The Wrong Doctor, The Right Process

 In Anxiety and Stress, Compassion, Health, Promoting Tolerance

At a family dinner with some close friends, I was introduced to a father and son who both, like me, suffered from GI conditions. Although not IBS specifically, those with gut disorders can all somewhat relate–and of course from my experience– that we are constantly on the hunt for the right doctor.

Amid a flare at the dinner table, I shared my story with them attempting to hide my pain. “I just don’t understand why these doctors can’t figure me out,” I expressed, prudently nibbling on a piece of shrimp–a common practice for IBS sufferers who are trying to look respectful in meal-time social settings. My intestines had been in flames all day. But then the pain suddenly subsided when the father said, “Sabrina, I know a doctor who could potentially help you. He operated on both me and my son. I trust him, I promise he is incredible. Let me give you his contact.” I pulled my phone from under my thigh and handed it to him, “Thank you, please do,” with a gracious smile. 

With each resource I obtain, I cannot be more appreciative. I cannot be more appreciative of the spontaneous connections I make through family and friends to mutual ones. I was able to schedule an appointment within a month, a huge win compared to the four and six months I had waited for others previously. Indeed, referrals from a doctor’s close friend go a long way, but they aren’t always the right ones.

****

Despite all the positive feedback I had heard about this doctor, I walked into his clinic that Friday morning skeptical that he would be understanding of my condition. The pattern of protocol, slim questioning, and dismissal was one I had endured for far too long; by this point, I was used to it. Appointment after appointment, the flickering spark of hope that once resided within me was dying out. But I had one last spark left: Maybe– just maybe– this will be the right doctor. And right here, before I begin to share this story with you, I’m going to tell you that he was not. 

We started with the nurse’s usual height, weight, and blood pressure checks. Within a short seven minutes, a tan, tall and lean doctor entered the room. He introduced himself with a firm handshake, his face radiating warmth. 

He stationed himself on the stool underneath his iconic whiteboard (whose iconicness will soon be explained): “I’ve read through all your records, Sabrina. Tell me what’s going on, it seems like this has been going on for a long time, and I want to hear your story,” he invited compassionately, leaning his upper body toward me. A sense of validation rushed through me–never had a doctor affirmed that they had actually READ my records and told me what they had gathered from them; never had a doctor WANTED to hear my story. I felt safe to share without being dismissed, attacked, and let back off the hook. I no longer wanted to return to swimming in my hole of hopelessness, back to lurking in my dark depths for a temporary remedy.

After he shared his summary of my file, I provided him additional information. Expressing my symptoms along this jagged journey felt different this time. It was like having a conversation with a friend who truly wanted to help me. A friend who truly cared. He looked me in the eyes as I spoke, and nodded his head as I answered his questions about my aspirations, hobbies, lifestyle, and diet. “I think it’s severe IBS, but I don’t think IBS can get this bad. I want to make sure there’s nothing else going on,” I stated. He made no targeted assumptions, and rather used the tools in his tool box and expertise to understand me. 

“Where does it hurt?” he asked, approaching the table upon which I was seated. I pointed to the left side of my stomach. He pushed into the spot as my neck tensed up from the pain. This was the first GI doctor who ACTUALLY touched me. “Yep, right there” I confessed, “Exactly.” 

After a twenty minute conversation he made his hypothesis: “Based on your records, what you’ve told me, and my experience as a surgeon, I can deduce a theory. I make my conclusions objectively and always want you to contribute to forming it. Now let me draw it for you, and you can give me your opinion.” 

Tearing open a fresh pack of Expo markers, he turned around to his white board and began to sketch a model of the digestive system. Unlike any other doctor, he walked me through every portion of it in plain english to ensure I could understand his theory. It was as if I was in class, this time, only studying myself. “I think this is what’s going on,” he remarked, “this right here could be the source of your pain,” and circled it in red. “This is a very rare condition, most doctors don’t find it, but because I am a surgeon, this is what I can hypothesize. It often requires a simple surgery to fix.” My jaw dropped contemplating the mere thought of an operation at eighteen. Impossible. 

He could sense the shock brought upon my mother and I as the word “surgery” came out of his mouth. “I am not enthusiastic about an operation either,” he comforted, “but I’m making an assumption based on my expertise, again, as a surgeon. At the end of the day, it is your responsibility to affirm or reject my theory. I may be right, I may be wrong, but ultimately, you know your body best. This is what you should be watching for.” 

Familiar with my already restrictive diet and the dozens of elimination diets I’ve tried, he made a few suggestions. Again, this was the first doctor who ACTUALLY CONSIDERED MY NUTRITION. “Try these food swaps, and let’s do some testing to see if my hypothesis is correct or incorrect. I want you to research it for yourself, too. We can revisit this theory in a couple of months and move forward from there.” 

The plan was in place. My mother and I thanked him with utmost sincerity for his time, genuine advice, and conservative approach. “Feel better, Sabrina. Good luck.” He gave both my mother and I warm hugs as we stepped out of his office. Off to his next patient he went. 

As usual, my mother and I discussed the course of the appointment on our walk back to the car. “Mom, he was so nice! He actually believed me! What an amazing doctor, I think he might help me! Finally!” I looked up at her, my eyes sparkling with renewed hope, my cheeks raised with a bright smile.  

This doctor bought my trust by guiding me through his approach and telling me what symptoms to look for so we could establish a diagnosis. I will emphasize that NOT ONCE did he pin a diagnosis on me, and NOT ONCE did he dismiss my symptoms. By assuring that he was not enthusiastic about operating on me, it was apparent that he would give me an honest opinion in my best interest and remain as conservative as possible. 

****

After a month of dietary changes and medical exams, my symptoms were still present. A few good days, a few bad days– I was still clueless as to what was helping and what wasn’t. Nevertheless, I was eager to discuss my test results with him and discover if his theory was, indeed, correct.

That Tuesday afternoon, the doctor welcomed us in the waiting room. “Hi, Sabrina, it’s so nice to see you! How have you been feeling?” I gave my earnest answer, “I’m ok I guess, nothing changed,” and shrugged my shoulders. “Hopefully today I can give you some answers, I look forward to discussing your results,” he said, proceeding to greet my parents and explaining the game plan for today’s visit.

“Before our appointment, I want to show you the images from radiology and explain them to you. Afterward, we can discuss the significance of it and the treatments I can provide.” He invited us back to his personal office, where we congregated around his computer. My test results were already pulled up, as if he was reviewing them again just before my visit. The supposed irritated areas were circled in red, identical to the illustration he had drawn on his white board during our first appointment. “According to radiology, your results were normal, but I gave the images a closer look and found them to depict a borderline condition. Let’s go back to the room so I can show you what this means.” 

We listened to him attentively, and him to me, as I shared my symptoms over the past month. “I tried what you suggested, but everything I eat gives me a stomach ache. There is no clear pattern, so I can’t really tell which foods make me react and what is ok.” For this reason, his theory– that I had somewhat of a structural issue– made sense in my mind.  

Both my parents and I inquired about any non-invasive alternatives to remedy this situation. “Of course, I am not enthusiastic about surgery either,” he said, “but unfortunately, the non-invasive methods are not effective and can actually pose more harm later down the road.” He explained each one and their implications, along with the details that his surgery entailed.

“Before doing anything, I would go in there and examine if I really needed to complete the surgery. I wouldn’t move forward with the operation if you didn’t. My only concern is that the condition could get worse if we don’t do it. I am giving you advice as if I was your father, and if I had to operate on you, I would operate on you as if you were my own daughter.”

I am one to cry only in times of excruciating pain, but this time was different. It was as if my eyes were my heart, bleeding tears of emotion so moved by his affectionate words of care and compassion. I couldn’t stop the stream of droplets raining on to the parchment. This was the first time a doctor had empathized with me and was genuinely committed to my healing. 

He repeated again, “Of course I’m not enthusiastic about surgery either, but surgery is what I do, and that’s all I can offer you. I encourage you to see other people for their input. I want you to get every opinion you can. If you still need my input, come back to me.” 

****

We scheduled an appointment for a couple of months later, planning on seeing other doctors in the waiting period. While nobody was excited about the results, I was actually relieved to have a potential answer and a potential cure. It’s hard to understand: For someone engrossed in a vicious cycle of suffer–search–repeat, if surgery is the only way out, I’ll take it. Anything to abate this ravaging physical and emotional nightmare. Anything to live a normal life again. 

Over the next month, we scheduled a video-visit not with a surgeon, but a top-notch Gastroenterologist. He was very adamant: “No surgery. Out of anything, not surgery. I can see where this doctor is coming from, but if I had to diagnose you from a GI standpoint, you have severe IBS. The symptoms are manageable.” He prescribed me a couple of medications, just like other doctors had in the past, to take as needed when I flared. No luck. 

Around this time, we were also referred to a dietician by another family friend of ours who experienced similar symptoms to me. “I saw a dietician back in December. My gut was angry, just like yours, and she cured me. I was on eleven foods for a month, and it was hard. But if it wasn’t for her, I don’t know where I would have turned.” He gave me her information. Currently, I am under her care hoping that this tailored approach will send me on a path to speedy healing. 

****

Genuine advice, compassionate communication, and empathy are qualities that must be infused into the process of healing a patient. Health care can no longer be standardized by protocol: Health care must be personalized with a holistic approach that validates symptoms and searches for their root cause rather than dismissing them and blindly medicating them. 

I am sharing this story because I want to shed light upon HOW the surgeon approached me. Although he wasn’t the right doctor for me, I believe that he came into my life for a reason (not all referrals from friends/family match even though they are looking out for you). People always do. His role in my life was to rekindle that dwindling spark of hope within me that there are some doctors who are invested in your care, and that there was a potential cure to my condition. 

The prospect of healing is the light at the end of a dark tunnel that can only be imagined when someone works with you rather than against you. A light that can only be imagined when someone guides you to it rather than pushing you back into the dark. While I sometimes find myself deep inside of that cavity, I think about this doctor to remind me that there is hope. There is hope that not only can I be cared for and cured, but that doctors like him can inspire others to approach their patients similarly. There must be others like him, who approach their patients with a personalized process rather than protocol. There are doctors who know better. Even if they are not the right person to treat you per se, their process can be the magical key to unlock doors filled with healing opportunities and as those opportunities come your way, it’s on you to decide which path you take. So yes–there are experts who know better, but as this doctor told me, “you know your body best.”

****

Doctors must gain trust of their patients in the consultation before proceeding with any treatments or plans. The process of healing someone and gaining their trust go hand in hand. 

Here are some tips for doctors and patients alike so they can establish a personalized process that targets solving the root cause:

FOR DOCTORS

FOR PATIENTS

  • Review your patient's medical records thoroughly prior to their consultation.

  • Ask them what symptoms they are experiencing, and how they impact their daily life. Ask the patient to share their medical history/story so the doctor and patient can puzzle the pieces together so they can partner in finding a remedy. 

  • Validate their symptoms with phrases like, “I hear you, I can see that you’ve been struggling and I’m going to try and help.” If looking to treat a patient similarly to another, say, “I’ve seen other patients with similar symptoms before, and this is how I’ve helped them, maybe we can try this approach.” Delineate the approach in simple terms and ensure the patient understands each component. 

  • Give ample time and space for the patient to ask questions. Use a compassionate toneAsk if they have any concerns about their care and remind them that they can reach out through X (medical portal/phone line/etc). I know you may be busy, but please be as responsive as possible. Your patients need your help and support 🙂

  • Give a specific timeline for when you would expect them to see improvement if the treatment were to work. Let the patient know when you would like them to report their progress. Have a plan B in mind just in-case plan A doesn’t work, and do explain this plan B to the patient.

  •  Be prepared to discuss your symptoms, the timeline of when they arose, and the degree of severity. Be familiar with what records will be discussed in your visit. (In a story I will share, I was unfamiliar with an element on my record and was appalled when the specialist contorted it into an assumption of my condition).

  • Keep a symptom/mood/activity diary in real time. Document any new symptoms or symptom changes, and lifestyle changes that have helped or not. Try to note what you were doing the few days or weeks around the emergence of novel symptoms. It’s essential to document what helps you feel better.

  • Bring someone to your appointments--a family member or close friend. It can be hard to remember all of the details of your medical history and what the doctor says during the appointment, especially if you’re not feeling well. Your family member/friend can take notes while you focus on conversing with the doctor.

  • Before jumping into any treatments, especially medication, inquire about side-effects or long-term health complications that can emerge from the treatment. Make sure to perform additional research at home as well. Even go to the extent of getting second and third opinions if needed.

  • Ask when you should follow up/touch base. When starting a new treatment, remember to ask when they think the treatment should start working if it were to be effective. This can give you an idea of how to plan for the future; be sure to recontact your doctor if you do not see any improvement.

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