Doctor - Patient Disconnect

[Calist]

Alternate titles-

"Stupid Patients" "Stupid American patients" "Calist's Manifesto" "Calist's big book of ranting." "1000 words that are sure to go unread and still meet with opposition." "A healthier approach to medicine."

Introduction

Really you can title this anything you'd like. I should have called it "Insert title here" as I'm sure that is what everyone on this forum will do. Some will enjoy it simply because I wrote it. Some will find it vaguely interesting or very confusing, riveting, heretical, groundbreaking, blasphemous. People tend to pre-judge content based on where it came from. That is nothing to be ashamed of. You formed an opinion when you clicked on the link, just like everyone else did. But while I have your attention I would like to speak to you about something very real and very dangerous. A trend that stretches back almost two hundred years before abruptly deviating and causing more harm than most people realize. This sort of behavior is nothing new. It is something that humans have struggled with for thousands of years. This new trend is simply a variation of it, a new spin on an otherwise old motif.

There is a plaque on the wall of the hospital where I work. It reads "Patients bill of rights". I had the joy of reading it one night and I did not find a single entry on it, not one single line that I disagreed with. This is because I disagreed with it's very existence. I disagreed with the idea that a patient would have rights under any circumstance other than the right to refuse treatment. As complex and as baffling as this might seem to some, perhaps you might agree with me when I say this contention deserves explanation.

Medicine was invented thousands of years ago- now I understand the perspective of people that would argue against that sentence. I realize that Hippocrates made a lasting impact on medical science and we need not look all that far back to see the contributions of De'vinci, I realize that some will point out physicians closer to our current era and state that they were the first. Some will even argue that previous attempts at medicine can not even be called medicine as it was deeply flawed and saturated with mysticism. No one is disagreeing with these points which have yet to be made. I am pointing to the Natufians and later "Sumerians" that began to piece together the foundations of science. The abstract concept of "Cause and effect" propelled this line of study forward and cemented the path that science would one day take. The idea that people would become ill and could be cured by remedies that they themselves could locate and prepare. At the time, medicine was studied and practiced by priests and shamans. Now I am not going to imply that these early practitioners had an overly simple relationship with the patients that they treated. They were priests after all and in the Sumer culture especially, relationship were anything but simple. But let me say 'Simpler'. An individual that required medical treatment would seek out one of these people, upon finding this person they would request help. And (for the most part) they would receive it. They did not bargain or barter with these practitioners, they did not request a priest beg them for the honor of treating them or demand that the priest change his views on medicine in order to better suit that which the patient had already assumed. Such attitudes were indeed, thousands of years off into the future.

This was again illustrated in the 1800s on the North American continent. People who were stricken with illness on the 'Frontier' or mid west, had very few options when it came to treatment. Often times you would have one, maybe two doctors who saw to the needs of the population stretching hundreds of miles in all directions. A person who came down with something would then have the option of seeing a Doctor, or not seeing a Doctor. There was no middle ground. Medicine was still relatively simple back then and not unlike our Sumerian ancestors. There were illnesses and cures. A person that memorized the proper cures for the correct illnesses was thus good at his craft. A person that confused them, was thus poor at his craft. Things changed over the course of the following century. The technology advanced. Even though Medicine had moved forward however, the patient population did not. Medicine took several leaps forward and it's complexity multiplied with each step. Where as most physicians of that era were 'General Practitioners', the level of complexity from research demanded that every physician specialize in his/her own school. From Neurologists to Urologists we find that 'broad spectrum' knowledge of Medicine is very rare as each Doctor explores the depths of his/her specialization.

This caused considerable confusion with patients as the cause/effect - illness/cure scenario was now hopelessly saturated with complexity and rather than progress with these new concepts that were being explored, they chose instead to ignore it. This produced a literal parade of con artists and pseudo scientists. With the invention of the microscope, it was easy to get common people to examine a slice of beef at the microscopic level and point out thousands of tiny bacteria crawling along it's surface- only to change this sample with a piece of horse manure and show them similar bacteria. Then one could surmise that beef had the same traits as horse manure. This was a popular line of reasoning for vegetarianism at one time.

But people were not turned off by these charlatans and snake oil salesmen. Likewise the growing complexity caused physicians to have great difficulty in explaining or dare I say 'Justifying' medical treatment to their patients. This caused confusion and frustration and strained the relationships of many Doctor-patient relationships. "What can't he just give me something for it?" This was quickly capitalized upon by con men selling 'quick fix' potions out of the back of a wagon. Where as physicians had a tendency to confuse their patients with what they saw as nonsensical bable-talk, these oil merchants put things into terms that a patient could understand 'It's a miracle potion!!!"

I would like to say that these people are a thing of the past but unfortunately they have become so common that they are have been mostly legalized. One day they may even become the preferred method of treatment. Medicine would not stand still and as we walked into the 21rst century, the technology gap became nearly insurmountable. Imagine trying to explain Pleural effusion to a person who is of the opinion that the lungs are a muscle. Or Idiopathic Intracranial Hypertension to a person that just wants a pill for a headache.

http://www.migralex.com/

Patients often attempt to treat their own symptoms long before they even know there is a problem. When a physician attempts to treat the underlying cause of the symptom, patients will often become confused. They don't understand anything outside of their primary symptom and they would prefer a method of treatment which falls in line with their own perspective rather than something that may run contrary to it. It reminds me of the body builder that put rice powder into dissolving capsules and sold them as weight lifting vitamins which will help you bulk up. Ancient viking secret of body building. The FDA had no trouble approving rice powder. Although I find his deception to be reprehensible, I secretly wonder how much money he made from it.

We have unfortunately become a fast food society, we judge all institutions as if they are a business and as a business, we judge them on speed, convenience, effectiveness and whether or not the cashier had a smile on her face. Medicine however is not a business. Now I understand that some people have created 'for-profit' models of Medicine. I realize that hospitals, clinics and doctors (especially in the US) do not work for free. Yet they are never included in the detailing of the service industry.

I once knew a Doctor who volunteered a month of his year, every year, to work in third world countries. I ask him about it once. I asked "Why are you sacrificing a month of your time to working for free? It can't be for tax-purposes, there are easier ways to get out of taxes." and he replied "Some people practice medicine and some people are Doctors but they should never be confused with each other." and he had a point. In today's day and age we have so many people practicing medicine that we have developed entire fields that have little to do with helping people. Plastic surgery and Bariatrics, where as I'm sure there will be some forum posters that will point out the few incidents where Bariatrics was used to solve a glandular problem and plastic surgery was used to fix some one who was burned in a fire... let us confess to ourselves that the primary reason there has been so much research into these two fields is obesity and giant breasts.

Since the dawn of time we have had people that attempt to capitalize on institutions that humans can not do with out. Medicine is no different. From 'for profit' hospitals to Pharmaceutical companies, we are surrounded by influences that have no problem with the direction our citizens are exploring. The very idea that patients can walk into their doctors office and demand Viagra has become so profitable that Pfizer has spent hundreds of millions of dollars in advertising alone. These groups wish that; and are prepared to convince us that; we live in a world where every problem has a pill which can solve it- and those pills cost $150 a bottle. But this is not science. Perhaps it used to be.

Patients tell me stories all the time. I know it may surprise some people to hear that I actually listen to them. I do. I may call them idiots afterward but I do listen to them. I had a patient that told me of his difficulties when he was a child. He was seven years old in 1933. He became ill. He was diagnosed with Strep Throat, Scarlet Fever and Pneumonia all at the same time. Doctor gave him a pill "A NEW PILL!!!!!!" and he got all better. True story.

I stood dumbfounded at his tale. Strep Throat, Scarlet Fever and Pneumonia all in a seven year old at the exact same time. Wow. But more importantly I wondered what pill it was that he was given. What pill could possibly cure all three of those at the same time? This story made very little sense to me on a medical level. I am not an expert in that area of diagnostics. I would say my skills would be amateur at best. I asked him what the pill was and he did not know. He repeated that it was a NEW pill. A new pill in 1933. One of the first things Medicine teaches you is to never believe your patient. They can be misguided, misinformed, biased and yes... they can outright lie. I had no idea the specifics of his condition or the type of treatment he underwent but his words always stuck with me. He knew as much as I did about the situation, mainly because he had never pursued it. He was content in his knowledge that the doctor had come along and fixed him with a new pill. This made perfect sense to him. It was fanciful to me. In all probability the physician who treated him did not know what he was doing. He told him it was strep throat, when he worsened he said 'Scarlet Fever' and when the kid got pneumonia the guy got on the phone with a guy that told him what it was and how to treat it.

I doubt we'll ever know. The patient got the answer he wanted and never questioned it.


Not to be misunderstood...

There is an inverse to this equation. Where as we have inherited a society that worships voluntary ignorance it does not need exceptions to prove the rule. I should not need to point out that physicians are not superior to non-physicians due to some class based hierarchy. Physicians are patients as well. They start off being spoon fed the same misinformation and they are subjected to the same inaccuracies and mistakes as everyone else. The only difference is that they have learned far more about their specific area of Medicine than the patient has. Even if the patient is another doctor, they have specialized to such a great extent that become an authority on the subject. But that does not mean that the patient can not do the same. I'm sure we all know the story of Augusto Odone, the Italian immigrant that single handedly treated his son of adrenoleukodystrophy by visiting medical libraries every day. (Popularized by the 1992 film "Lorenzo's Oil"). It is always with in the power of the patient to educate themselves, regardless of how much time it may take. When I say 'Educate' themselves however, I am referring to real education and giving a scornful glance at the idea that this education can be achieved by requesting random people on the internet to provide a summary paragraph of what they consider to be 'Common knowledge'.

There is a poster on this forum named GVZ. Let me take this opportunity to throw him a nod while I open up another soda. (Ker-choonk) That was the sound of the soda. I had to type it because I realize that you all can't hear it. GVZ approached me a while ago with questions about sleep science. A lot of basic stuff. Hypopneas, AHI, REM disorders, EEG, Tonic REM. A lot of this stuff he could have found in the "AASM criteria for sleep scoring" or the Atlas of sleep medicine. Since he did not know of them however, he asked me. At first I was a bit concerned about his attitude. He was doing exactly what I disagreed with. He was asking questions instead of leaving sleep science to physicians and medical professionals. But as he continued I began to realize that he was not asking for advice. Nor was he asking for knowledge in which to treat himself with. He was genuinely curious. I directed him to http://www.binarysleep.com/ and I told him he could learn a lot more from there. There are sleep docs and sleep techs and all manner of medical personal who frequented that board. GVZ began to burn through the information I had directed him to. There seemed no limits to his curiosity. In many ways I was glad to have met him. It was at that point that I felt I had met the opposite of the fast food patient. He was inquisitive, insightful and above all else- scientific. He wanted to learn for the sake of learning, not because he hated physicians or feared they were trying to deceive him. He was what a lot of CPAPTALK misfits had claimed to be... a patient that wanted to learn more. We talked all night. I told him that he would make a great sleep tech but the truth was that he would make a great anything. As a person obsessed with finding out how things work, he is every physician's dream patient. "A person that already knows part of what you will tell him and won't jump to conclusions with the things that you actually do tell him."

Unfortunately

He is definitely not run of the mill. What we have is a community that is apprehensive of science. Recently a band called "Insane Klown Posse" released a song called "Miracles." You may have heard of it. They went so far as to openly accuse anyone reffering to themselves as scientists as 'Just a bunch of liars'. If not, help yourself....

http://www.youtube.com/watch?v=_-agl0pOQfs

One of the lines of the song made headlines on pop-culture blogs all over the internet. "Fucking Magnets- How do they work?!". This was of course followed by a Saturday night live spoof but I won't get into that. Where as we once lived in a country that worshiped science as an unquestionable theocracy, it seemed to reach it's peek in the 1950s and now we have swung to it's polar opposite. Complete distrust. Neither option was very helpful but as a human collective that is all we seem capable of doing, jumping from one idea to it's inverse. We treat technology as if it is magic with the idea that we can solve any computer problem by calling the BestBuy geek squad. Even in our concepts of sci-fi entertainment we find it perfectly acceptable that the time space continuum can easily be altered by newly discovered alien technology if we are stern with Dr. Rodney McKay and yell "DAMN IT RODNEY! I don't want to hear it! You have two HOURS!!!!" I used to watch Stargate Altantis all the time but I always waited for the scene after they got done yelling at the actors that played technicians. "That damn Rodney, he is always asking for more time than he needs. I know he's lying. Fucking magnets, how do they work?" This is not a new entertainment format by any means. It is very common to see this repeated time and again in many mediums. The techno-bable talking nerd with glasses. In perpetual servitude to his leader, the handsome and whitty lead role that solves problems by force of Charisma alone.... not minding the people that work for him who are apparently capable of bending time and space inside of two hours with a device they have never seen before. This sort of guile and hubris seems to be everywhere in American culture. Indeed one may look no further than our government.

http://www.youtube.com/watch?v=u1WSs9B4H5s

Perhaps I'm dwelling a bit too much. My rant is running away with itself. Let me back up.

The Solution

You basically have three options. I realize that you may desire seven and I realize that you might wish two of those seven were of your own design. Unfortunately science is not as kind as one might like.

1: Find a good doctor. When I say 'Find a good doctor' I don't mean find some one that you like. I don't mean find one with good hair or one who looks similar to a good doctor you saw on a soap opera. I mean find one that is EXCEPTIONAL at diagnosing and treating his patients. This may be the hardest thing you have ever done. This may be hard because it requires you to think in a way that you are not used it. It demands that you throw out everything you have ever believed about physicians and get yourself a doctor based on a whole new criteria. I can't tell you how to find a physician either. The way I do it is to write 'Encephalopathy' on a piece of paper and ask him to pronounce it. The skill in which he displays at pronouncing it teaches me a lot about him. Whether it is talking to nurses or testing his knowledge or even just googling his name, you need to find your own BUT do it scientifically.

My mother had breast cancer about 14 years ago. She had a mastectomy and ended up getting lymphodema. (That is where a limb, sometimes an arm, swells up from lymphatic fluids). One night she called me up and told me that her arm was hurting a lot. I asked her if she wanted to go to the ER and she said no, she wanted to sleep and see how it was in the morning. In the morning it was a lot worse and a new symptom had arrived, nausea and stomach pain. Hurting left arm, nausea, stomach pain, possible chest pain. I was starting to think it was cardiovascular. She said "Take me to my arm doctor". I have no idea what an Arm doctor is but I picked her up and she directed me to his office. The Doctor walked into our exam room, glance from at her from the doorway and asked "How long have you had Dermatitis?" I said "Huh?" He strolled over and looked right at her arm "She has Dermatitis. Is this new?" So I puased right there and questioned him. I said "You've barely looked at her, how can you tell it's Dermatitis?" The guy pulled out a sharpie and drew a circle under her shoulder and asked "See how the skin is discolored on her forearm but not above it? Everything above this line is fine, everything below is another color." The difference was definitely there, but so faint that I hadn't noticed until he outlined it with a marker. From across the room, he picked that up with just a glance before even asking her symptoms. I didn't question him again. He had won my trust by showing himself to be superior in his field.

2: Read, read read and read some more. I'm not talking about respironics pamphlets or articles in 'Sleep Medicine and Respiratory Care Monthly" I am talking about medical books. I have told people time and again on this forum to read the "Principles and Practices of sleep medicine" and the "Atlas of Polysomnagraphy." I realize that the words may be a bit big. I realize that the content may be a bit confusing but if you take your time and look those words up, you will know more than 99% of the people on this forum. You will have an incredible grasp of medical science as it relates to sleep.

3: Do nothing. Remember that this was always your right. This was the one thing which should have been posted on the patient's bill of rights. The right to refuse treatment. The right to say "I understand that some things may be true and others might not be but I don't care. I will not seek out, nor ask anything of... Medicine."

Thanks for reading.

[Julie]

Oh dear... I know you thought that this lengthy note would somehow convince everyone to put on their 'ignorant' faces and immediately stop trying to play doctor (or practice medicine) on their own. To automatically just drop any pretense of knowledge and accept (blindly?) what doctors tell them regardless, perhaps, of even the fact that they may naturally have better instincts than some, many or all of their doctors (after all, it's only their bodies in which they have lived for decades). In the face of many doctors who, unlike your mother's wizard, may not be as naturally perspicacious at all times, may in fact be overworked, dealing with HMO's and who knows what personal problems, not to mention just not being the brightest light in the bunch whether or not they sat through years of lectures and learned to regurgitate what teachers told them. It's not going to happen! The one thing you cannot take back is knowledge. And now that we're armed with a little bit (I know, it's dangerous) we do want more and will continue to get it. Life is dangerous, but so is ignorance, and if I choose to question a doctor or anyone else regarding what might be done to my body or my family's bodies, then I will do it. Of course I'm aware doctors have more education (who decided that a specific number of years was adequate for their education, BTW?) and quite possibly excellent instincts, but that doesn't mean I will close my mind and mutter 'yassir' to every pearl they drop, or answer they give, not when my instincts are screaming that something is wrong, doesn't make sense or just plain feels wrong, and most of all not when I bring my little knowledge to the table and want to share it in support of my own life, hopefully to learn even more, but if necessary to clarify things and/or veto them when it feels right. Sorry!

[NotMuffy]

May I suggest that this thread be allowed to silently slip out of sight?

[Bons]

Let me speak from my area of training. In the 16th century priests thought that the members of their churches had no need, and therefore no right, to view scripture. After all, the priests could tell them whatever they needed to know, instead of taking the risk of untrained people coming up with their own interpretations.

And then Martin Luther decided that this was wrong. And now the Bible is the top-selling book of all time. Even among Catholics, and Catholic lay people are among the most spiritual people I know.

Or I could just tell you about the well-respected and usually very good doctor who, on a busy day and without thinking about it quite enough called in a presciption for my husband to treat his pneumonia without seeing him (sent him for a chest x-ray when he called and described his symptoms to request said appointment, rather than bring him into her office, which was a prudent decision as it reduced risk of his infecting others in the office or picking up a secondary infection). However, because she was rushed that day and didn't think, she prescribed a med. he cannot take because of his medications for his Afib. If we had simply trusted a very competent doctor, he would have been in danger. Instead, he read the package insert and then I went online (to a government agency site) and then we immediately called the doctor who said that she had goofed big time and called in a different script. Thanked us profusely for being involved patients.

Excellent doctor made a dangerous mistake and it was caught by patients who trust her but also know that it's good to know what's going on with, and into, our bodies. We'll stay with her until her retirement. But my sleep doctor, who insists I have no need to even know what pressures my ASV unit, for which I was never titrated, are set at, is being replaced today.

[Julie]

Or how about the time my long time family MD examined me when I thought I had measles (and my very first job starting that day!). When he was finished, he said that if only I had a particular little lesion in a particular spot would I have German measles, but seeing as there was nothing there, I had to stay home with 'regular' measles. Well, I took his hand, guided it to where I knew the thing was (not especially hidden) and lo and behold, there it was, so I got to start my new job after all (felt fine, just had a red trunk rash hidden by clothes).

[Calist]

and quite possibly excellent instincts, but that doesn't mean I will close my mind and mutter 'yassir' to every pearl they drop, or answer they give, not when my instincts are screaming that something is wrong, doesn't make sense or just plain feels wrong, and most of all not when I bring my little knowledge to the table and want to share it in support of my own life, hopefully to learn even more, but if necessary to clarify things and/or veto them when it feels right. Sorry!

It's funny because I write these huge diatribes and then I end up having a sixth sense when some one tries to get away with skimming through it. A person brushes through the material, assumes what it was that I said and replies to it.

Ironic that it was those type of people that I was moaning about.

[Calist]

Let me speak from my area of training. In the 16th century priests thought that the members of their churches had no need, and therefore no right, to view scripture. After all, the priests could tell them whatever they needed to know, instead of taking the risk of untrained people coming up with their own interpretations.

Your area of training? Are you a historian or a 16th century priest? I tease.

And then Martin Luther decided that this was wrong. And now the Bible is the top-selling book of all time. Even among Catholics, and Catholic lay people are among the most spiritual people I know.

Yeah but then the Beatles turned out to be bigger than Jesus. =P

I see where you are going with this but here is the thing, you are comparing the oppressive rule of the 16th century Catholic Church to modern day physicians. No one was ever set on fire for translating a medical journal into the English language. There have been no edicts which forbid the release of knowledge to the public. You can easily go to amazon.com and find out anything you want. If you are broke you can go to the public library or even download a lot of this stuff off the web. I haven't seen anything resembling the Atlas online but I'm pretty sure we can hack a kindle for it.

Physicians aren't keeping this information from you. They themselves are simply refusing to call the gossip of CPAPTALK, information. Really I figured you would go the Lorenzo's oil route with this and say that Doctors are too dense to be taught anything "when we are the ones finding the cures" but instead you went with the 16th century "They are trying to keep us from reading" angle.

Or I could just tell you about the well-respected and usually very good doctor who, on a busy day and without thinking about it quite enough called in a prescription for my husband to treat his pneumonia without seeing him (sent him for a chest x-ray when he called and described his symptoms to request said appointment, rather than bring him into her office, which was a prudent decision as it reduced risk of his infecting others in the office or picking up a secondary infection). However, because she was rushed that day and didn't think, she prescribed a med. he cannot take because of his medications for his Afib. If we had simply trusted a very competent doctor, he would have been in danger.

So you went home, cut the phone line and decided to never talk to doctors again because they were too incompetent to help you? In one breath you are telling me about how a Doctor nearly killed your husband and in the next breath you call him an excellent Doctor.

Instead, he read the package insert and then I went online (to a government agency site) and then we immediately called the doctor who said that she had goofed big time and called in a different script. Thanked us profusely for being involved patients.

A government agency site?

Excellent doctor made a dangerous mistake and it was caught by patients who trust her but also know that it's good to know what's going on with, and into, our bodies.

This is exactly the part I have a problem with. You need to understand that you have summed everything up in a single sentence. I hope that everyone skimming through this thread pays special attention to this post right here. First you make a case for "knowing whats going on with, and into, our bodies" but then we are left with the fact that you probably don't know whats going on with or into your body. I would be seriously down with every single patient in the entire country "knowing whats going on with, or into, they're bodies." if they started here http://www.amazon.com/Campbell-Biology- ... 777&sr=8-4 unfortunately however they don't. Most people do not seek to learn what goes on in their body. Instead they assume themselves to be experts after watching days of our lives.

Surely you can't agree with that. Surely you can not recommend a person refuse the advice of their physician when they have conducted no legitimate research of their own on the issue. I think most people would shy away from such a recommendation but at the same time, please understand that I see it every single day in many different formats and people get do hurt from it.

We'll stay with her until her retirement. But my sleep doctor, who insists I have no need to even know what pressures my ASV unit, for which I was never titrated, are set at, is being replaced today.

I am not so worried about replacing your sleep doc as I am about the methods you are using for finding another sleep doc. There are patients (I'm not saying your one of them) but there are patients that will seek out the scummiest, filthiest, worst doctors in the state simply because they find their opinions to be in agreement. I have no issue with changing up Doctors and from what I know of doctors they don't mind either. People change doctors all the time for mundane reasons but please please please make sure this new doctor isn't just going to write a script for anything you want with out thinking about it. Remember that even drug seekers have doctors they consider to be 'Great doctors'.

[robysue]

NotMuffy wrote:

May I suggest that this thread be allowed to silently slip out of sight?

I second NotMuffy's suggestion.

[Calist]

NotMuffy wrote:

May I suggest that this thread be allowed to silently slip out of sight?

I second NotMuffy's suggestion.

Motion has been moved and seconded. We will now vote on the.... wait a moment. This ain't a democracy. lol.

[Calist]

I have a lot I want to add to this section but I want to break it down into sections before tackling each. I have no time today but I will definitely reapproach it tomorrow. I feel that this problem is largely systemic and indicates something much deeper in society. I don't want to go after it however until I have nailed down some of the more specific symptoms. Stay tuned.

[scrapper]

May I suggest that this thread be allowed to silently slip out of sight?

I too agree.......this is not the purpose of this forum

[rubymom]

Stay tuned? You're kidding, right?

[jnk]

Would someone please offer me $1,000 to read the OP's post, so I can say "No, thank you"?

Good grief.

[Calist]

Oh dear... I know you thought that this lengthy note would somehow convince everyone to put on their 'ignorant' faces and immediately stop trying to play doctor (or practice medicine) on their own.

If I can prevent even one from doing it, it would be worth it.

To automatically just drop any pretense of knowledge and accept (blindly?) what doctors tell them regardless, perhaps, of even the fact that they may naturally have better instincts than some, many or all of their doctors (after all, it's only their bodies in which they have lived for decades).

I have known a lot of people that prefer instinct to knowledge. Ironically there are some who contend that a human's ability to oppose instinct and employ conscious logic is what set them apart from animals. This is I'm sure further illustrated by some of the posts on this thread, people that have not read my words, nor very little I had previously written but instead decided to oppose it because they found something to be slightly offensive. Now they stand confused that they can not seem to get rid of me by the power of hate alone. Medicine should not be based on instinct.

I realize that statement flies in the face of 'holistic remedies' but the statement of "We know our bodies better than anyone"- is that really true? Logically speaking, if a person knew their own body better than anyone then there would never be a reason to see a doctor at all.

In the face of many doctors who, unlike your mother's wizard, may not be as naturally perspicacious at all times, may in fact be overworked, dealing with HMO's and who knows what personal problems, not to mention just not being the brightest light in the bunch whether or not they sat through years of lectures and learned to regurgitate what teachers told them. It's not going to happen!

I must protest. I feel that all physicians need to be like my 'mother's wizard'. There is no room for laziness in medicine and I would not abide anyone in any field of it that did not give 110%. I have known people like that in medicine, I'm sure that we all have. But that does not mean that we should adopt some sort of acceptance of their attitude. There should be no physician in the world that does not know his craft inside and out, forwards and backwards and is ready to annihilate any medical challenge that presents itself. Physicians that fail to reach that point in their careers are physicians that desperately need to be run out of town.

The one thing you cannot take back is knowledge. And now that we're armed with a little bit (I know, it's dangerous) we do want more and will continue to get it. Life is dangerous, but so is ignorance, and if I choose to question a doctor or anyone else regarding what might be done to my body or my family's bodies, then I will do it. Of course I'm aware doctors have more education (who decided that a specific number of years was adequate for their education, BTW?)

"True knowledge comes in knowing that you know nothing." -Socrates.

Now that I got that out of the way- I agree. I agree that people need to learn and I agree that it is dangerous. One of the first things I learned in medicine was that know one knows all of everything or even most of one thing. People are constantly differing to others. I am an EEG tech turned sleep tech- if another sleep tech suspects the patient is having a neurological problem, that tech knows that he can come to me for assistance because I have superior experience with that particular circumstance. But I have know a lot of respiratory techs who turned sleep tech and I have gone to many of them with respiratory questions. It doesn't matter if you are a physician or a tech or a nurse, any good practitioner knows when he or she is out of their element or when a problem exceeds their practical experience. And they know that there is no shame in tapping some one else on the shoulder with a question. Notice I said 'Good practitioners'. Where as it is true that Doctors have more education, the education itself really does not matter in this situation. It is experience and more importantly- the ability to track down anything that they do not already know by simply calling an associate.

In contrast, there are a great deal of people here that do the exact opposite. Instead of seeking out the 40 or 50 years of sleep research, they are instead standing in opposition to physicians due to their own irrational feelings and substituting medicine with untested rumors. When it comes to medicine, finding out the truth is as easy as opening a book but many of the prominent posters I have seen see that akin to treason. Likewise anyone who repeats this information is then slandered. This attitude is NOT so different from the rest of the country. People make up their minds and then try to bend the facts to serve their predisposition. Where as knowledge may be dangerous, ignorance (as you said) is far more dangerous.

and quite possibly excellent instincts, but that doesn't mean I will close my mind and mutter 'yassir' to every pearl they drop, or answer they give, not when my instincts are screaming that something is wrong, doesn't make sense or just plain feels wrong, and most of all not when I bring my little knowledge to the table and want to share it in support of my own life, hopefully to learn even more, but if necessary to clarify things and/or veto them when it feels right. Sorry!

You know, I completely agree. But when does the education begin? Which textbook will be the first that a patient places upon his desk?

[mreewh]

Fall mania season is in full swing, folks.