To My Wife’s Patients: Things She Can’t Say To You – But I Can

My wife is a family physician. On average she sees 25 patients a day, works through her lunch and usually arrives home after dark. During her career I estimate she has seen around 35,000 patients. In order to become a doctor she had to do the following:

  • Graduate from a four year college.

  • Take advanced courses in calculus, chemistry and biology required by med schools.

  • Sit for and do well on the MCAT exam.

  • Get accepted into med school.

  • Spend 3 years taking full-time classes and 1 year doing rounds at hospitals and offices under the supervision of doctors.

  • Work 80+ hours a week for 3 years in internship and residency.

  • Pass several all-day written and hands-on exams to become board certified.

  • Spend several days each year in continuing education classes to keep up to date on the latest medical research and treatments and maintain her credentials.

Doctors used to be treated like gods. They were fawned over and never questioned by patients. Today we’ve swung to the opposite extreme where patients are treated as “clients” and management encourages staff to believe the “customer is always right” as they compete with other health care providers and health care systems for business.  To me much of the below is common sense, but it’s amazing how uncommon common sense has become.

Be polite to her. I know I shouldn’t have to say this, but manners have seemingly gone the way of men wearing fedoras and women wearing head scarves. When she enters a patient exam room,  she has had less than two minutes to review your chart (which often has hundreds of pages in menus and submenus in the electronic health record) and learn what you are there for from a medical assistant or visit notes that often say no more than “Fever.” When she opens the door, no matter how she feels herself you will have her full attention. She will make you the center of her universe for the few minutes that she is with you whether or not you deserve it to an outside observer like me.

Medicine Can’t Cure Everything. When you tell her, “I can’t be sick” with a cold or the flu because you are going on vacation or a wedding, tell that to her patient with pancreatic cancer, but you’ll have to go to his gravesite to do so. He didn’t want cancer but Fate had other plans. My wife is a doctor not Jesus. The truth is that your body will heal itself, and it’s my wife’s job to help it – and it will take its own sweet time doing so if it wants.

Antibiotics are powerful drugs and should only be used when needed. If she says you don’t need an antibiotic, you don’t need an antibiotic. What this means is you have a virus – likely a cold or a flu virus and antibiotics don’t affect viruses at all. If they did people wouldn’t be dying in Africa from Ebola because we could treat them with antibiotics, but we can’t because antibiotics don’t work on viruses.

If you say “But the last time I had this a doctor gave me a Z-Pak and I got better,” the Z-Pak had nothing to do with your recovery; your body beat the virus itself and the doctor only gave you an antibiotic because it was easier to give you one and shut you up than to be honest with you.

What you may not realize is that antibiotics have side effects, something the Wife knows first hand. Years ago she was treated for a bacterial kidney infection with a Z-Pak and the drug damaged the smell receptors in her brain. She couldn’t smell anything for a year, and it took two years more before she could smell the roses in her garden, five before she fully recovered. Antibiotics not only cause bacteria to become resistant, making the drugs less effective for everyone, they can also in rare cases kill you. Z-Pak has been found by the FDA to cause irregular heartbeats that have kill 47 people per million doses, and 245 per million for those with heart conditions. Even penicillin and its variants can damage your liver and kidneys. A common side effect is they screw up your body’s natural defenses, killing the so-called “good bacteria” that populate your gut and skin, causing yeast infections and diarrhea that can be worse than the cold that caused you to see the doctor  in the first place.

Immunizations save lives. If my wife notices you are not up to date on your immunizations she will offer to bring you up to date by vaccinating you in the office. If you then say to her “Vaccines are dangerous,” you’ll immediately reveal your idiot status although she won’t say so. Instead she will waste her time trying to educate you on how vaccination is the greatest medical discovery of all time. She’ll tell you that vaccines have saved more lives than any other drug or treatment ever imagined by Medicine bar none, and that idiots like you have only not gotten polio because the rest of us had parents who weren’t morons and got us vaccinated. The wife and I have been to places in the world where polio destroyed young lives, and have given money to paralyzed beggars in the streets. She’ll try to change your mind to help save your life; I’ll just laugh at you and say “Darwin Award!”

My wife is not a drug dealer. If you come to see my Wife because of back pain, she will likely explain that back pain can take as long as two years after an injury to heal if surgery isn’t warranted. My wife knows about back pain first hand. She was nearly killed by a tree branch falling on her neck in Africa, and she has suffered occasional back spasms that last for weeks ever since. She doesn’t take pills for these spasms. Instead she stretches her back, does some yoga, and lays on a heating pad.

If you come looking for narcotics, you will leave empty handed. Thanks to computerized medical records and a federal government centralized reporting on prescription narcotics, it is very easy for her to see who you got your meds from, what narcotic was prescribed and how many pills you got. If you tell her (as some patients have) that you’ll just get the drugs on the Street, go right ahead. There’s nothing you can say to her that will erase her sorrow at the loss of one of her patients, a young boy killed in an accident caused by his parents who were drugged up on Oxycontin they had gotten from other doctors. Later she’ll worry about whether there’s anything more she could have done to help your addiction; I’ll remind her of that dead boy.

Speak up. My wife is not a mind reader, and is a people doctor not a vet, so she will ask you questions and doesn’t need to guess. Speak up. Be honest in your answers. Ask questions if you don’t understand. My wife seriously wants to help you. Ask a med student why they want to be a doctor and chances are they will say “to help people.” That’s what my wife said, and it’s true.

But shut up if you don’t like gays, Jews or African-Americans. My wife is not a racist and is open minded just to the point where her brains don’t fall out. She respects everyone, and even if you don’t just keep it to yourself.

Don’t assume she’s rich just because she’s a doctor. My wife has chosen the second lowest paid specialty because she felt called to it, not because of any financial windfall. Every month I cut a mortgage-sized check to pay her student loans and will continue doing so for another couple of decades. We do have 4 cars though: One is a subcompact she bought used. One is a Southern Lawn Ornament, broken down at 170,000 miles. The other two (mine and my son’s cars) have 200,000 and 150,000 miles respectively. On a per-hour basis my wife makes about as much as a plumber does – and he can’t kill anyone or be sued if he does. And he sure didn’t finish plumbing school with $225,000 in plumbing school debt. (That’s a hint to any kids considering medical school who stumble upon this post.)

My wife works in a medical office not Burger King. You can’t have it your way. You can demand an MRI as one of her patients did, but you won’t get one. My wife is specially trained in soft tissue and musculoskeletal disorders and doesn’t need a $3,000 test to tell her that you have tennis elbow, the treatment of which is like many conditions in medicine: Time. You can’t have it your way because a) you aren’t a trained doctor and b) you really don’t know what is best for you. If you did you wouldn’t weigh 400 lbs and complain of knee pain. Perhaps the cases of Mountain Dew and bags of potato chips I see in your cart at WalMart have something to do with your problem, and again, if you want a miracle ask your pastor, not my wife. Exercise and limiting your calorie intake will do more to fix you than any drug she can prescribe, and I’m sure even Jesus would tell you to lay off the pork rinds.

My wife isn’t perfect, but she is the most intelligent woman I’ve ever met which is one reason I had to marry her. She also cares about people, many of whom don’t deserve it in my opinion. While some of you treat her respectfully a lot of you don’t, and you make me angry because it’s up to me to remind her of the lives (yes, LIVES plural) she has single-handedly saved. In addition to those she has made countless lives better through the exercise of her clinical skills, training and experience combined with her natural intuition. There aren’t many plumbers who can say that.

 

 

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11 Comments

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  7. Bookworm:

    Apropos immunization, the measles that started in Disneyland have hit Marin, which has one of the least vaccinated populations in the U.S. The schools have already announced that, if one case of measles shows up in the school, all unvaccinated children must stay home for 21 days. Should be interesting.

  8. Scott Kirwin:

    And it’s the elite upper and upper-middle classes who have been stupid about it. It’s about time they suffer for their stupidity. Schadenfreude? Yup.

  9. James C.:

    Congratulations for marrying a true medical professional. When I visit a family care / primary physician / nurse practitioner, I only want one thing, above all, from them; the truth. I will try my best to describe my condition, in as much detail as I can, and can only hope for the kind of care your wife provides to her patients. Oh, and I hope the clinicians I need to wait for (patiently) appreciate that my (silly? stupid? corny at the very least) sense of humor helps me to deal with situations that are frequently painful, and sometimes embarrassing…

  10. The Razor » Blog Archive » Council Submissions: January 28, 2015:

    [...] To My Wife’s Patients: Things She Can’t Say To You – But I Can The Council Has Spoken: January 30, 2015 [...]

  11. Carleton Jones:

    That is awesome!
    I’m sending the link to my students, many of whom are interested in medical school.
    Thank you for the post and please pass on a ‘thank you’ to your wife for her service.

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