Monday, July 19, 2010

Not Responsible Enough

I was watching Real Life in the ER this weekend (I think that's the title of it), in which real ER doctors recount their most amazing, amusing, puzzling or just plain interesting stories. The story is reenacted by actors, but sprinkled throughout are interviews with the actual doctors. Mostly I watch it for the "how could anyone survive that?" element (a screwdriver through the skull, a tree branch from anus to diaphragm, etc.).

The episode I watched this weekend included the story of a mentally ill homeless woman who arrived in the ER, in the middle of a breech birth, completely denying that she was pregnant. The doctor, a resident at the time of the story, recounts how he delivered a breech baby with only basic textbook knowledge of how it's done. Then he starts to reflect on the miracle of life, the circumstances the child faced, and said this:

I mean, his mother wasn't even responsible enough to know she was pregnant.

Um, what? "Responsible" was really the word you were looking for, doc? "Responsible"? We're talking about a mentally ill homeless woman. Mentally ill. As in sick. As in, that woman with food poisoning wasn't responsible enough not to throw up. That diabetic isn't responsible enough to produce insulin.

Responsible was not the word that doctor- doctor!- should have been looking for, but I bet that's exactly what he meant.

I encounter this attitude all the damn time. "Ugh. Why do I always have to help you open jars and carry things? It's so annoying." Because I'm not strong enough to do so. I'd like to be stronger. This annoys me, too.

"Why are you always dropping things? It's like you do it on purpose." I have carpal tunnel. I'm losing the feeling in my hand. This is worse for me than it is for you.

"Why did you do that?! Why did you fall over- you almost broke the TV!" And my arm, thank you. I have problems with my balance. I think I'm straight, but I'm really leaning to the right and . . .

Fuck you. You know I'm sick. I've explained this to you. Figure out what that means and leave me alone. And take your responsibility with you.


  1. Unsettlingly many doctors are just totally deficient when it comes to handling mental illness. It's so incredibly rage-inducing that when I've encountered it during family members' mental illness episodes, it really takes all my self control not to start choking and kicking and biting. The most seemingly ignorant attitudes I've encountered are, in fact, NOT in the ER, but in the psych wards themselves, and not specifically stuck to the doctors, but to the nurses and assistants. In my unfortunate experience, there is a real epidemic of forgetfulness when it comes to the fact that MH patients are sick. I've heard a doctor (a general practitioner/family medicine guy at that!) dress down a psych ward for treating its patients with such little humanity or respect with the exact phrase, "If this were the ICU and your patients had heart failure, you would never DREAM of treating them or their families the way you're treating these people." He got damn heated, and again, it took all my self control not to stand up on a table and start cheering. I understand that MH patients are often frustrating - their behavior is not rooted in a rational mindset - but come ON. If you're working in a hospital, you signed on for this. Learn to deal with it appropriately. I knew a psychiatrist who lashed out at an acquaintance with adult ADD because the patient (my acquaintance) kept interrupting him. It's just like... DUDE. If you're going to deal with ADD patients, you have to know they're going to interrupt you. BE PROFESSIONAL.

  2. That's just sad. Lashing out at someone with ADD for interrupting? It's what they do. Get used to it. (I had a very good friend in college with ADD. I learned to talk in sentences of 8 words or less.)

  3. I have found, due to the chronic nature of the aftermath of my injuries and disabilities, that people may "feel for you", but damn few want to touch you.

    How many times have I been told, "You're not responding to treatment", usually accompanied by a belligerant, accusatory frown?

    If I suggest that the problem may be misdiagnosis, the wrong prescription, the fact that the "professional person" (as opposed to me, who was, presumably at one time a "promising amature person", who never fulfilled his potential) might have his "professional" thumb up his ass and his professional "brain" in neutral, this is met with anger, scorn, contempt, ridicule.
    Then, a couple of months of misery later: "Son-of-a-bitch! We sure missed THAT one"!

    I have learned to address and interact wit doctors and academics in the same way they do me.
    Drives them apeshit.

  4. okay, next time i go to a doctor, i'm bringing sarge as my translator. i imagine it going something like this:

    Me: my knees is bothering me a little . . .

    Sarge: what she means to say is that you aren't doing your job, moran, and you need to take one little piece of all those years you apparently wasted in med school, use it remove your head from your ass and then take a look at her knee.

    Me: yes, actually, that's exactly what i meant.

  5. Me, too. Sarge, I think you have a promising career as a medical translator.

  6. Actually, you need my wife. I am often unable to speak or express myself (last winter my mouth was actually wired shut for several months) but over the years she has become noted among much of the local VA staff as person of perspicacity and ferocity.

    I stand up for myself, but when I'm unable to communicate she weighs in. Her addressing of one of our medical elite at one location as "Dr. Puffbuttock" was enjoyed by all.

    But thanks for the consideration.

    It is fun, when they insist on being called DOCTOR" TO SAY, "or you'll do what? Not cure me? That horse left the stall a long time ago".

    Most "professional people" who "have degrees" are probably not worth breeding from, and their competence is usually pretty iffy.

    I've found that people will bow, defer, and scrape to just about any entity that has "academic credentials" no matter what.
    They get a pass. They could be the most incompetent boob ever to put on a lab coat and cripple hundreds, but he's still "doctor". I personally respect a good carpenter, plumber, or auto mechanic more by factors of thousands.

  7. Sarge - either you've been stealing my thoughts, we're long-lost twins, or you've been to the same selfish, self-centered, sanctimonious, STUPID and stubborn and incompetent doctors i have.

    sigh. what the FUCK is WRONG WITH DOCTORS?!?!?

  8. PF, I'm the permanent legal guardian for a young woman with severe autism. She was one of my GAL kids and when she aged out of care, she needed someone who could do a better job for her than the local Guardianship Program could. She's totally nonverbal and relies on people paying attention to her to even discern when she's in pain and such.

    Last Friday, she got upset at her summer school program and when they couldn't calm her down, they called the police. They Baker Acted her (that's a 72 hour Mental Health hold). I finally was able to get her out of the hospital this afternoon. What did I find on her intake paperwork?

    Atypical Psychosis with Auditory Hallucinations.

    "Why did you think she was having auditory hallucinations" I asked. "She's nonverbal. How did she communicate to you that she was having hallucinations?"

    "When we talked to her, she covered her ears, closed her eyes and rocked back and forth, crying," they said.

    "What was the aggression?"

    "She bit herself."

    So they took a 20 year old autistic woman, handcuffed her, drove her to a hospital in an ambulance with a siren and flashing lights, put her in a strange bright room, with strange dumb people, badgered her with questions she can't answer and she covered her ears, closed her eyes, rocked to self-comfort and when that didn't work, she started biting herself?

    I give you the state of mental health care in my county....

  9. Marzie...

    i don't know what country you're in [i am under the impression that you live in a European country - but there's HOW many? and, of course, i could be wrong in my assumption, that happens]

    but i don't CARE what country - every single one of those assholes should be tortured as SHE was.
    starting with the school people! WHAT THE FUCK WERE THEY THINKING?!?!?!? why didn't they call you???!

    just - i weep...

  10. The Baker Act is a Florida statute so I'd guess... much closer to home.

    Unfortunately, "mental health" facilities (in any country, really) tend to largely be staffed by the grossly incompetent and/or barely functional because the better practioners in the field tend to wind up elsewhere (where the pay is far better, and the work far less unpleasant, or at least less voluminous). You may be familiar with the axiom that "Those who can't do, teach"; well, in psychiatric circles by and large, those who can't even teach end up working in mental health facilities.


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