The 90 Minute Checkup

The case of mind-body medicine.

Is Getting Sick Like Being Assaulted? A Physician Responds

Healing the wounded healer.
Lissa Rankin
This post is a response to Is Getting Sick Like Being Assaulted? by Lissa Rankin, M.D.

I have written a response to a blog posted elsewhere on this website.  There are obvious cracks in the medical system.  My blog is an obvious response to what I feel are the shrotened times where I can see patients and how I think 90 minutes would be optimal.  I cant see patients for 90 mintues because I would go out of business.  In the time alloted I try my hardest to answer every question and do all that I can for a patient, and I am sure that I fail some, but I do my best every day.  A fellow blogger and gynecologist wrote and article wondering if getting sick was like being assaulted and I felt the language was not representative of my personal practice and I respectfully guide you to read her article.  Quotes from her original article are in blod followed by my responses.

Lissa,

As a fellow gynecologist, psychology today blogger, author, and still in private practice physician I want to make some agreements and diversions from your post. There are things in it that are concerning to me on many levels. I am going to quote you and put in my two cents after the quotes because I feel somewhat misrepresented at times.

"In the office, we strip off people’s clothes, insert cold foreign objects into their warm vaginas" — I don't feel as though we strip off women's clothes, we ask them to disrobe so that we might be able to do a proper exam which I believe in most instances is expected of us as physicians. The cold foreign object is a speculum and I use room temperature not specifically cold ones. My rooms are comfortable and I believe the experience tolerable.

"We forget to call people by name, fail to ask for permission, and walk out before listening for the questions our patients may be too frightened to ask" — I do not do this.

"In the hospital, it’s even worse. We dress people in modesty-stealing hospital gowns, feed them bad food, and wake them at 4am for blood draws (and stick them again a few hours later when their doctors think of new tests they want drawn after rounds.)" — Most patients wear their own clothes and the hospital gowns are usually provided if they do not have their own. In many cases for the very ill these gowns keep them from soiling their own clothes and it does make it easier to perform an exam with a side-opening gown. The 4 AM blood draws are so information is available at 7-8 or sooner not out of spite for the patient's sleep habits. Yes it may be for the doctor's convenience so they can do office hours (seeing patients that need to be seen) or surgery. We don't stick them again out of spite, if new tests need to be drawn it is because something was indeed caught on the first wave of tests. If we were all truly intuitive then we could order everything at once but unfortunately medicine has not achieved nonlocality, but me may be moving in that direction.

"We call them “Room 201" — this indeed happens way to frequently.  I think as residents we can visualize the room which is much easier to remmeber than 10-15 different names that change on a daily basis.  It isn't the right way, but I can see why this has come to be over the years.

"In the midst of all this, my IV ran dry for hours" — this is more a reference to for-profit hospitals trying to do more with less. This is unfortunately not getting any better.  My wife also had two cesarean sections and we were not allowed to see our baby for hours as he was in the NICU.  It was brutal, we complained and were treated horribly.  This needs to change.

"As doctors and other health care providers, aren’t we supposed to comfort, nurture and heal, rather than assault, violate, and traumatize? " — Again I think the assumption should be that we do comfort heal and nurture, and I would never openly traumatize or violate. I would hope this is more an anomaly than the standard in most medical systems that patients feel traumatized.

I feel like there is a definitive aspect of truth but admixed with melodrama and psychopomp in order to prove a point or extend a platform. If there are stories of excellence then lets focus on them as well and use language that floats both ways. I am still in the trenches and I have my own story. I guess the discussion could begin with your story and why you exited. We all have our wounds and we all epitomize the wounded healer archetype. Why did you go to medical school, why OBGYN, why did you eventually leave. These answers are all part of the narrative inquiry that must be understood in each and every case or else as you try to heal the medical paradigm you might seem like you are just barking orders.

Shawn Tassone, M.D., is a board certified OB-GYN, Ph.D. candidate in mind-body medicine, and author of two books.

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