Reports from a Resident Alien

The doctor knows best.

Or does he?

Fact is, doctors don't always know best. They are human beings who make emotional decisions, use intuition, make mistakes, and flat-out guess at some things. They misdiagnose up to 10% of their cases (in the field of psychology, that rate is a lot higher). They forget you're allergic to something. They prescribe medication by trial-and-error. They (and their staff) are, essentially, human beings with average judgment and a lot of knowledge.

It's not that doctors are careless, stupid, or ill-informed; by and large, they do their best. It's just that medicine isn't an exact science. Every patient is different; every case is different. Some things can mimic other things. You don't always know which treatment will work. And there's a lot that isn't known yet. And doctors are driven by the same things that drive many of us: When there's a problem, they are inclined to simply do something... even if they're not sure what that something is.

That doesn't mean you automatically make any better decisions than your doctor does. You yourself are also a human being with average judgment, and while you have the advantage of living in your own body, you have the disadvantage of being less experienced. (Even if you're the type who will research your own problem or medication and know more about it than the average doctor, fact remains you've only seen one case, and you probably don't know general anatomy/physiology as well as your doctor does.)

What it does mean is that there is absolutely no reason to be intimidated by your doctor. It means you ask questions, get the reasons for his decisions, study your medications and your diagnosis on your own. It means you make sure "informed consent" is more than a formality. It means you get involved in your own medical care, rather than expecting the human body to be a TV set you can just drop off a the repair shop. After all, you can always buy a new TV; but you've only got one body.

Yesterday I went to the ob/gyn for a birth control prescription. I have really painful periods and I am tired of losing a day out of every month, especially when that can be seen as 'absenteeism' by a boss or a professor. The doctor told me that I had three options--birth control pills, Depo-Provera, or prescription-strength ibuprofen.

At this point, I made my mistake: I asked about side effects. Asked to see the documentation on the different types of medication. I am already heavy and I do not want to gain any more weight. And I have a history of depression and I sure as heck don't want to end up with another episode thanks to messing with hormones. But it was like he didn't want to discuss this with me. Wouldn't give me odds. Wouldn't give me the fact sheet--"You'll get that with your prescription". As though he just wanted me to choose "the shot, the pills, or the painkiller".

Then he left, assuming I didn't want any treatment at all. Why did he think I was in his office?

I finally had to track down a nurse and tell her that there had been a miscommunication. Quite out of my control, I was prescribed birth control pills and prescription-strength ibuprofen. (Luckily, I did some internet research and saw that this would have been the choice I'd made given actual information to make it with.)

It's not just doctors who act this way. Everyone, down to repairmen, seems to want to keep their "trade secrets" and want me to shut up and pay them, rather than ask what they're doing and why. It's like they're insulted if I ask for more information than they give me. I've gotten weird looks from a grocery store cashier when I asked whether one of their sales was meant to undersell a nearby store, which sold just above that price. (Maybe the cashier didn't know, in her defense.) The only place I don't get this is the library, where mentioning the Dewey Decimal number for a particular subject is considered normal enough not to draw comments.

Doctors ARE the worst offenders, though. "Take your pills and shut up" seems to be the biggest attitude. When I was in the mental ward I was the only one who asked for informational print-outs on the meds I got, and then asked why I was being given anti-addiction medication (for some reason) plus about a million other things I didn't need... I can see how this could be labeled non-compliance. I've already been labeled as having "minimal insight" for not agreeing with a psychiatrist (who saw me for one hour, total).

Do NTs not ask for information like this? Is it normal for an NT to not care about why her sink is leaking or why the grocery store puts milk and bread on opposite sides of the store? Are they over-awed by a medical degree? Is it normal for people to choose medical treatment with very little real information; or is it just that people don't think it's possible to understand medicine, or plumbing, or any number of "specialized" subjects? Is that why I'm getting treated so strangely?