Chapter 6/1

The Medical Dialectic

In the summer of 2009, our daughter had four major surgeries to correct almost unbearable physical problems. It was a medically dialectical summer. The medical dialectic comprise three things: doctor/patient relationship; the doctor’s thought pattern, particularly in diagnosis and choice of treatment; and the nature of medications.

Doctors Are Not Gods

The Dialectic dictates that we live by dialogue with each other. In a medical situation, this means that: we should be prepared to tell the doctor clearly and concisely what we understand our problem to be; the doctor should be a good listener; and she should be prepared to engage her patient in question and answer dialogue. Too often we give our physician an incomplete and somewhat vague account of our symptoms and their history. If our problem is at all serious, we might be wise to take written notes with us lest we forget something important.

In Neil Ravin’s novel, M.D., he tells of a woman who after months of being treated for asthma, told her doctor that she only wheezed when she was in his waiting room, a room furnished with wool-upholstered chairs. And she was allergic to wool. When asked why she had never before mentioned this, she responded that he had never asked. Needless to say, her physician cancelled all her medicines and suggested she stay away from his waiting room. Who was at fault in this situation? Was it the doctor, or the patient? He had not asked, she had not told. No Dialectic at work.

We need to give our doctors the clearest and fullest information we can, and we need doctors who will listen and be willing to deal with our questions. Otherwise, the Dialectic will not work. If we find ourselves with a doctor who has a god complex, one who dictates without listening, a doctor who makes us uncomfortable, nervous, or angry, we should find another physician. If, for some reason, we question the doctor’s decisions, the Dialectic strongly suggests we get a second opinion before proceeding. The doctor-patient relationship is one of the most important elements in our ongoing health.

Earlier, I said that our daughter Cynthia had a medically dialectical summer. She dismissed her family physician and a prominent specialist because of, among other things, unsatisfactory doctor-patient relationships. Moreover, Googling led her to seriously question the procedure the specialist had scheduled. She searched for another specialist from whom she could get second opinion. When she did find the one specialist in the state who was qualified to deal with her specific condition, she found that, even there, she had to separate herself from one of his arrogant nurses.
Cynthia took the initiative for her life and health and did extensive research on her problem. On the World Wide Web, she found that the procedure recommended by the first specialist was dangerous and had many enduring side effects. But, she he was able to track down, via the Internet, the Houston specialist who, by way of three surgeries, ended her problems and restored her to a normal life.