Saturday, May 15, 2010

The other pain in my heart

There is a Post-It note affixed to the lid of my laptop. It reads, simply, December 10, 2004.

Five years of my life continue to be such a blurred memory that I had to look through old planner books to find out when, exactly, I was diagnosed as having bipolar disorder. From that point, I've been able to put some events on a timeline and bring mental order to a prolonged and profound cognitive fog.

This has been on my mind because of my conversation last week with the cardiologist. I told him that I did not believe my diagnosis of BP was one-hundred percent correct. At least, I had lived for 43 years without medication and without major problems, and I believed that the meltdown was the result of poor prescribing practices on the part of my primary care physician. "Of course," I continued, "I understand that I probably had some sort of genetic predisposition, but I don't believe this condition would have become manifest without the perfect storm of elements coming together at once."

Dr. C waved this off saying that probably I just hadn't realized I had the condition. He implied that it didn't matter what I thought, I had BP and I needed to accept that.

Now that more than a week has passed, I am troubled by this prejudice. A doctor who had known me for all of 15 minutes was quick to tell me that I had no nervous system malfunction, no chronic health problem, no pain disorder at all. He shot down the possibility of my having anything I thought I had (or that other doctors suspected), yet eagerly latched onto the validity of a BP diagnosis. Why are you so willing to choose this one as likely but not that one when you don't know much about me either way?

Earlier this week I had a regular scheduled visit with the doctor who tends to patients with chronic inflammation, hormonal or chemical issues or malabsorption problems that lead to or complicate chronic health problems. She assured me that she would not have continued to keep me on as a patient if she didn't believe there were a legitimate, physical etiology for my condition.

I told the doc that I felt my medical history was robbing me of credibility. If what the cardiologist said was true, then most doctors stopped considering my health issues as legitimate as soon as they got to the BP/lithium notes on my chart. "It seems to me," I said, "that from now on I would be better served by just leaving that information off of any paperwork I fill out and never making any mention of past depression or the BP diagnosis."

Dr. S nodded slowly and said, "You're probably right. You are right. If I were you, that's what I would do. I don't think that would hurt you."

Well, OK then.

It still troubles me, though. Why was the cardiologist so much more willing to believe I had a mental problem than he was to consider the possibility of a physical illness? What does that say about his attitudes about patients in general? Would he have held the same prejudices if I were a man?

How frightening to know that our medical care can be derailed so easily by one person's hubris.

1 comment:

Ethereal Highway said...

I agree that it is a good idea not to mention the BP to doctors. Too many of them are like that cardiologist.