As I’m reading submissions coming in for this month’s PFAM on “getting the attention you need”, I have begun to realize that my original concept was somehow flawed. I wanted to fight against the streamlining of healthcare, the homogenizing of symptoms and of feelings. I hate the way in which my symptoms don’t matter because it’s not cancer or the fact that I have absurdly low blood pressure is a “good” thing. But in the desperate need to get some attention for myself, I blurred together all healthcare practitioners, thinking that there must be a cookie-cutter way to get the help I so desperately want.

life of a grader

Because I look younger than I really am, most physicians don’t take me seriously as an adult. I’ve spent hours lying in bed trying to figure out what I can do to give an “adult” first impression. I remember really clearly that the first physician that took me seriously as an adult was Dr. Leo. At the time, I attributed it to the fact that I was grading blue books. Only someone who teaches college students would be grading blue book exams; therefore, I must be a college teacher and must be an adult. QED. But really? I think Dr. Leo would have taken me seriously as an adult even if I was reading Christian fiction. Because that’s the kind of person that he is. He’s not in a hurry, he’s willing to listen, and he doesn’t easily dismiss things even when he thinks they might be tangential.

Dr. Voluble knew that I was a graduate student. In fact, he spent many, many minutes telling me how I could be a better graduate student. (Outside his scope of practice, anyone?) It wasn’t that he didn’t know that I was an adult; he took that and ran with it, ran in an unhelpful direction.

Maybe I care about people too much. Maybe I’m hypersensitive to what’s going on around me. Maybe the girl who prayed for her classmate who was battling a hangover during class has turned into the girl who prays for the exhausted pregnant nurse. Maybe it’s just a part of who I am. But I’ve discovered that part of getting the long-term care that I need is getting to know my physicians (and other healthcare providers.) Not in a creepy way. Always maintaining professional boundaries, of course. But taking the five seconds to say, I hope you have a good day. OR congratulations on your promotion. It’s not just about giving them a token of appreciation. It’s about changing your attitude. It’s about realizing that you’re not feeding information to a robot in the hopes that the robot will give you the proper feedback. This is one human being talking to another. You’re paying for their expertise, their care, so the focus is on you and what you need. But that doesn’t make them any less human.

In the past year, I’ve had a healthcare practitioner win a major research award from the university, someone who moved to a new state, someone whose toddler died unexpectedly, two physicians who fell and strained their knees, and someone who is expecting a (first?) child. I either saw announcement elsewhere or the information had some bearing on scheduling and the like. None of these affected my plan of care directly. But I did find myself spending the five seconds to say Congratulations or I’m sorry.

not what medicine is supposed to be (except maybe Dr. Google)

Over the long term, these observations did change how I approached these practitioners to get the help that I needed. For the first few months, the physician who lost a child seemed lost in his own grief and frequently lost his train of thought. In my interactions with him, I kept everything really succinct and tried not to say, I need help with the following seven things. I picked the items that were most important and then presented them individually. I respected that it was hard for him to be back at work and tried to be patient. (I did consult other physicians about things I would normally have asked him, and I did wonder whether things would ever return to the way they were.) But I need his expertise and his genuine care for me, and at the time, that meant adjusting my strategies for getting the help I needed.

It was similarly with the physicians who strained their knees. One physician seemed extra happy and pointed out that being strong and working through any pain is the only path to healing. (See? Me too!!) The other physician was in a lot of pain and hobbling around the exam room, so he was extra irritable. Half of me was upset. I pay good money to see you, and how dare you not be in tip-top condition to devote your full attention to your client. This is a service-oriented industry, and you’re not giving me the service you advertised!!!! The other half of me understood. It’s the end of a very long day for him. Just take a deep breath, and figure it out. He’s trying really hard to help you even though he probably wishes he was a million miles away.

I don’t know if this is a rambling post about the Golden Rule. I don’t think it’s a post about accepting reality even though it’s less than ideal. But I do firmly believe that if we want people to see us as humans with specific needs and lacks, we owe it to them to view them that way as well. If we’re not parts on an assembly line, they’re not robots assembling either. Medicine might seem like a giant bureaucracy or one big monster, but in the exam room, it shouldn’t be.

Abigail Cashelle

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