The Only Good Doctor is a Compassionate Doctor

It seems my last post made it clear how I've been suffering with my bipolar disorder, compounded by the death of a friend and a funeral that did me - and another friend - more harm than good.  I heard from several compassionate readers.  (I want to include here a painting I did Sunday night that vividly illustrates the high and low, but technology is defeating me.  Maybe tomorrow.)

The background:  the last time I saw my trusted psychiatrist he told me he couldn't do squat for me.  (You can read the post I wrote then here.)  Nothing.  He suggested meditation, which showed me that he hasn't heard a thing I said, or if he did, didn't write it down, or if he did, didn't take time to look at my file.  I told him I've been meditating since I had cancer in 1997.  That's not the kind of thing they think matters.  I was wrong to like him as much as I did.  I'm sure you should never trust a doctor who always runs on time.  We don't need clockwork doctors.

The whole problem with a teaching/research hospital is that the doctors who survive there are the kind who want to do research and pontificate in classrooms.  These jobs use areas in the brain (and ego) that have little to do, I am sorry to say, with humanity or compassion.  OSU is infamous around here for its unfriendliness, but we experienced similar contempt when we visited the Cleveland Clinic a couple of years ago.  I suspect teaching hospitals are like this unless a considerable effort has been made to be friendly.

The whole idea of doctors doing research and teaching hospitals nests in the whole idea of Western Medicine, which I am beginning to call a Parliament of Clowns (or choose your obscenity).  Here is a neat illustration that I pulled off the internet comparing Western Mechanical-Man medicine to traditional Chinese medicine, which views the body as a garden:

(It's fun to blow this up, print it, and color it.)  It is very Western to think with the left-brain, to respect advances in technology, to believe that enough money and knowledge will cure you - and that's how all the big hospitals advertise, too.  They are cutting-edge, they save kids with weird cancers.

The brand of Western Medicine I have been unfortunate enough to live through, which misdiagnosed me for three years (I almost died of suicide), then ruined my kidneys with lithium, then charged me $200,000 for a transplant, and then didn't  give a damn what happened to me after that - is actually American medicine.  I hear things are better in European countries.  American medicine is profoundly influenced by the American Dream, the get-rich get-status gunplay frontier attitude on which this country was founded by a bunch of  fortune-hunters and misfits (and a few good men).

At present we have a medical profession run by rich old white guys and the occasional Queen Bee, too many of whom went into it for money and status.  Too few went into it out of compassion, out of a desire to relieve suffering and heal the world.  (And I do know those doctors exist.)  People who want to help others often go toward the helping professions, ministry, nursing, teaching, massage, alternative healing modes.  Who can afford med school, anyway, but the sons (and, recently, daughters of the rich?  And who can endure the brutal frat-boy hazing system of internship and residency, which is not nearly as much fun as Grey's Anatomy makes it look.

What do you do when a system is broken at its very foundation?  Anyone can tell you it's going to be a long long uphill climb of the Sisyphus kind.  Nevertheless, we should try.  Here are my suggestions:

1.  Medical schools should begin screening with psychological tests all applicants who look smart and diligent enough to be admitted.  Test for this:  compassion.  Test for what we call people skills.  That shouldn't be too hard.  Further, interview selected candidates.
2.  We patients should begin interviewing and evaluating our doctors.  What is their spiritual practice?  Why did they go into medicine, why this field?  What do they do when they don't know what to do for a patient?  (Throw her out in the snow?)
3.  We should all begin asking ourselves what each of us can do to bring attention to this awful mess, how we could suggest corrective measures.  (Don't overlook the ability now to rate doctors on internet sites.)
4.  You should print out this post and send it to your doctor.  Or former doctor.

I myself intend to write that doctor a letter, striving for compassionate communication, explaining to him how this has affected me.  Try to show him that it was appalling to dump me - a known suicide risk - out here without any help in coping with this dangerous mental illness.  I want to suggest he consider going into administration full-time.  He's already rising in that department and told me he likes it.  He likes being busy. 

I may also write to Les Wexner, a local rich man who has given OSU so much money that his name is now part of the name of the OSU Medical Center.  I don't need to mention the bad doctor's name; the point is not to punish an individual who thinks he means well.  The point is to examine the very premise of the place.  If anyone is in a position to set a few balls rolling and shake things up, it's Les.  As I think about it, such a letter sounds to me like skillful means, one of those Buddhist concepts.

I won't have time to do this today.  I highly doubt I will be able to do it tomorrow.  It's been day UP/day down since I went off Seroquel, and that would make tomorrow a down day.  Those days it's a real struggle to get dressed, to drink my water take my pills on time and eat halfway right.  To somehow distract and amuse myself during the endless blank painful hours of a day like that.  To fall asleep.  But maybe the day after that.  After all, I have taken the Bodhissatva vow, to save all beings.  You have to keep working at it from wherever you are.

No contrast dyes!

The internet thinks Mark Twain originated the saying: "I've seen many troubles in my time, only half of which ever came true." Or maybe Josh Billings or Alfred North Whitehead. I thought it came from a Native American and began, "I'm an old woman, and I've seen many troubles, most of which never happened. "

In teaching meditation, many of us like to say, "Try it for six months or a year, see how it works for you." This is so unAmerican, isn't it? We want to be happy now! And the truth is, ten years is a better trial period. Then the change in you begins to show up at odd moments.

This morning I had an odd moment, registering for a CT scan at 7:30 a.m. I was given the usual multipage form to fill out, which led my mind idly down the path of One-of-these-days they're going to get this computerized. All this information about my surgeries and medications and allergies is in fact in the OSU computer system, from the extensive workup for the transplant list. But radiology can't get there.

Filling out forms is repetitive, inefficient. I remember how I used to get mad - frustrated, really- but I didn't this morning. However, my ears went up at the questions about the use of contrast dye.

There it is on the medical info sheet I carry with me, No Contrast Dyes, highlighted in yellow. This is because these dyes could further harm my kidneys, and there's not much left to lose. Hmm, I thought. Well, they're going to have to talk to my kidney doctor before I take a contrast dye. I might have to reschedule. That didn't make me mad, either. Waste of my time, I would have once thought. I used to feel so overloaded, so stressed, to have to go without my morning coffee like this, to waste two hours, that would make me crazy. Now I'm in touch with reality: if you are going to deal with a big western medical system, you are going to run into inefficiencies. That doesn't have to mean people are careless or stupid.

I took the form up to the receptionist, who told me the technician would talk to me about the contrast dye. He came for me in a few moments, and assured me we weren't planning to use one. It's just that everyone gets the same form. In a few moments, I had been scanned, having made the required joke, the one he hears 40 times a day, "Where's the cat?" ("They run around in the machine") and was on my way home to a really satisfying cup of coffee.

What was equally satisfying was thinking how different I am from the person who got practically hysterical just four years ago, when I happened to have a nuclear stress test scheduled on election morning. In fact, I got so frustrated waiting for that test in a cold, inefficient office that I walked out, which turned out to be a good idea; anger can sometimes lead to useful action.

But you can walk out quietly, without hysterics, as I was contemplating this morning.

I still have anxiety about medical procedures, going all the way back to a couple of gruesome childhood experiences. I'd had a little nightmare in the night, and slept fitfully after that. (Maybe if I live to meditate another eleven years, I won't have that.) But this anxiety is nowhere near the level it once was, even for a quick, noninvasive test like this.

My first thought was to credit meditation and Buddhist thought. I can think of myriad ways it has impacted my reactions, mostly by teaching me that they're just my reactions. Emotions brought forth by thoughts and memories, which are mental emissions that will pass if you let them. Sitting quite still in retreat, we learn not to scratch an itch, to watch our impulses pass.

Then there's the Buddhist emphasis on "skillful means," which is not usually whirling in a frenzy of rage like the Tasmanian Devil. Ah yes, he used to be one of my favorite cartoon characters. It's only fairly recently that I took him off my bookshelves, but I didn't throw him away. You never know when he might be just the skillful means you need.

Was it just meditation that turned a nightmare into an errand this pleasant morning? Not at all. These last years I have worked to cultivate a low-stress, nourishing life, and done intensive therapy regarding those childhood issues. Truly taking ownership of your body and your feelings is not just a spiritual matter, but involves psychological growth as well. Well, that's as abstract as I want to get today.

If you are an American, enjoy voting. We are privileged.