I’m a one-at-a-time divulger, usually. But I walked into my doctor’s office and I had a list of three things I wanted to talk about. My arthritic finger that my husband has diagnosed as Lyme’s. My thyroid medicine that was switched last month but isn’t “right”. My undiagnosed ADHD that is morphing into early Alzheimer’s. (See Friday’s pie chart.)
I wrote all three things down on a clipboard that I brought from home, with the carefully worded back story on each. I labeled and underlined and went in order of least bothersome to most because I know how these appointments go when you start to add to the list of complaints, now that you have their attention.
So many patients go in for a hangnail and then try to squeeze in random little symptoms of normal aging, such as their failing kidney, skyrocketing blood pressure, and silly little erratic heartbeat that wakes them up at night in a cold sweat. But the doc needs to stay focused on treating the hangnail. The other things are secondary and the patient should come back for those another time, another co-pay. The girl at the front desk can schedule those for you.
It has become abundantly clear to me that medical students are learning that, to make decent money, treat only one ailment even though the patient has a grocery list. The doc may skate around item number two or discount its connection to item number one and vaporously remove item number three from the air once you put it out there.
Zap! It never existed. Just as a bartender at a club doesn’t see you to take your drink order until you’re waving for his attention with a $20 bill, so too will the doc fail to acknowledge ailment number two’s existence until you drop another co-pay. It’s almost better to just go to the bar instead of the doctor the way these $20’s fly out of your wallet.
Ever notice that after you describe the first thing that brings you, they quickly move the conversation to a plan of action, before hearing the whole story? Without a plan of action, they can’t get you out and the next patient in. You know that awkward part where the doc wants the conversation to end? His body language indicates “there’s a door in the room. I will walk through it in a moment and you will never see me again.” He’s calling shotgun. “I got the door first!”
As the patient your job is to distract the doctor from the door. Watch his feet. If he starts wheeling his stool toward the door, asking questions is a fabulous speed bump. Before he finishes answering, slip in ailments two and three rather quickly. They should always be more of a treatment priority than ailment number one. If he looks at his watch and scoots toward the door, cry. Try to speak, cry and blow your nose, using their scratchy office tissues. If you bring your own tissues, you’ll look like you’re used to crying. Don’t risk it. Always use theirs.
Get them to look around their supplies, the way a mother frantically looks for a binky, a remote, matches, anything to satisfy her toddler. That’s the sign that they’ve shifted gears. They’ve realized “okay, this is the one patient that’s going to knock me off schedule.” They allow for one a day. You just have to sell them on making you “that one” and if it takes crying, it takes crying. Man up to the task. Squirt some tears out. Pinch yourself if you have to. But you are your only advocate here, so if you want to get all your issues addressed, I suggest you ramp up your self-advocacy skills with well-rehearsed waterworks. It’s either that or the door.
I can’t tell you how much more medical attention that trick can get you. I don’t like to brag. But trust me, I get more than my fair share of tests and x-rays. If they only take one vial of blood out of you to run tests, you have underperformed as a patient. If you walk out without any prescriptions you are out $20 and a drink.
I was so ON yesterday, they took three vials out of me. The first one was to test for rheumatoid arthritis. (I told my husband it wasn’t Lyme’s.) The second one was to test my thyroid six ways to Sunday. The third was to check for anemia, since they took so much out with vials one and two.
I’m always totally freaked when it’s time to get my bloods drawn. A total stranger is going to poke a hole in my arm with a sharp object and I’m going to sit there and let him drain me. I don’t even like brushing up against the screen door! My sock seams make me fidgety. Tags on shirts make me chase my tail.
I tell the lab tech how anxious I am, because my body language — curling into the fetal position, facing the opposite direction and rocking — isn’t self-explanatory. He’s going to be required to exercise his coaxing skills that he learned in the “drawing blood from monkeys” seminar he took for continuing education credits.
He shifts gears beautifully, so I instantly trust him. He tells me to look at his face and close my eyes and he talks nonsense about “what I can see” while telling me he’s not even close to putting the needle in, and then “ouch!” it’s in and he has drawn three vials before I know it. He snaps off that blue tourniquet and tosses it back into his portable supplies basket, the same kind I have at home for my cleaning supplies.
I say, “Wow, you were swift! You could rob a safe!”
He laughs uncomfortably. He isn’t sure if he wants to think of himself that way. Hey, I’m not sure if I want to think of myself as the lady who has to cry to get three vials of blood and a prescription for ADHD/early dementia. But we all have our roles to play.
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