Saturday, April 14, 2007

Playing the Blame Game

There was an article in this morning’s paper about doctors who blame the patient
http://www.sacbee.com/107/story/154551.html

It’s happened to me. Doctors who ask me about my health/exercise/dietary habits, and because they cannot imagine that it is possible for someone with such healthy habits to be so sick, they accuse me of lying and demand that I confess to being a coffee-swilling alcoholic couch potato who smokes 3 packs a day and a steady diet of junk food, because the extent of my disability requires they blame the patient for bringing it on herself. They just can’t get their heads around the notion that healthy habits are not a 100% guarantee of health.

As Dr. Wilkes notes in his conclusion “sometimes bad things just happen”. I ate right and exercised every day. The only thing that I did to bring this on myself was to leave my apartment during flu season. Somehow I came in contact with someone who had the bug that gave me the virus. Since none of my friends or co-workers came down with CFS, none recalled being sick the same week I did, the assumption has to be that it was a chance meeting with a stranger. If you want to put the blame on someone for my illness, let’s put the blame on the person who was out and about while contagious, sharing their germs with innocent bystanders.

One of my friends has a car that seemingly has a target painted on the side; I’ve lost track of how many accidents she has been in where she had the green light and was T-boned by someone who ran the red light or pulled out without looking; she’s an innocent victim, too. The only thing she’s guilty of is having extremely bad luck. The police have cleared her of blame in every accident.

Let’s address the mind-body connection here. No, I’m not insinuating that CFS/fibro have a psychological cause. But there is evidence that someone who is already sick will feel worse physically when they are under mental stress.

The doctor who lays the blame for the symptoms on the patient will bring on an attack of the guilts that will more than likely make the patient’s symptoms worse.

It was this false assumption that I was lying about my diet and exercise, alcohol consumption, etc., that likely played into the doctors’ refusal to give me pain pills. Pain pills can also be used to party with -- I know one fibro patient who now takes for pain the exactsame pills he used to party with, but with far different results -- so if I was lying about what I did that caused the illness, then it can be assumed that I’m also lying about the amount of pain I’m in so that I can have pain pills to get high on. Or maybe so that I can sell them on a street corner to have some income because I’m not working.

It’s simply counter-productive to blame the patient. It’s more important to look for the real cause, not give the patient the third-degree followed by a heaping load of guilt. Or an unwarranted psychiatric diagnosis. If someone had made more of an effort to find the physical cause for my symptoms early on, I might have gone back to work within a few months. Instead, we missed the window of opportunity because doctors were playing The Blame Game.

“Go home and don’t eat any of the things that you’ve said you don’t eat, and then come back and tell me if you feel better not eating what you already don’t eat” or “go home and exercise every day for two weeks and come back to tell me if you feel as bad as you say you feel when you exercise” has only one benefit -- it benefits the doctor’s profit margin by getting the patient to pay for another pointless appointment.

Patients go to doctors to get help, not to get blamed for having an illness that they have no control over. Yes, some people get cancer because they chain-smoked; some smokers never get it and some people (most prominently Dana Reeve) get cancer without smoking. So, there’s no reason for doctors to automatically assume that every case of cancer could have been prevented by not smoking, or that a patient is lying when they say they never smoked.

Dr. Wilkes, in his article, puts the blame where it really belongs: on doctors’ attitudes. So does Nurse Fransen (see prior blog post).

Don’t let yourself be made to feel guilty because you have CFS/fibro. You did nothing wrong.

I have faced down many doctors who assume (or, as Professor Kingsfield explains, “make an ASS out of U and ME”) that I smoke (not even one puff in my entire life), drink coffee (gave it up 30 years ago), drink alcohol (I got out of the habit of having it in the house when I was married to an alcoholic), eat fast food (since I don’t drive, it’s not “fast” -- it takes me longer to get to the nearest fast food and back than it would to cook a healthy meal at home), don’t exercise (when you don’t drive, you walk; even when I take the bus, I have to walk to/from the bus stop), and don’t want to work (yuh-huh, which is why I dragged myself back to work in 1987 the day after I was first able to sit propped up on pillows, and in 1999-2000 continued to drag myself into work as my condition got worse and worse, and started my own business the day my Unemployment ran out).

Daring to call the doctor wrong may earn me a reputation as a difficult patient, but someone has to tell them that their assumptions are faulty when they blame me for things I have no control over.

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