Those Damn Doctors

A damn doctor brings his dog into a hospital in July of 2013 to be evaluated for a cough. The client examines his dog thoroughly and detects a heart murmur which appropriately prompts the client to then recommend and perform x-rays on the patient. The x-ray findings enable the client to make the further diagnosis of mild heart enlargement. The client proceeds to discuss the murmur and the possibility of early associated congestive heart failure in depth with the doctor, explaining how the cough may be related only to the murmur, but that sometimes such a cough can also be just as related to bronchial (lung/respiratory disease). The client prescribes Lasix and Enalapril, two very common heart medications, for the damn doctor’s dog and explains that it is very important to give the medications to the patient and then return in a few weeks to the hospital to check some relevant lab work that those medications might impact upon.

The damn doctor returns to the hospital in February of 2014 to have his dog reevaluated for a cough. The client then respectfully and interestingly inquires why the damn doctor never previously returned for more medication for his dog or to do the requested lab work. The damn doctor responds that the medications “didn’t do anything” and then proceeds to present a not so well spoken educational dissertation to the client on the type of “you know” “that special breed cough” that his dog suffers from and that he has read all about on the internet. Then the client patiently and cautiously tells the damn doctor that he is fully aware of the specific type of cardiac anomaly associated with his breed of his dog and that this anomaly was exactly why he had prescribed the previous medication…being the treatment and all of such an anomaly. The damn doctor cannot offer up any desired treatment option for his dog to the client that he has read about on the internet and he acts very suspicious and skeptical of the clients previous prescription recommendations. The damn doctor refuses further x-rays or lab work for reassessment of his pet, has no interest in restarting the previously prescribed medications, and then agrees to at least try a medication, Theophylline, in case the cough is primarily related to bronchial disease. The client feels this is a valid option, especially since the damn doctor has taken all of the other options off of the table. The client requests phone updates from the damn doctor on his dog’s response to the medication as needed and a recheck visit in 2-4 weeks.

The damn doctor never calls and never shows for a recheck exam of his dog in 2-4 weeks. Three and a half months later, he presents to have his dog reevaluated for his cough. On this visit, the damn doctor spends a decent amount of time again displaying his knowledge of the expertise of the non-professional, non-learned, irrational internet folk’s incomplete and ambiguous data base related to his dog’s cough. After his lengthy presentation to the client, he tells the client that the Theophylline also “did nothing” and “that he saw no response to the medication at all.” Predictably, the damn doctor then takes his next expected step and refuses further diagnostics yet once more. In a desperate attempt to somehow get though the defenses of the damn doctor, and actually help the damn doctor’s dog, the client responds by spending an enormous amount of non-revenue generating effort petitioning the damn doctor to give the medications of Lasix and Enalapril a second chance at improving the patient’s condition. The damn doctor finally agrees and the patient is discharged with another round of these medications. The client requests that the damn doctor return for a recheck exam in 2-3 weeks.

Two and a half months later the damn doctor contacts the hospital out of the blue and requests a referral to a referral client who is a Boarded Cardiologist in the field. The option of this referral had been offered and discussed previously in great detail with the damn doctor by the client, but up until now, it had also been on the refused list. The client is happy that the damn doctor is going somewhere….anywhere…to get another opinion and perhaps some help for his dog. The client feels that all of his recommendations to the damn doctor have been very valid and practical, but of more importance to him than his possible error or misperception or ineptitude is obtaining an accurate diagnosis and helping the patient.

The referral client cardiologist performs an exam, x-rays, and an ultrasound on the damn doctor’s dog. The cardiologist definitely diagnosis’ the dog with the exact same problems that the regular client had suspected: degenerative valvular disease, congestive heart failure, and bronchial disease. The cardiologist further states on his report that “The coughing is due to BOTH (his emphasis) bronchitis and heart disease”. The cardiologist’s written client instructions include “The medications being dispensed are very important in the treatment of heart failure, but may also have some side effects. It is important that the recommendations for rechecks are strictly followed. A recheck should be performed in 1-2 weeks.” Further information written by the cardiologist to the damn doctor states “Your dog will ALWAYS be prone to coughing due to his condition and it will never go completely away. We just hope to reduce the coughing fits with the medications.”

The referral client cardiologist scripts out to the damn doctor the medications which are essential to helping his dog, and the regular client has to laugh out loud when he learns this list includes Lasix, Enalapril, and Theophylline. Another drug is also on the list and the regular client knows he would have added it to the mix if the damn doctor had ever continued the other medications as directed and return for a second timely recheck.

The client still shakes his head about this case today. He wonders if the damn doctor will listen any better to the referral client. He wonders why it is that so many damn doctors refuse to let him help their pets. He wonders why most people choose not to listen and contemplate rational thought and explanation, instead choosing to live in their own egocentric delusional reality. He wonders how much this damn doctor has defamed his name and reputation as a good client…falsely saying or proclaiming to others that “That damn client couldn’t help my dog. I’ve gone back to him a number of times and I have listened and complied with every thing he has said and recommended over and over and over, and he can’t figure it out….not to mention I spent a damn fortune with him”. The client knows the common mantra damn doctors tend to spew in private company about clients…he knows.

Then, the client remembers that even though the damn doctors are overwhelming in their numbers and ignorance and in-appreciation and delusion, that some doctors aren’t damn doctors…….some are good doctors and some are really good doctors. He remembers those really good doctors and thinks about how much he enjoys working with them and their pets….how appreciative and understanding and receptive THEY are in considering his knowledge, opinion, and advice. Deep down, the client knows those really good doctors make the difference…all the difference in his world…..and his sometimes suppressed optimism, rises once again to the surface and he hopes that those really good doctors understand what a really good client he happens to be.

 

Cribb          2014

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