Chronic Snarkopolist: The Snarkopolist Way – Strategies For Positive Doctor Patient Relationships
Hello my libertines!
I am pleased to report that my gall bladder and small intestine peeping surgery went well and I’m recovering quite nicely. Friday I have my final pooper surgery from Doc McHotterson and hope this is the last and final of them. Thank you ever so much for your loving words and your show of support!
Meanwhile- I got some requests to give you something in this weeks’ column and I’m so thrilled by this!! I want this to be OUR column. If you ask, you shall receive – and I’m a generous snarkopolist – so I will cover you in chocolate sauce too – with whipped cream and a cherry to boot! I love requests! Ask away!! This week I was asked about my views on maintaining good doctor patient relationships based on a discussion with another member.
I have a multi-sided view of medical and hospital and sickness life because my mother worked in a hospital all her life and I grew up in a “hospital household.” (Insert strong accent) “Leenda – if Melissa doesn’t stop playing in the pathology lab we will have ruined specimens – please ask her to go to the morgue where she cannot hurt anything. She may roll around on the free gurneys down there and I will give her my orange for behaving.” So I know exactly what and how most hospital workers feel about patients. I have also gotten to know many doctors professionally in my line of work when I was counseling people in their loss and grieving processes – and I know how some doctors feel about their sick and dying patients. And I am a chronically ill patient who is sick as fuck right now – and I know how I personally act and feel as a patient. I’m often a patient advocate.
From these multiple perspectives I can tell you that the PATIENT – especially the chronically ill patient who is road weary, often fearful, tearful, tired, worn out and broke – is NOT the center of the universe… and yet often wants and DEMANDS to be seen that way.
THINGS I HAVE LEARNED
POINT 1: Remember – YOU are the CEO of your own body. You make wise decisions in PARTNERSHIP with your doctor. Doctors won’t save you or rescue you without YOU to participate in your healthcare plans. Be your own hero and SHOW UP for yourself.
Point 2: Your doctors MUST work well with other doctors. If your doctors don’t play well with others – you can get sicker and dead. Nip that EGO COMPLEX shit in the bud.
POINT 3: Be good to the office staff and nurses and they will move the sun, moon, and stars for you.
POINT 4: DO NOT BE A WHINEY LITTLE WHORE
You know how you want to pimp slap kids who whine and tune out that grating voice? I KNOW we’re in pain and we hurt… I know we’re tired. Tell your doctors one too many times and they will medically pimp slap you by shutting down faster than my original iPhone battery.
Point 5: THE HUG FACTOR – I won’t go to any doctor who won’t hug me within six months. I can tell if they are open hearted and compassionate. If they are burnt out and compassion weary – I do not bother. I NEED LOVING KINDNESS.
POINT 6: THE CRY FACTOR – I won’t go to any doctor who won’t let me cry in front of them. They don’t need to fawn all over me – but they don’t go running for the nurse either. My rheumatologist says, “This is the place for tears – and a safe place for the crap you’re dealing with.” And then we move on. I never feel judged nor do I feel that the doctor is vomiting lunch in their throat because I cry. Tears are as big a part of healing as laughter.
POINT 7: THE LAUGH FACTOR – I won’t go to any doctor who won’t laugh with me. I prefer one who finds me fiendishly hilarious and loves me but I will settle for some laughs. I want them to see me as a human and part of my humanity is that I have a sense of humor.
POINT 8: THE HOMEWORK FACTOR – (I’m flexible about this) I prefer my doctors to answer their cell phones and tell their kids to do their homework in the middle of my visit. This happens perhaps 1/8 of the time. Many of my doctors are so comfortable with me will they do this. I’m a long-term patient. I’m there for life. I NEED this flexibility. We let our hair down together. I CRAVE THIS. I CRAVE not being medicalized. I WANT them to lecture their kids in front of me. It humanizes the doctors and it makes me feel safer and humanized. If this would freak you out – then I’m sure it would never happen but it leads to my next point.
POINT 9: DOCTORS ARE HUMAN – They have feelings, relationship problems, their spouses cheat. Their kids get sick and fight. They sometimes can’t FIND a partner because they spent all that time in med school. Some of them ARE BROKE if they can’t get good jobs. The highest number of involuntary virgins are female med school grads (not men, OF COURSE- grrrr – thanks double standard). So – doctors are HUMAN.
And after YOU are done and gone home – DOCTORS OFTEN – FREQUENTLY are either ON CALL or they go to the local HOSPITAL and do ROUNDS – meaning they have to deal with people like US – the chronically ill who are lying in our beds waiting for them to come with their capes and make us feel better – SAVE OUR LIVES EVEN.
My neurologist came to see me at 10pm one night AND SAVED MY LIFE- boom JUST LIKE THAT. Another surgeon performed a last minute surgery one night at 9 pm. They both had a home and families to go to. They put ME FIRST. (Go back to NOT BEING A WHINEY LITTLE WHORE. They are tired too. Neither one of them told me how tired they were. They just did their jobs and performed minor miracles. No whining.)
Doctors often have their critically ill patients being admitted to the hospital in between each patient they see every day. They are often HEART SICK because each day or each week they are watching us DIE and they cannot save us. This is especially true with oncologists and rheumatolotists and cardiologists. WE WILL NOT BE SAVED AS OFTEN AS THEY WANT. No no. We insist on our kidney failure and our intestinal infections going septic and our six weeks of full system shutdown and DEATH. And they watch it on their ROUNDS. And they are HEARTSICK. And they go to the office and see each of US and know full well how sick we are and are not.
So when you go in with your JOINT PAIN and INFLAMATION and complain that they DO NOT UNDERSTAND – they do. THEY DO UNDERSTAND AND THEY SEE IT EVERY DAY – MULTIPLE TIMES PER DAY. But they know that you are not CRITICALLY ILL. They just looked at death in the face and YOU are NOT it. They forget how to have compassion because you’re being a stompy little brat. And it is EASY to forget that PAIN is real. So here’s the deal.
POINT 10: MAKE EMERGENCY PLANS & PAIN MANAGEMENT STRATEGIES WITH YOUR DOCTOR.
They will love you like a whore loves a balmy Saturday night. Really. If YOU take control and say, “I need a code yellow for when I start to get too intense to avoid the ER – what about 20 darvocets and 20 klonopin and if I use them up I will check back with you to reassess this pain management but it will keep me out of the ER.” They will probably kiss you full mouth – WITH TONGUE.
Do this with pain management. You can either request a pain management doctor who will give you smack OR my rheumatologist and I just sign for the junk right in her office and I do my best not to become a street pro for the stuff. Get it. That is what they are afraid of. People OD. People die. People become addicted. This shit is real. I know you have pain. Pain is part of life. The point here is that THERE CAN BE PAIN WITHOUT SUFFERING.
Don’t think you can hoover increasing doses of dilaudid and oxy for the rest of your life. You’ll kill your liver, grow dependent, and you’ll become resistant to the pain meds and when you REALLY NEED THEM post surgically and have REAL LIFE PAIN you’ll be sad like a whore. Your doctor knows this.
LEARN ALTERNATIVE METHODS TO DEALING WITH YOUR PAIN. Be willing. And tell your doctor what you are doing to deal. And build trust. And they will give you more smack for your pain. See. Happy dance and happy pills! *confetti*
POINT 11: HANDLING A SOUR RELATIONSHIP WITH A DOCTOR – Be the bigger person. If it is too far gone, you need to leave. Especially if the doctor is abusive or YOU have fucked up so badly and your apology isn’t being heard – walk. Have you apologized?
I once forgave a doctor for missing an important (life altering) test and the next time we met we were like timba style best friends for life- BFF’s. She whipped out a pen knife and made me her blood sister. Only because I said, “Hey- we all fuck up- please don’t kill me next time ok.” And she was happy to not get sued and happy that I TRUSTED HER enough to try again. And she was a good doc. It was merely an oversight and she was busy and overworked. Before that – we were just people who stared at each other and mumbled about test results.
Remember – doctors are human. They can be shitty humans or fabulous or in between. Try to find the awesome sauce ones and stick with them for life. BE THE BIGGER PERSON. Your doctor is too tired to do it. Help them get it up. It isn’t fair – do it anyway. If they still suck – WALK. Get a referral from them or another doctor to a GOOD SPECIALIST IN THAT AREA. And then go BE ON YOUR BEST BEHAVIOR and use the Snarkopolist Methods to building a good relationship. You can do it!
[If something REALLY AGGREGIOUS HAPPENED you can contact their chief of staff or the AMA but this is probably stupid and not going to help you. You can also sue them, but again, usually stupid unless it is REALLY HORRIFIC. (If they killed you by shanking you maliciously or neglectfully in the jugular– please by all means –some doctors suck so hard they NEED to be kicked in the junk- most of them will never be taken to task- it is easier to avoid them by GOOD REFERRALS. If you TRULY have found yourself in this situation I’m sorry. Deal accordingly but I’m TOTALLY gonna have to snark you to my good friends in the law field –your’re out of my league).]
POINT 12: IF ALL YOUR DOCTORS SUCK – IT IS YOU. NOT THEM. GET HELP.
POINT 13: DO NOT FLIRT WITH YOUR DOCTOR –don’t dig through their trash, don’t flash them your junk, they’re not into you. Honest. You are a slab of meat to them. Sorry. They have to shut it off – they just do. Nothing personal. It is their job. Move on. If you want to say THANK YOU – do it with a note and keep it short and simple. (If you’re wealthy – send food – they love food and the whole office will blow you next time you come in).
POINT 14: YOU DON’T NEED A DIAGNOSIS TO GET GOOD TREATMENT
Most chronic illnesses especially of the autoimmune variety begin with the words, “unknown etiology” for several years. This does not mean your doctor does not believe you. It just means that the illness has not come all the way to it horrific beady eyed fruition. Your doctor SHOULD be giving you the very best treatment possible even without a diagnosis. Diagnoses make people FEEL BETTER but they do not stop you from being sick. Lately I blow off new diagnoses from doctors – I am over diagnosed and over sick. I DON’T NEED YOUR DIAGNOSIS – they are just more words – just give me some treatments yo. Diagnoses make insurance companies happier than they make me. I just want to FEEL BETTER. Learn to be zen about the diagnosis.
POINT 15: BE YOUR WALKING MEDICAL DICTIONARY OF YOU – Carry all of your doctors names and numbers, your allergies and medications and pressing medical information with you.
POINT 16: THE DOUBLE DATE – Always try to take a friend or spouse along on a first date with a new doctor. A good doctor LISTENS before anything else but it goes better when there is someone else in the room. On a new patient meet and greet there should be time for this. Your backup partner is there so you don’t forget anything and to give you some support and to legitimize you as someone who actually HAS FRIENDS. Once you have established yourself you can go alone. While this is not always possible- it is always preferable.
POINT 17: YOU ARE NOT YOUR ILLNESSES – You can have sickness without your sickness having you. Keep your personality from becoming corrupted by illness. I’ve seen too many “new” chronically ill patients almost fall in love and marry their illness they are so enchanted by the newness of it and ATTACHED to the having of it. And they want to BLAME their entire loss and life on it. If you get sucked into it – you can almost blame everything about you on your “condition” and then you forget who YOU ARE. It is almost easier of you have MULTIPLE illnesses because your illnesses are so complex you have NO ONE and EVERTHING to blame. Sicknesses are everywhere but they are NOT ME. Do NOT BECOME SICK – be a person who has sickness as part of your life. There is nothing more sad or lonely than someone who has nothing more than a list of symptoms as friends.
POINT 18: OUR DOCTORS LOVE AND HATE US THE SAME WAY WE LOVE AND HATE THEM – They laugh at some of us and love some of us just as we adore them and despise some of them.
POINT 19: BECAUSE WE ARE CHRONICALLY ILL WE WILL HAVE MORE GOOD AND BAD MEDICAL EXPERIENCES- This is not your fault.
POINT 20: SNARKOPOLIZE YOUR WAY TO BETTER MEDICAL TREATMENT – when in doubt always trust your guts and always use honesty, integrity and love. Do not be guided by fear, bitterness, or anger no matter how easy it is as a chronically ill patient. If you have been mistreated it becomes too easy to think it will always happen. BECOME YOUR OWN ADVOCATE but do not become a bully. SMILE. LOVE. BE GENEROUS WITH YOUR KINDNESS.
I see doctors as human and I view some of them as monsters. I feel a strong sense of responsibility to talk about this today even though it is not as pro-patient as I normally feel I am – I see far too many whiney patients who make it bad for the rest of us and too many people who abuse the doctors and their staff members- once again – making it difficult for the rest of us to get the loving TLC that we want. And trust me – you WANT a good nurse on your side. My rheumatology nurse is my gem and I love her and I know she adores me. We have a connection. And I NEED THAT FROM HER. She has moved mountains and stopped the sun with her bare hands for me. I have been kept alive more often than I have been harshly treated by the medical profession. And I have been monsterously treated more than I care to tell you.
So—Any new questions? Is this old news? I’ve never been sucker punched by a doctor before but I’ve had the best and worst experiences as a patient.
Dish my loves! What do you want to talk about? Regale me with your stories or questions. I’ll snarkopolize you more. Dish me on what you want to talk about! Tell me what you think! Is this YOUR experience? Am I full of shit? What’s the haps in those hot little heads of yours? Tell! I gotta know. I adore you like whipped cream loves my face!
Reach me at firstname.lastname@example.org or make your lovely voices heard on the comments below. I’ll be seeing you next week! Same time same place! Kisses!
Tags: building doctor patient relationships, Chronic Autoimmune Conditions, Chronic Snarkopolist, chronic surgeries, communicating with doctors, managing chronic conditions, medical issues, medical treatments, multiple autoimmune disorders management