(no subject)

[rivka]

On Wednesday, I went back to the doctor for a follow-up of the thing I had removed from my nose.

It was back, or rather, it never really went away. There was still a bump there after he cauterized it, which I first thought was just swelling and then thought might be a tiny raised scar. But eventually it became clear that I still had a lesion (or papule, or whatever you want to call it) in the same place.

So I went in on Wednesday expecting to be biopsied, because that's what he said we'd do if it came back. And instead he said cheerfully, "Oh well, I'll just cauterize it again."

"Wait a minute," I said. "I'm not entirely comfortable with the idea of just cauterizing it again. If it's something that came back, I want to know what it actually is."

I don't think he has patients disagree with him very often. He leaned in and put his hands on my knees - I was up on the exam table, fully clothed - looked me searchingly in the eye, and explained that I need to trust him to advise me to do the right thing. He explained that a biopsy would leave a scar. He explained that even if it were a basal cell carcinoma, he would still just want to cauterize it. He explained, again, that a biopsy would leave a scar. On my face. Which, apparently, was supposed to be sufficient reason to avoid it as long as possible.

I wanted to walk out of the room. I wanted to tell him to take his hands off my knees. I wanted to leave and ask my doctor to set me up with a real dermatologist rather than a plastic surgeon. But instead I gave in and agreed to have it cauterized again.

He said something to indicate that he'd only done a shallow cauterization last time - because, of course, a deep and thorough cauterization can also leave a scar. On my face. And he had wanted to avoid that if at all possible. At that point I lost my temper.

"I don't care if it scars!" I said loudly.
He looked hurt. "But I care. I don't want to leave a scar if we don't have to."

At least this time I could tell that he cauterized it thoroughly. It took more time and hurt more, and there's a significant burn mark. More importantly, there's no remnant of the bump - in fact, there's a slight depression. I think this time he probably got it.

I'm frustrated with myself for not being a better advocate for my health care priorities, and for not telling him to keep his hands off my knees. I won't go back to him again, and I'll tell my primary care doctor what I didn't like about him, but I also should have handled the situation better while I was there.

Comments

[jinian.livejournal.com]

Bleah. I would feel slimed, too.

Nice as it would be to tell him off, not going back is enough. If he needs that particular clue-by-four, he's probably immune to getting the smackdown from a patient who's a girl.

[wiredferret.livejournal.com]

Ugh. That's no fun. Telling your primary care doctor is exactly the right step to take. I have done that with doctors who disrespected me, even a little.

When I was 16, I had plastic surgery to remove some keloid scars from my face. The plastic surgeon was nice, and respectful, but also weird. He talked about other things about my face that we could FIX, while I was under anyway. Things so small that I had never noticed or been bothered by them. Which made me wonder if I should worry.

My parents and I decided that he was, by the nature of his job, just used to dealing with people who valued appearance much more highly than we did. That his pride in work was making people happier with what they met in the mirror.

That does not justify your doctor being dismissive of you, but it was useful for me to think about expectations.

[k-crow.livejournal.com]

I'm sorry this doctor was so awful at both respecting your boundaries and giving you the health care you needed in the first place. Definitely tell your primary care doctor what happened and how you feel about it. I very much sympathize with your frustration with yourself. At the same time, please keep in mind that he was the one who overstepped by touching you, and even more so by not following your wishes in the health care you wanted to receive.

This reminds me very much of a gynecological exam I had that went very wrong. I still feel some frustration with myself for not being more insistent that the doctor stop what he was doing. I knew my body, and I knew that much pain was not supposed to be part of that exam. All I can say is don't go back to a doctor who doesn't show even the most basic respect for your person. "Should have" doesn't matter. You've learned from this, and I guarantee the next time a doctor doesn't listen to you, you will be a better advocate for yourself and your health. Take care.

[elisem.livejournal.com]

"Should have" doesn't matter. You've learned from this, and I guarantee the next time a doctor doesn't listen to you, you will be a better advocate for yourself and your health.

Exactly.

We learn to do better by being in situations where we don't do as well as we would like. That's how it works, I think. And hey, you noticed what wasn't right, and you are going to do something about it, and you are forearmed against possible future instances of poor practice by medical folks.

The feeling of "I should have"... makes me think of "This shouldn't have happened!" And you're not the one who made it happen. Yeah, maybe you wish you had spoken up more strongly or something, but k_crow is right:

please keep in mind that he was the one who overstepped by touching you, and even more so by not following your wishes in the health care you wanted to receive.

You getting flustered or intimidated is not proof of your fucking up on being assertive. On the contrary, it's additional proof of the doc's inappropriate actions. If someone can do this to you, then for goodness' sakes, what chance do his less informed, less articulate, or less empowered clients have? I bet your GP knows you aren't easily pressured. If so, I would cite your difficulty in advocating for yourself with that doc as an additional illustration of the type and degree of inappropriateness. (It's your call, though, of course. You'll know if that fits or not.)

[Sheeze. Now I wanna smack him. Grumblerumble.]

[jenett]

Blergh. Bad doctor.

I know I find it harder to stand up to a specialist than I do to my primary care person - I don't think it's just me doing things differently, I think it's that a lot of specialists aren't used to the 'It's my body, talk to me before you do things to it or make decisions about it' view. I think they're more used to people coming to them semi-frantic and wanting any answer that sounds like it will work. (My arguments with my asthma specialist in college were interesting....)

In the situation you have, I'd probably report it to my primary care, and write a letter to the doctor, and basically say "This made me uncomfortable. I wish I could have said so more clearly at the time, but I wanted you to know so that you could avoid this with future patients." and then give very specific examples.

(The hands on knees isn't just way too personal without a medical reason, but it could also, obviously, be actively painful to someone with joint problems)

[therealjae.livejournal.com]

Grr. Argh.

I'm with gwynyth on writing the letter. I think it'll make you feel better, and it might just make him think.

-J

What she said

[ororo.livejournal.com]

and a hug.

[tsjafo.livejournal.com]

I hope the bump is gone for good. I've found that having someone with you who can act as your advocate works well. I will get right in someones face if I think it's needed when I'm with one of my children or my wife. On the other hand, when I'm by myself I tend to speak up less and take more horseshit from medical personnel. So my wife frequently acts as my advocate and I act as hers. She'll ask questions I won't think to ask, and I do the same for her.

[hobbitbabe.livejournal.com]

I'm sorry he was icky.

I hope it helps for you to tell your PCP - maybe to write a letter or something too.

Our PCP seems to appreciate the "reviews" P gives her about various specialists, and seems to remember / respect the reviews she gets from other patients. e.g. she told P that she was sending her to a "non-X-supporter" allergist, when X = a dismissive git that P as well as many others had complained about. The non-X was good, but sent P to Toronto because nobody here could do the tests she needed. (She went to Toronto, but weirdly enough I can't remember if she ever got any results. Hmmm.)

[rmjwell.livejournal.com]

The hands-on-knees thing reminds me uncomfortably of folks who negotiate bdsm scenes in character.

If he (or any other doctor) tries something like that on you again, whack him across the metaphorical nose with your own medical credentials. Something like "As a medical professional myself, I find your attitude remarkably unprofessional."

[johnpalmer.livejournal.com]

Did you know that the mole on my nose is visible across the room? It's the first thing people notice about me? People's eyes are drawn to it, and it will detract from their impressions of me?

Me neither.

I really don't understand doctors sometimes. (BTW: I was there to have a polyp removed from my nose. It'd have been called a "wart" if it'd been on the outside, but it was on the inside. But that mole... Something Must Be Done.)

For whatever reason, these doctors seem to take other people's faces personally.