Mea Culpa

[drbandage]

Haunting these boards, it's been my observation that apnea patients, including myself, often tend to feel extremely short-changed by disease, circumstances, science, financial expenditures, mankind being inherently exploitive, and a vast array of other perceptions and emotions. I can sure see why, having suffered miserably badly myself for far too long. Recall perhaps a post where I stated that I was damn mad and didn't want to take it!

In my opinion, this overwhelming sense of being "let down" by apnea's circumstances is absolutely understandable. As I have said, I have had many of the same feelings. But this same overwhelming sense of being "let down" by apnea's circumstances is also absolutely positively guaranteed to translate into plenty of misplaced rage against "the medical system". That term is so broad that it bothers me to even use it because of the obvious potential for misunderstanding.

That misplaced rage, unfortunately, may put any member of the medical community at an instant and very unfair disadvantage regarding both image and credibility. Unfortunately, patients with bones to pick (either irrational or justifiable) may tend to forget that MDs and other health care workers happen to be real live humans with feelings and social needs also.

I will confess to being taken aback by the degree of hostility that I have seen here in regards to the medical community at large. It is helpful to remember that physicians, nurses, and all the other folks are not to be equated with the medical insurance industry. Undeniably linked, much to the chagrin of physicians at time, but still, there it is. There is a seething resentment from physicians on many levels that the almighty dollar and those who would seek it often trump the physician's best efforts to "do the right thing" for the patient.

Nope, can't have that drug.
Nope, can't have that physical thereapy.
Nope, can't have that MRI.

Dozens of times per day I am confronted with making the best of a bunch of bad choices. I signed up to help people, not to Rage Against the Machine in my laughably little "spare time", although I have done my fair share of it, I am proud to say. It needs to be done, but it ain't no part time job, and I would need to be able to explain to my paients why their doc is MIA while grappling with well funded and highly motivated adversaries.

Not all docs are saints, that's a fact. But, you can only try to imagine how difficult it is to see the health of the patients that you care so much about being put at risk by decisions that are pure and simple intended to fatten corporate wallets. There are bad docs, duh. Hate 'em. But, the vast majority that I have met or worked with are decent, honest citizens just like the vast majority of this board.

I made a decision not long ago that although my opinions and thoughts were indeed my own, that no matter the topic, my comments were immediately colored by the fact that "a doctor" expressed them. And of course, it is true, that for good or for bad, the source should be considered when evaluating statements that are made. However, to me it seemed like I would have a better chance of having my message heard for what it is if it arrived naked, and the reader were not aware that I am a doc. Forget the preconceived notions, right or wrong, just judge the posting by the validity of the comments and it's inherent worth or lack of it. Let it stand or fall, not based on who said it, but what was actually said.

I made a decision with that mindset that I now regret. I posted with an assumed name on two occasions. My nom de plume was SleepinPeace on one occasion, and Saleepy on the other. While certainly there is ample precedent for using a nom de plume, both here and throughout history, and I do not object to it at face value, I feel like it was disingenuous of me and I wish I hadn't done it. I am not sorry for what I said, but I am sorry that the message was delivered in a deceptive manner. I apologize deeply to those who I may have offended. Although my intentions were good by my standards, posting in this way does not suit me. Again, I apologize to any who may feel let down by "yet another doctor".

drB

[-SWS]

Doctors are humans too. This board truly is a place to "hash things out" as Bill puts it so well. I personally prefer to hear views hashed out without negative emotions that might impede the exchanging of those contrasting ideas.

But alas we are all humans, and my personal preferences regarding how analytic debate might amicably occur here are probably never going to happen. Regardless, I think it's nice to hear multiple opinions/views/paradigms. Maybe I'm a neurological and behavioral anomaly that way, doctor. Is there a shot for that?

[Snoredog]

ah don't worry about it doc, know where you are coming from, if these people don't feel they got their monies worth in advice then to hell with them I say

As far as beating up the establishment, I think it comes out of shear frustration as the cause of that, many docs are poor listeners, you are the exception to the rule. And I'm no better, I beat them up also and I have kids, cousins aunts and uncles that are MD's, several with Ph.d's, in fact one even a Professor like yourself, my family history goes back to one of the very first medical reference books ever published, back in I think 1848 area. One of my relatives back east has the original copy, has to be worth a mint by now, somewhere, it was online for a while, scanned from the original copy, it was pretty funny because back then you were supposed to double the dose if the horse was over 10 hands high

[blarg]

The only question I really have is:

Were your opinions taken in a different light when people didn't know you're a doctor?

I'm kinda curious actually. lol.

[dsm]

A good and thoughtful theme.

When I think of the typical way forums such as cpaptalk work, I am always reminded of families & playgrounds. The dynamics of interaction seem so similar

One concession that might be made to some of us is (my belief) that when therapy is going well, maybe we are better at communicating & interacting as takes place here, but when our therapy (or other closely related life events) aren't going so well, it seems probable that this can find its way into the exchanges that occur & cause disharmony.

As a last comment - cpaptalk is a haven compared to some other forums I have seen over the years.

DSM

[drbandage]

Maybe I'm a neurological and behavioral anomaly that way, doctor. Is there a shot for that?

If there were, I would want to be first in line for it.

Bartender, I'll have what he's having.

Any quirks or anomalies that plague -SWS are fine by me. You may not realize it, but I really am one of your biggest admirers. Thoughtful, courteously written script enthralls me, and you pretty much set the standard for that, IMHO.

[drbandage]

ah don't worry about it doc, know where you are coming from, if these people don't feel they got their monies worth in advice then to hell with them I say

Snoredog, you make me chuckle, quite literally.

it was pretty funny because back then you were supposed to double the dose if the horse was over 10 hands high

Reminds me of my dad's story about coming home from medical school one summer. He was born and raised in a little spit in the road named Phillips, Nebraska. Kind of near Grand Island. He went to the big city, i.e., Lincoln to get edumacated. First day on his summer break, home from med school, there was a knock on the door. The neighbor had a horse with a real bad tooth, and wanted Dad to come have a look. Not a veterinarian, not a dentist, but still . . .

http://wichita.kumc.edu/prevmed/research/dismuke.html

then my little cousin she has done pretty good for herself:
http://www.musc.edu/cheps/vitae/dismuke.pdf

looking forward to checking out these links

but when I get sick, I get out the horse sauve

Like I said, SnoreDog, if it works for you, it works for me.

Hey, where's the "chuckle" emoticon?

[drbandage]

The only question I really have is:

Were your opinions taken in a different light when people didn't know you're a doctor?

I'm kinda curious actually. lol.

Good question, Blarg. Dunno for sure, of course.

My suspicion is that there would be more focus on the message, and less on the messenger. What a concept!

[blarg]

My suspicion is that there would be more focus on the message, and less on the messenger. What a concept!

OMG, I can't believe YOU would say that! I'm SO offended.

Ok, sorry, just couldn't resist.

I suppose if someone really wanted to carry out an experiment, MattMan would be a good candidate for going incognito and seeing what happens. I love psychology experiments.

I guess I'm used to the internet, perhaps a bit much, but really, all you can do is trust that people are who they say they are. I appreciate your candor, but personally I think it's more of an interesting data point than an offensive action.

[drbandage]

A good and thoughtful theme.

Good on ya, dsm.

When I think of the typical way forums such as cpaptalk work, I am always reminded of families & playgrounds. The dynamics of interaction seem so similar

One concession that might be made to some of us is (my belief) that when therapy is going well, maybe we are better at communicating & interacting as takes place here, but when our therapy (or other closely related life events) aren't going so well, it seems probable that this can find its way into the exchanges that occur & cause disharmony.

Sounds entirely plausible to me. Of course, that's only my opinion!

As a last comment - cpaptalk is a haven compared to some other forums I have seen over the years.

I suppose I have led a sheltered life in that regard, at least in recent years. I have grown fond of the forums in medicine that are interactive and spirited, but where blowhards are quickly identified and they know it. I believe it may be similar to the "Tall Poppy" phenomenon down under.

Thanks for your thoughtful remarks, dsm.
BTW, how's Thursday shaping up?

[dsm]

BTW, how's Thursday shaping up?

Ripper mate !

DSM

[kteague]

DrB (aka SaLeepy),
Had to laugh, because your confession sure cleared things up for me. I had read SaLeepy's posts and thought to myself "SaLeepy is DrB's clone." I even scrolled back to double check the name because I thought I had scrolled into one of your posts without realizing it. Even wondered if maybe the system didn't let you log in so you had to use another name. I'd venture tosay I wasn't the only one who had that thought. Isn't there a saying about a thinly veiled disguise?

Blarg,
I have a confession to make also. When I thought that about SaLeepy, I also thought, "SaLeepy must have picked his style to copy because he's a doctor."

Snoredog,
I too look forward to reading those links. Seems a strong bent toward things medical in your family (including you). Nature or nurture? Hmmm.

Kathy

[tomjax]

Doc,
you are articulating very well your perspective as a patient and a doc.
I hope your skin is thick enough to weather the slings and arrows of those who like to unload their built up hostilities and mistrust of any authority figure or icon.
Apnea patients are no different than most patients of other specialties. They want to blame everyone but themselves for their condition and fail to recognize or admit their own role in their condition. It feels so good to put the blame on others.

I do not know how old you are or how long you have prqacticed medicine or what specialty,
I am 66 and have the benefit of going back a long time in knowing doctors, both in a social and professional perspective. As a pharmacist, I heve observed docs differing approaches to their practice and their ptients. As a amateur behaviorist, I think they are no diffenent than others.

We can never go back to the Norman Rockwell days of the avuncular familty doc with a calm voice and practical advice. The lawyers have seen to that.
Something happened about the mid 70's when medicine and pharmacy changed from this idyllic age and the docs were trained to have a different attitude to their patients.
It was the BOUNDARY PROBLEM they were indoctrinated with and that they simply must never get too close to a patient.
Remember the line from Patch ADams, "What hapens if you get too close to a patient, do you explode?"
Nowadays patients are herded into a group practice that is totally impersonal and become a number. When they finally get to see the doc, it is very brief and the patient rarely comes away with that bond that was so prevelent in earlier times.
When this is combined with the quality of many of the new docs who are probably the best educated and trained in the science of their profession, but have practically no exposure to the ART of their job, then the patients are left with further estrangement and frustration.
I call these doce as well other of the brainier students 4.0 idiots.

I must get back to my private writing ithat I do for my own therapy. I have a new chapter titled MY DOCTORS in which I trace all the docs I have known as a patient and as a pharmacist. It helps to put it down in writing.

Nuff of this rambling.
Hang in there doc, but realize you are not in the comfort and safety of your doctors lounge surrounded by friendly and protective faces.
Tomjax
and, btw, you are welcome.

[JohnMudie]

Dr B wrote

But this same overwhelming sense of being "let down" by apnea's circumstances is also absolutely positively guaranteed to translate into plenty of misplaced rage against "the medical system".

When I find that my fatigue is hitting me, I mourn and grieve as I want to have lots of energy. And this mourning and grieving can take many forms. One of the forms of grieving is anger. I can choose to express anger at the nearest thing in site which is not filling my needs to get better instantly, a doctor.

Then also I would like all the resources in the world to be devoted to getting me well immediately. Unfortunately there are other people in the world with the same need as mine and we all get to compete for the same limited resources. There are always not going to be enough resources to fill this demand. In our current environment this limitation can show up as insurance companies or as wait times to see a Dr. But something is always going to limit access. Greed and wanting everything for myself is an inherent property of the human condition.

So is there a way of dealing with this suffering which is going to occur some-way some-where in our lives as our (especially mine) bodies degenerate?

Dunno, but at least we can recognize the process and understand it and our shared humanity and try to love each other in the process.

Maybe we need bumper stickers which say "Love your DME" or " I got OSA, what do you got?"

So Dr B. Thanks for sharing your humanity. Please keep sharing your wisdom and please understand what's going on with me when I rage at the medical profession. For what its worth, the medical profession gave me a medication which destroyed my kidneys but the medical profession also gave me a kidney transplant. Right now I am into fatigue and the medical profession has tried real hard to figure it out but hasn't quite made it yet so I am having to choose between calling them SOB's or enjoying meeting you on CPAPtalk

John
A Dr too but luckily a Ph.D. not an M.D. so I dent get raged at

[NightHawkeye]

The only question I really have is:

Were your opinions taken in a different light when people didn't know you're a doctor?

Blarg, since SaLeepy directed some of his postings at me, I can tell you that it didn't make any real difference in how I perceived or responded. Like Kathy, I sensed the similarity and the thought in my mind was that SaLeepy was either drbandage or someone with a similar mindset who had read our recent exchanges and was mimicking the behavior.

I also seem to recall that my good-natured challenge to SaLeepy went unanswered.

Regards,
Bill