Tuesday, September 27, 2005

Another Experience with Animal Medicine

Daughter Eleanor, whose earlier experience with Animal Medicine was the subject of a recent posting, now reports another and concludes with a comment on who should make clinical decisions.

In a truly remarkable set of coincidences I have had further opportunity to notice the difference between human and veterinary medicine.

One of my friends got diagnosed with breast cancer last spring - underwent a lumpectomy and radiation, and found (on her own) a lump in the other breast four weeks ago. After waiting two weeks to get in for the biopsy, she is now going on week four waiting for the results. Call after call to the Doctor’s office has resulted in promises to call back - but so far, no call. Her pushy friends are going to go to the Doc's office with her tomorrow and demand her file (which is her property) and look at the test result.

By contrast, my cat – earlier diagnosed with cancer - had some strange new symptoms on Wednesday. We saw the internist who is filling in for his honeymooning oncologist (that seems like a pretty good excuse to be away to me) on Friday afternoon (I couldn't make it up there in time on Thursday). She examined him in the truck (he freaks out in hospitals) and then spotted the staff neurologist out with some patients. We walked over for a quick consult, which lasted for twenty minutes. Then we went back and did some more checking on Auggie (my cat, named for St. Augustine), after which she went back to her office, looked two things up and came back with another round of chemo therapy in case that was the cause. Two exams, a neuro consult and chemo all in under two hours, and I never left the truck. I forgot to pay the bill before I left - but I will get it in the mail today. I'll be surprised if it is over $200.

Oh, and Auggie's doc called on Saturday to see how he was doing.

Try getting that kind of service in a people hospital.

I then called my ex-husband, a neurobiologist by training - and asked what he thought, did the two tests he suggested and called back the doc - who was happy to get the additional thinking on the problem and I am now waiting for a call back from her after she talks to the oncology and neurology staff again. She'll call tonight (after rounds) or tomorrow AM.

Try to find a people doc who will listen to a Ph.D. non- MD and take it seriously. Or even approach a complex set of symptoms as a systemic problem to be solved. They are out there - but few and far between in my experience.

Harvard Alumni Magazine last month ran an article on the effects of sleep deprivation. I for one will never go to a teaching hospital and be looked at by residents ever again. The data is clear - sleep deprivation makes you stupid, clumsy and irritable. Chronic sleep deprivation may make it irreversible. Maybe this is one of the roots of our problems in human medicine - we don't pay attention to the data.

Who should make medical decisions? I vote for smart, knowledgeable people who have gotten enough sleep.

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