Wednesday, January 23, 2008


I'm glad to have humor back in my life. It took several weeks to return. You really miss it when it's gone.

Sadness is always there, very close to the surface. I can cry at the drop of a hat.

I'm finding that anger is much closer to the surface than it used to be as well. Evidenced by my day yesterday. I was insanely grouchy at my patients yesterday. I felt bad, they didn't deserve it, and I'm not great at hiding my emotions. I'm never rude (to people's faces, anyway), but I'm not sure they were feeling the love.

One of my first patients of the day set me off. They're an altie family. I really enjoy them, and their kids, but I have to do a lot of stroking and hand-holding whenever we're talking about antibiotics for infections or vaccinations. Overall, I think we do pretty well.

The father inquired about my family, as I've been out so much. I've been telling patients who ask about Henry. I feel that I ask them to trust me a lot, so I feel it's fair to open up a little myself.

He expressed concern, and sorrow. So far so good. Then he started in on juicing. How he gives his kids wheatgrass shakes every day and it keeps them so healthy (I refrained from pointing out the URIs and ear infections we were treating that day.) How he's "done a lot of reading" and he "treats" a lot of cancer patients, and even their oncologists think it's a great idea. How you can cure, yes cure, breast cancer with wheat grass.

If his kids hadn't been screaming and antsy to leave by then you could have heard the pitter-patter of drops of contempt hitting the floor all around me. I could barely contain myself.

You bought a f*cking juice bar a year ago and now you're telling my how to treat my kid's cancer?!? The arrogance was overwhelming.

I've spent 7 years learning my trade. I spend lots of time discussing the limitations of medicine with my patients. I'm agonizingly aware the hubris of medicine. I politely bite my lip when it come to complementary medicine - tho I think most (if not all) of it is a steaming pile of donkey poo.

How dare you.

So, my patients for the rest of the day paid for it. I feel bad about that. But things are just pretty close to the surface these days.


JeanMac said...

His type is arrogant, ill informed and down right dangerous.
I get some ignorant suggestions to apply to our daily life (living with Alzheimer's)- people spout off total inaccuracies.You and family are in my thoughts daily.

Anonymous said...

I think you get a medal for not throwing him out of your office on the spot screaming "wheat grass, my a#%!". He's got a hell of a nerve, but his sort usually do. What a maroon. On a comforting note, our state board recently fined a pharmacist $1 million for this sort of foolishness. Why he's not in jail is a mystery to me, he kept several cancer patients from getting treatment and some of them are dead. Course, the DA is investigating, too. Hang in there, we're thinking about and praying for you.

Eric, AKA The Pragmatic Caregiver said...

hrm, mom's front lawn is looking a trifle shaggy....I am SO GLAD we can kill two birds with one stone! I wonder if she should skip the morning Xeloda or the evening Xeloda, and how much Zofran she's gonna need to choke down that much grass. . . .do you think she could get away with just the mowing clippings, or is she gonna need to get down and edge?

Cure breast cancer, indeed. Having drank wheatgrass, though, honestly? I'd rather take Arimidex.

Seriously, this is why I can never be a physician. This clown would never be allowed to make another appointment, and he totally would have gotten called out on the ears and URIs. Actually, being TOTALLY EVIL, I think I would have suggested, right there in the exam room, that the best way for adults to absorb wheatgrass, because of the changes that "environmental toxins" have caused to their gastric mucosa, would be to take it pr. Dad should start doing at *LEAST* a liter, pr, every morning and evening, and hold it for a good solid hour. I would have delivered this with my deadpan calm voice (the same one I use to punk the physiatrist by explaining how we got my 85 yo FIL Rollerblades for Christmas because of a paper I read about how it helps people with PD balance - the look on her face was PRICELESS - but, I digress) and with offers to track down the paper where this was published.

I don't expect clients to share my belief system, but they do have to believe in the basic tenets of reality that everyone else shares. Heck, I'm open to the altie thing when it does well in RCTs. The rest just cheeses me off as taking advantage of sick people.

Anonymous, you hit it spot-on - that was the *EXACT* phrase I muttered to myself when I saw what this asshat said.

There's the well-meaning but ill-informed; they're a different problem altogether. I had someone trap me at the post office to explain that she'd seen an ad for a "pill that keeps breast cancer from ever coming back", and that my mom should have been on it. I didn't have the heart to explain that, eventually, it can stop working, and that when you've tried all of them, you end up where mom is, but I did have the opportunity to break down in the car for a few minutes afterwards. Really made my afternoon. I guess she thought I hadn't already spent the last 24 years searching for a magic bullet, and had just missed the one available at every corner druggist.

It's not too late. Send a followup note with the "suggestion". Tell him you want to treat him as a hole person.

Eric, Crankily

Jen said...

I've never figured out why lay people figure that they know more about any illness than any medical professional, or that they feel the need to comment freely on things that they know absolutely nothing about. I would never dream of telling someone how to "cure" cancer, yet we had various quack opinions thrust on us regularly with my mom, my daughter, and now with my kids with autism.

Fortunately I'm in a position where I can tell them where to go if a gentle "no, thank you" doesn't work. I admire your restraint.

The Country Doctor said...

While I admire your restraint you should have gone off on him. It would have made ME feel better. Now I just have to still over here and stew over this too.

Anonymous said...

I like eric's idea of the pr wheatgrass, but don't think a liter would be enough. Perhaps a bale of hay (that's grass, right?). Sideways.

Dr. Smak said...

Wow. Looks like my readers have a bit of pent-up aggression as well. It's like having a whole family of big brothers ready to flatten my ex-boyfriend.

Eric, AKA The Pragmatic Caregiver said...

Dr. Smak:

If you ever need to rent a case of all id, all the time, I'm your huckleberry. No pesky oaths, no professional credibility to feel compelled to maintain, just a very low BS tolerance and a visceral hatred of stupidity.

If you need something childish done, like a flaming unbleached recycled paper bag of vegan dog crap on his doorstep, Ill do it and send you the pictures. Just tell me where to go.

If you'd get emotional satisfaction from a scene involving his juice bar and accusations of frog parts in my smoothie, I'll pick bits of Kermit out of my teeth right in front of the breakfast rush.

And the beauty is, I don't really internalize it. I may have the text of the Riot Act memorized, but I'm normotensive seconds after I'm through with the reading.

You've got enough to worry about - outsource your anger for awhile. ;0)


Anonymous said...

Dang! Where would you find a vegan dog?

Eric, AKA The Pragmatic Caregiver said...

I live in a crazy place, anonymous. You can totally buy vegan dog food at the regular grocery store.

Dr. Smak said...


Remind me never to piss you off.