neurologist left the wwritten diagnosis in front of me and sneaked out >>>the >>>room "to answer the phone" - but I'd guessed anyway. >>> > > > >-- >No virus found in this outgoing message. >Checked by AVG Free Edition. >Version: 7.1.392 / Virus Database: 268.5.3/331 - Release Date: 5/3/2006 > >---------------------------------------------------------------------- >To sign-off Parkinsn send a message to: >mailto:[log in to unmask] >In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn