Doctor patients and doctors’ responses: two tales

A doctor becomes a patient

Don’t give your daughter driving lessons

On a long drive so my daughter could log more driving time before taking her driving test, I got pain down my left arm – again. Not cardiac of course, just an abused cervical spine – self-diagnosis.

True to doctor form (no GP), I organised my own neck CT. Yes, it was inconclusive and did not fit the anatomical distribution. So off I went to a neurosurgical colleague. Again could be neck but I should get a consult from a thorough physician colleague with a bias towards vascular – need to exclude the unusual, that is cervical rib and Raynaud’s-related pathology.

That too was good – no pathology found but some carotid ultrasounds would help. Ducking out between seeing patients two days later for the ultrasound, I became a patient and learnt to be scared. The ultrasonographer repeated the study again and again, not answering my queries. Then the physician was summoned and there was whispering in the corner. When he spoke to me, it was in that empathetic soft, slightly deeper and slow way – we all do it. This was something bad.

The rollercoaster began – mostly down. I had a virtually occluded carotid artery so needed an immediate angiogram (like any doctor I’d had no breakfast, just a quick early cup of coffee, so was already fasted).

Vascular surgeons were summoned, and scheduled an urgent carotid bypass. I had the preop blood tests, ECG and anaesthetist review while still in the angiography suite, and made the difficult phone call to my wife. But the worst bit was the preop chest
x-ray. For this, I had to be pushed on a trolley (I had to be horizontal because of the femoral puncture for the angiogram) from angiography to the x-ray facility, in front of staff and patients at lifts and in corridors. As a staff member, you try to keep a low profile once sick (but I was not sick, I had no symptoms) and definitely try not to be a pushy doctor.

Why are we embarrassed when people show kind and sincere shock, concern and caring at our plight? I don’t know, but I was. So around a corner I pulled the sheet over my head – solved, no one could see me. However, a group of people cried in horror as a dead person was wheeled past. Sheet off my head, more corridor recognition and enquiry, but a successful operation on a lucky doctor saved from a big stroke.

I have learnt to live with my ‘cervical radiculopathy’, as well as a lot about being a doctor patient. MT

A doctor responds to having a doctor as a patient

Ignorance can be bliss

Denying pain, muscle atrophy and a limp, I finally got a CT of my lower back. I eventually needed two CTs because there was a lesion at a higher level (the L2 nerve was the problem), as well as an MRI (the disc protrusion had separated and sequestered through the dura). The clinical literature rates such sequestration at one in one to two million cases of disc herniation.

The operation was a success but in recovery, due to lack of ordering of an antiemetic, disaster. Vomiting and retching, I heard and felt deep sutures in my spine snapping. Still I pleaded for an antiemetic. The doctors were busy with the next case but said they would send me to the ward where the RMO could fix it. Sensing a catastrophe, I asked staff to page the ward RMO, who I knew well, to have her meet me on arrival. During the trolley trip, vomiting in the lift (I never vomit!), I got worse but all the damage had been done (I spent months lying flat as the continued CSF leak required a second operation).

On arrival at the ward, I was transferred to a bed by concerned staff. I asked where the RMO was, but no one knew. Five minutes later she came in the door clutching a bunch of flowers and chocolates that, being the caring doctor she was, she had rushed to buy when she heard I was the patient.

A truly beautiful moment after a nightmare I still at times remember, especially when my back hurts. MT