Monday, 15 June 2009

Carry on Doc

We have just managed to get around to signing on with our local surgery, and this morning was my first doctor's appointment. It was not with the lady who is to be my usual doctor, but with a locum. As you can imagine, over the years I have collected some choice anecdotes about the 'pull yourself together' school of medicine, so I never hope for much when meeting a new quack. This one had a mobile which kept going off during our consultation, which does not auger well for a start, though I have had worse - the GP who kept asking me for advice on how to work his computer during my consultations with him for one. This one seemed very nice. He diagnosed several 'itis-es', then started questioning me off the cuff about my ME, as if it was the wrong diagnosis. Who made the diagnosis? Had I had any blood tests? What were my symptoms?

Now, this is a good one. Ask any ME patient, and they will tell you that in the midst of a relapse they can hardly remember their name, let alone a comprehensive list of all the myriad symptoms they suffer. Usually, if I expect to be questioned on this, I make sure Pat is with me, as his memory is better than mine and he has a far better idea of what I am capable of than I do. Unfortunately, he wasn't available, and I had to go on my own. If I'd only known... but never mind. In such cases, I always end up coming away with a sense of frustration and spend the next week thinking up all the useful things I should have said. (Hindsight is a regular companion of the ME patient.)

If this locum had had access to my medical records, which of course had not yet come through from our old practice, he would have had a better chance of understanding my case. If he'd had time to read them, which seems unlikely seeing as it is such a huge practice. He certainly did not understand that this was my first visit, and he was supposed to be taking a detailed medical history as a matter of course. And, how could I, sitting there like a startled rabbit in a car's headlights, explain my situation to him in ten minutes?

The problem with the way the medical establishment sees disease, and mine in particular, is as a series of isolated 'itis-es' that are stuck together with glue. They are scientists who are trained to break problems down. It seems they struggle to conceive of the human body is a complex system of systems, a complex, holistic ecosystem of interdependencies. ME is a collapse of that interdependent system. It is a whole bunch of things that break down. Hence the long list of symptoms. And if you treat only one thing, you fail to understand the knock-on effect it has on other systems. You fail to understand the collapse of the whole.

You can observe the failings of this method in pretty much every British person over seventy. They have tablets for their arthritis, which have the side effect of upsetting their stomach, so they have tablets to control that. These knock out their blood pressure or make them depressed, so they have more tablets for those problems. Maybe they have trouble sleeping so they have more tablets for that. Which creates ever more side effects, and so on and so on. When I see how many medications my mother-in-law is on, for instance, though she has very poor health, I can't help feeling that the medicine is half the problem. She practically rattles! I certainly know from my own experience that taking a painkiller will upset my guts, which upsets my eating, my teeth, my sleeping, and which requires me to take something else, and on and on in ever decreasing circles.

Hello? It doesn't take a genius to work this out!

Human beings are such complex creatures and there are so many factors that need to be considered in a diagnosis. What a person is eating, whether they are drinking enough water, how much stress they are under, whether they are exposed to certain agricultural or industrial chemicals, how they have been effected by past medical treatments which may have caused more damage than they healed, and so on - all of these factors need to be considered and more. So how can you tell me that a complete stranger without any medical history of me can tell me that I only have ME if I have been diagnosed as such by a consultant?

Now I face a new series of tests and medical corridors and strangers prodding and poking me and diagnosing me without looking into my face like I am human being instead of a monkey. Oh, joy. I just love the medical establishment. Almost as much as I love the Tory party....

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