The doctors and me
I go to a lot of medical seminars. And thanks to being a middle-aged white guy, I’m often mistaken for a doctor. No doubt it is my suave good looks and extensive vocabulary. OK, you can stop laughing now. But being mistaken for a doctor lets me hear things that real doctors would not say if they knew there was an undercover diabetic in the room. (Cue the James Bond theme song).
And I’ve noticed over the last few years that many doctors manage to use the word “diabetic” like a curse word. So how can I demonstrate this with the written word so that you can understand the tone, the inflection, that I hear far too often? Harsh. Biting. Like spitting out wine that has turned to vinegar.
Hmmmmmmm….OK, so if someone told you that Dr. X said, “I find these diabetic patients to be very taxing.” Well, now that sounds harmless enough. Maybe even honorably honest.
But it is the way “diabetic” is said that makes the difference.
What is the most vile, disgusting, gross thing you can think of? Yeeeeeewwwww, there’s a bunch of used condoms on the picnic table! Yeeeeeewwwww, there’s a leech crawling up your leg. Yeeeeeewwwww, there’s ….. Well, hopefully you get the idea.
That is how a great many doctors say “diabetic.”
But now, as if I don’t already have enough to do, I’ve been given a chance to do something about this. Not about the used condoms; about the attitudes of doctors.
I was recently drafted by an enlightened doc at a university hospital. His job, among other things, is to train “Residents.” Residents are not people who live at a hospital. Well, actually, come to think of it, they pretty much do. But I’m talking about proto-Doctors in their final phase of training.
Hearing on the grapevine that I was not making enough money in the first place, and am now making even less, he hired me to drive half way across the state two days per month to help him out. The job description was a little vague, but the pay was good.
I figured I’d be working with patients. Wrong. I’m working with the Residents. My first day on the job I was sort of a fifth wheel out-of-place observer. In every way. I work at a clinic where I know everyone by name. All the staff are on first name basis (of course two of them have the same first name: Doctor).
Now I was in a place with hundreds of employees. Maybe even a thousand. It is daunting. Thrilling. Scary. All at the same time.
So what the heck am I supposed to being doing here exactly? I asked my new boss at the end of the day. “You’ll figure it out,” was his response.
It wasn’t until I was driving home the first day that my mission dawned on me. It took a while to sink in. I was replaying the conversations, observations--everything I said, heard, felt, did-- on the way home when it hit me. Suddenly a light came on. Oh crap, I bumped the stupid dome light button!
Then, slowly, a theme emerged. Something I heard three different Residents relate to their preceptor. I’ll paraphrase, as they all pretty much said the same thing: “So the patient hasn’t done anything we asked them to do on the last visit, so I had the complications talk with her.” Picture a self-satisfied smirk. An inquisitor who just lit the bonfire at an old-fashioned witch burning.
I flipped open my cell phone and dialed. You want me to teach the children (his word for the Residents) what makes diabetics tick.
So I guess my next business card will read “Diabetes Ambassador.” My new part-time job is to make the next generation of doctors different from their forbearers. Not to view us as disobedient children; but as complex living organisms who have to exist in an even more complex social environment.
So today, two weeks after my epiphany, on my second day on the job, a young proto doc was complaining that a patient was still eating too many tortillas. After he finished his rant I said out of the blue, I've got a coupon for a free sex change. Would you like to have it?”
Awkward laugh. “What??”
Would you like to be a woman instead of a man?
“No…of course not…wha…why…why did you ask that???”
Because it is easier to change your gender than change your diet. You are asking too much. You are using threats and fear to affect change. That might work for a little while, but it is not sustainable. You need to understand your patient. You need to motivate, not intimidate.
Long silence while this set in. “So how do I….?” And we had a great chat. Not diabetic to doctor, or doctor to diabetic, or even peer to peer; but person to person. I love, love, love patient care. But this is a very cool gig.
I really do love Docs. Maybe I’m the right guy to make them love us back. What do you think?