I initially sat down to write this post in November of last year but could not finish it. Reliving all the clinical encounters and clinician visits was simply too difficult for me. Mentally and emotionally, these visits evoke painful emotions. But my experience now in the clinic with patients has finally allowed me to appreciate being ‘on the other side.’ My approach to the countless physician visits was to agree with their recommendations at the time and ponder it later. If his/her management did not make logical sense to me I would go against their medical advice. This comes with a caveat: if the physician’s specialty was one I knew little about, I would always concede to their knowledge.
The patient-physician relationship is one like no other. The exchange of information has no limits; patients divulge the most intimate details of their health: from thoughts of suicide to sexual dysfunction, there isn’t anything beyond the physician’s scope. This information is given in hopes that the physician’s knowledge and expertise will fix the problem. Consequently, the patient role is an incredibly vulnerable one.
—- Why? —-
My approach of agreeing with the clinician and speculating later relied on my many years of medical training. But what does someone do if they do not have the medical training I possess? Remember my approach came with a caveat: I would always accept the management if I had decided that his/her decision was rooted in knowledge I did not have. The problem is that most people do not attend medical school, thus the medical decisions are always out of the scope of the patient, and if this person took my approach then he/she would almost blindly accept any decision. You’re always taught as a patient to ask “why” of your physician. Sometimes the answer is “because there was a study completed in Sweden that told me to do so.” What should come next? Should one accept the decision or scrutinize it? Being on the ‘other side of the coin’ has allowed me to see that while most decisions made by your clinician is based on years of reading and medical knowledge, all of their decisions are rooted in logic that each of us possesses (for example if a diabetic who only takes pills for their condition is directed by their physician to start insulin after elevated home readings or a high HbA1c; while the patient may not possess the knowledge to know that Glargine insulin lasts longer than NPH, the logic behind this decision is something we all possess. Ask, why now? Why do you want to start insulin now? Even though the knowledge of diabetes management is beyond the scope of most patients, the logic that the diabetes is progressing and so should the medications is a flow of thinking that every patient possesses).
—- Compassion —-
The other trait we are taught as clinicians and expect as patients is compassion. How would you define compassion? To me compassion is displayed through empathy. The best way to show compassion is to draw from a similar experience you’ve had in the past. This poses an issue in my situation in that very few people have been through a situation similar to mine. Thus how can I expect true compassion? It is crucial then that the clinician identifies the emotions that the situation evokes, and draws from a situation that he/she was involved in, in order truly to relate to that emotion. I’ve had visits where the clinician did this showing compassion, and also visits where they felt sorry for me (sympathy, see the earlier post). I could sense the difference, and I suspect you would be able to as well.
 HbA1c = hemoglobin A1c, the quantity of hemoglobin (your blood) that is taken up with sugar. It’s a way to diagnose and follow diabetes.