Saturday, September 03, 2011

"Practicing" Medicine

I am reminded today why doctors "practice" medicine. It is supposed to take at least 10,000 hours to get really good at something but there has to be more to it than that. What if the right lessons aren't learned, or the practice-part is off-kilter?

These questions swirl around in my brain now because the poor communication skills of my mother's oncologist and his Galleria-mall-trained front office staff is really so much worse than asking the same stupid questions and approaching an ill old woman in front of God and everyone and announcing, "so yeah, you can't have chemo today or you'll die."

The head-smacking part is this: Way before the bladder cancer invaded Mom's pelvic wall and pressed on her kidneys, causing such agony she called 911 and had to deal with the dirty boots of local paramedics on her clean carpet, Mom was seeing this doctor for blood marrow problems. He is a hematologist AND an oncologist. There must have been some kind of special going on when he finished medical school - two specialties for the price of one. Plus, a discount card for the local coffee place.

In keeping with the tradition of this medical group's mantra of never speaking to other doctors unless absolutely necessary, he diagnosed a myo-something-or-another blood marrow disorder that danced all over her immune system and ate platelets for lunch. Since the gastroenterologist was never in the loop, this duo-immersion hematologist/oncologist apparently didn't know about the medication the stomach doctor gave her to squelch that pesky Crohn's Disease. Now here is the funny part: The immeron? The drug that fights Crohn's? (Wait for it...) It wreaks havoc with blood and kidneys!

Why did Mom's kidneys almost fail during chemotherapy, boys and girls? YES! And why did she need 2 blood transfusions, injections of a medication that costs $7,000 for five doses, and require half-chemo doses the last two treatments? YES! It seems patients who had Immeron CANNOT TAKE CHEMO! Go figure!

Being a good reader, I often make connections between texts I read and the real world. That often spills over into real life. At school, we are immersing ourselves in the work of Jim and Charles Fay, the developers of a self-discipline program called Love and Logic.

There are two logical responses I have for this practicing doctor who never told my mother that her bladder would eventually have to come out or that the chemo isn't going to kill everything because it will kill her first, and that 77-year old bladders cannot be called "antique" and made into stylish handbags.

The first response is vintage Love and Logic: I shall call the office, shake my head, and say, "Bummer." After waiting awhile, I will add, "There is going to be a consequence, but quite frankly I don't know what to do about this right now. But try not to worry... I will think of something."

(Now to re-read the NEXT chapter.)