The Neighborhood Internist & An Embarrassment of Gynes

I went to my internist yesterday because L kept telling me I need antibiotics.* The chemo nurse thought I might, too, since I've had this cough and sore/dry throat for two weeks. She said I could still do chemo April 16 if I was on them. I don't know how long I've been going to this doctor. Maybe 10 years? I started going to her erstwhile partner, an older (than me) Belgian woman who B and S see. I didn't like her. I started crying in her office and she told me I was depressed, not anxious. I know I'm anxious. I don't have anything against depression, but that's not what I am; I don't feel there's a stigma with it. I've never had the classic signs of depression. Though I know I interchange the terms here in this blog. I thought it was arrogant of her to say abruptly and brusquely, You're depressed. So I went to the partner, who's Filipina, about my age, and who since moved to another office in the same building. Her staff speak Tagalog, so there's a mix of English and Tagalog in the office. Both arespoken quite muscially. There's always a wait. I was running late so I drove and parked at a meter. The appointment was at 11:45 and I got there about 10 minutes late. She saw me about an hour later. I worried about the meter but as I was contemplating going out to feed it, my name was called.

This doctor is always in a hurry but she's not so hard to reach by phone. She called me when she heard I had breast cancer and said she was praying for me. She didn't blink an eye at my cupping marks. She prescribed an antibiotic and said to call on Monday if I wasn't better, and she'd prescribe a steroid. Which I'd like to avoid since I had two courses of them in the late summer and fall and I think the chemo has steroids in the mix. And if so, shouldn't those steroids be helping my breathing?

Caveat: Now it gets personal. You may skip.
She did a Pap smear because I hadn't had one in 15 months. My periods have been so long that it was hard to schedule one. She found a polyp and said I needed it removed. She said I should also have an endometrial biopsy because of my long periods (which may be stopping because of the breastectomy and chemo). She said I needed to check with my gynecologist.

I do not know who my gynecologist is. I have a wonderful nurse practioner/midwife (Don't ask--I've never been pregnant) who hates the health care system and spends a lot of time in appointments and on the phone. But she can't remove polyps. She sent me before to a young gyne who removed a polyp and was going to remove my ovarian cyst and scrape away my fibroids but got freaked when I said I wanted to keep the ovary and just have the cyst cut out. She was afraid I'd be mad at her if she took the whole ovary out. So I went to a doctor she recommended, then I went to a doctor my friend A at Fancy recommended, and he did the surgery--removing both the ovary and salpingo (Fallopian tube, but salpingo sounds so much better). He said that fibroid surgery often doesn't work. (My cousin who has them has found this out the hard way.) This gyne is fine, though too good-looking to trust as a doctor (my irrational bias) and it takes fifteen layers of bureaucracy to get in touch with him. Both the nurse practioner and young gyne are easy to get a hold of. But neither is connected with Fancy Hospital. I guess I will call the Fancy one and see if I can get an appointment. I must add that my internist has been concerned about a lump on my former left breast for almost two years. She sent me to Saint Hospital to get an ultrasound about a year and a half ago and I was told it was nothing. She wanted me to get it checked out again this summer. Soon after I went to the male gyne and he told me it was nothing. It was nothing, if you consider that Stage 2a cancer is nothing...

I told L this afternoon that I'm breathing much better and he said in a deadpan voice, It must be the cupping.

Last night we dinner with our good friend V. She is our local friend V. We also have a Michigan friend V, who took the photos on this page. I was telling our Chicago V that an acupuncturist cupped me, and V kept saying, I don't believe you. Then she explained that she was thinking of cupping as it was practiced in the steel mills where she and L used to work. It's a prank I can't hear enough about for some reason. The workers would get a styrofoam cup and stick it in grease and then place it surreptitiously on top of the hard hat of a foreman. The foreman would wear this cup, looking ridiculous, until he figured it out. It's a variation of taping Kick Me on someone's back. It was very good to laugh and laugh over our very nice dinner of enchiladas and tamales. (I have become liberal or loose in Passover observance. I embrace my alleged Sephardic roots and eat corn, beans and rice, which they are allowed to eat on Pesach.)

Then I showed her my back and L said it was burned but V confirmed it was not. Though the polka dots are still red.

When I got back to my car after seeing the internist, the meter had run out and I had a ticket. I couldn't bear to look at it but I'm sure it'll cost more than the co-pay and antibiotics together.

*L claims he didn't keep telling me, that he told me once or twice.

2 comments:

Garry Cooper said...

Docs are way too quick to diagnose depression--and very inaccurate at it. They can't differentiate between normal reactions to bummer events and depression--two very different conditions which require very different responses and treatments. I think their overzealousness about diagnosing depression is partly due to the fact that they've been trained in the fiction that antidepressants are a magic pill (in fact, antidepressants, like most treatments for depression, work about 2/3 of the time. And placebos work a third of the time). Ergo, they're quick to diagnose depression because they believe that once they diagnose it they can cure it.

Garry Cooper said...

addendum: today's Washington Post has a review of Jerome Groopman's new book, How Doctors Think", which sheds excellent life on above post. http://www.washingtonpost.com/wp-dyn/content/article/2007/04/05/AR2007040502325.html