Headed Home & Random Updates

Twelve days later, and I am returning home to my “Pack” of critters and my spousal-equivalent (what a romantic term…). In the almost 20 years that we have been together, I had never been away from my family of choice for more than 1 week . Despite all of my concerns over being homesick, leaving the safety of my food controls, and entering into the heart of my past, the time flew by.

I intentionally took my professional physician-hood with me – both as a self-protection against the illness surrounding me and to deal with my parents’ doctors (something I had never done as I am loath to play family doctor with my relatives). This worked surprisingly well, and I had warned my family ahead of time of my intentions. Using my jovial and best Texas drawl (doesn’t take long to lope back in to it), I would introduce myself, “Hello, I’m Dr. X, please call me Jan.” I met wonderful nurses, food service personnel, respiratory therapists, and hospital aides during my father’s inpatient stay. He loved the neurosurgery or surgery resident who visited with him every morning. The attending neurosurgeon (see post and comments below) only saw him immediately post-op and right before discharge – just as well. There is a reason the medical school involved graduates the second FEWEST number of primary care doctors out of the 141 schools in the USA.

Comments from family and friends who have had quality experiences with surgeons (including me – thank you again, Dr. Katie Artz) have been swirling rapidly across my phone and e-mail since the post about my father’s surgery. Let me reiterate that many surgeons are wonderful physicians – there just aren’t enough of them, and there are not enough excuses for poor bedside manner among physicians of ANY specialty.

My mother’s cardiologist is a good clinician and excellent communicator, though he looks younger than our puppy. Her primary care doc is amazingly aware of her myriad conditions and addresses most, especially when prompted – it’s good for those visits to have another face in the room to slow him down. I’m glad that I no longer practice primary care – the office setting remains overwhelming; patients management is becoming more complex; needless paperwork continues to grow; and insurance companies are more intrusive than ever. (I had another “lovely” encounter with the folks’ Medicare HMO that ended up with much threatening on my part and finally some service on their’s.)

Spending time with my sister who does the primary care-taking of our parents was a joy and a privilege to be able to give her some respite. The few hours that I was able to be with my hard working bro and his wife (my 3rd seester – our family’s spelling) was an absolute delight and far too short. The family has many tough decisions ahead as my father attempts to recover back to baseline, and my mom probably faces her 3rd heart valve surgery for severe congestive heart failure.

Eating was mostly OK. I experimented with sweets and diet drinks – blech. I pined to be able to walk but self-imposed obligations and ungodly heat/humidity kept me from exercising. I cannot wait to get back on track to “clean” eating in a structured format. Oh, I did buy a swimsuit – my sagging skin would put me in a freak show, but HEY! I have curves again!

Update on Miss Mattie: Her ocular tumor was a melanocytoma meaning almost no risk of spread. We are all most grateful, wondering if something less invasive could have been done (radiation?), but she is learning to bump along with one eye and ominous wink.

I will get back to posting more sanely and also honor Karen@Waisting Times‘s blog award when I get off the iPad. Learned much about my history from my dad…

Post-op Day 1

Who could have imagined that my biggest source of frustration so far would emanate from… other physicians. That is, if surgeons are really physicians and not just technicians.

A physician is respectful of her/his patients – does not make jokes about their age, refer to them as ancient, nor sneer when speaking to family members. A physician does not ignore standards of care when managing postoperative pain – the very pain she/he inflicted. In fact a physician cares about the well-being of his patient beyond the organ or disease or injury he is trying to treat; listens to input of others involved in the patient’s care (nurses, therapists, even lowly family members who know the patient’s baseline health care status best); and takes time to conduct more than cursory examination of the wound site (perhaps then he could recognize the signs of significant blood loss).

Yes, it is a rare surgeon who also is a physician. Fortunately for Dad, my not-so-subtle involvement in his care has brought a hospitalist to his bedside so I can sleep tonight without worrying that he is suffering needlessly or at risk of complications because a real physician is not available 24 hours a day during his recovery.

Closing rant summary:

A surgeon at a top ranking medical facility is not necessarily a good physician.
Families must be ever vigilant in their loved ones’ (and their own) medical care.
No amount of health care reform will make a good physician out of someone with a medical degree.