NOT

Continued from Chronic & HYSBYW

Chronic pancreatitis.  Serious.  Poor prognosis.  For three distressing weeks I dealt with that diagnosis as I waited and waited for yet another doctor’s office to schedule an appointment.

Aggravated at waiting forever to hear back from the physician to whom I’d been referred, I wrangled a different referral elsewhere.  In an effort to be thorough, I picked up disks with all my imaging studies to take to the new doctor.

Before delivering those disks, I popped them into my computer.  Not only do the disks contain images, they also contain the radiologist’s reports.  At the very top of one is a note that a correction to the report was discussed with the doctor’s PA.  The correction?  One word was omitted from the original report.  It should have read that there is NOT necrosis…

Capital letters.  NOT necrosis.  Not chronic.

This correction was dated two weeks before the doctor delivered the bad news.  He somehow didn’t see the corrected report and didn’t see the PA’s notes in my file.  He was too busy typing on his computer to look at me.  Apparently he was also too busy to look at all the reports, since the report on the second CT was even clearer.

And I’m wondering. When would I have learned this if I hadn’t looked at those computer disks and opened the radiologist’s reports?  What was that doctor thinking?  I am so angry that I spent three weeks stressed about this because he didn’t read the reports and so gave me the wrong diagnosis.  I understand that mistakes happen sometimes, but this guy just glanced at the initial report and never bothered to read it, never bothered to read the corrected report, and never bothered to so much as glance at scan number two.

While I am dismayed that the wrong diagnosis was delivered, I am relieved to know that I’m not dealing with another chronic condition.  Acute is such a nice word.

I saw a second gastroenterologist in a different hospital system.  No accusations of being a lush there.  Quite the opposite.  They read the radiology reports and told me that my case is very normal:  70% of cases of pancreatitis are women with gallstones.  That’s not the only contrast in the care they provided.  The first GI didn’t even read the reports; this second guy looked at the CT images and tracked down a radiologist for help interpreting them.

The second doctor, who I saw initially the day after I phoned for an appointment last week, is working on fitting me in to get the procedures done next week.  Next week!  Not next month or the month after.  Next week.  As a bonus, I don’t have to drive clear to Seattle.

NOT chronic.

Have You Stopped Beating Your Wife?

Some questions are loaded, and there’s no good way to answer them.  My high school debate coach was the first to introduce me to loaded questions.  We were taught that lawyers are infamous for this technique, but once you know about it, you recognize it other places, too.  Some of the medical questionnaires I’ve had to complete lately seem to have been designed by people who like loaded questions.

For example, have you stopped beating your wife?  sounds like a simple yes-or-no question.  It’s really a trap.  “No” means you haven’t stopped; you’re still beating her.  “Yes” means you have stopped, so you’ve beat her repeatedly in the past and recognized the need to stop.  When feeling pressured, few people think to say, “I have never beat my wife so there’s no need to stop.”

My family physician only asks for “average number of drinks per week.” I’ve never before seen such questions as these new doctors are asking.  Date you quit drinking?  is one of those questions that really have no good answer.  What if you haven’t quit?  What if you don’t know a date?  What if you do know a date?  Does that mean it was a significant event worth remembering?

Now that my pancreas has decided not to function properly, doctors are actually reading some of my paperwork and looking a little closer at how I answer their increasingly detailed questions.  One of my new doctors flipped through all the forms I’d filled out; apparently I interpreted the loaded question wrong, because he asked, “Have you ever been a heavy drinker?”

Should I ask for a definition of heavy?  I have a neighbor who is drunk before 3:00 every afternoon, but he insists he’s not a heavy drinker.  Does anybody ever respond “Yes”?  Is “No” ever believed?  Is there a way to broach this subject without sounding defensive?  If it won’t change anything, then there’s not really any point in asking.  Are there different treatment tracks based on the patient’s past ETOH use?

Maybe (unlikely) I’d forget all about it, except that I went directly from that doctor’s office to another who insisted that I can’t have chronic pancreatitis, because only long-term alcoholics get that.  Despite the fact that there’s plenty of evidence to the contrary, if that’s what practicing doctors believe, I foresee problems ahead.  I can anticipate being grilled about my drinking history for the rest of my life, and it won’t matter what I say.  If anything, telling the truth will make things worse because the doctor will be convinced that I’m untruthful.  That’s not particularly encouraging.

When doctors put “Date you quit drinking?” on their patient history forms, the line on which answers are written needs to be longer than 1/2″.  I want to write, “I was never a drinker, so there was no reason to quit.”