Doctors expect patients to be “compliant”—that’s a very important word with them—and compliance extends beyond “Take the medicine I prescribed.” It really means to be pliant. Accept what I say without argument. Sit in the chair beside my desk and nod obediently. Do not question. Do not challenge my rightness.
I have had more than one doctor, when I’ve challenged him, say to me, “I went to medical school!” but they were not arguing with me about medical reality. They were not giving medical facts to explain why they were right. They were citing their medical degree as evidence of their authority. The message was, ‘Because I graduated from medical school, I’m powerful.’
Decades ago, I worked in the Syracuse University Bookstore Shipping and Receiving Department (also called “The Basement”) under the direction of a guy who was a retired drill sergeant. If you questioned why you had to do something, he would bawl, “BECAUSE I’M THE BOSS!” It not only was clear and concise, it was honest. ‘I am in charge,’ he was saying, ‘because that’s the way the system works.’
There’s a big difference between being ordered to do your job and being ordered not to question your health care.
Doctors have confused medical knowledge with power. We all want to be the boss. We all, as human beings, want to state what we believe to be true, and have it unquestioningly accepted as truth. My neighbor wants me to agree with her theory that we’re going to have Indian Summer for a week but I can’t do that because the Weather Channel is predicting temperature drops into the thirty’s starting tomorrow night and I’ve learned that they’re more right than my neighbor. We all want to be believed and validated. My friend’s boss wanted people to believe that he was smart and had brought in a good computer project.
It is critically important to our sense of self to have people tell us that we are good, and right, but “good” and “right” are not synonymous. You can be a very good person but still make mistakes and get it wrong. Likewise, you can get the job done right every single time and still be a son of a bitch. There is no correlation between what is right and what is kind. The parents of a child with Down’s syndrome were maligned for sending the child to mainstream kindergarten instead of putting her in a special education class. Their reply was that maybe their child could not learn to spell but, by being with others, she could learn to be kind.
Doctors do not learn kindness. They think they learn rightness—that they always and only know more than people who haven’t gone to medical school—but they’re wrong. The body is impossibly complex. No doctor can know all the answers. The wisest doctor I know, in the face of my persistent questioning about a medical issue, threw up his hands and exclaimed in exasperation, “I don’t know!”
“Well all right,” I said, leaning back in my chair and laughing. “That’s an answer I can respect.”
I have a suggestion. If doctors worked on goodness instead of rightness, they might be loved, and a loved person isn’t afraid to admit mistakes and ignorance. Too many doctors are trying to work out their salvation by being right, or at least maintaining the appearance of being right. One of the ways they try to keep up this appearance is by keeping me away from them. They send me certified letters telling me to leave them alone.
Doctors, probably because they’re smarter than most people, have set up a system in which their rightness is never challenged. The Office of Professional Medical Conduct very rarely finds a doctor guilty of doing wrong. It is almost impossible to bring a lawsuit against a doctor. Doctors go forward safe in the unchallenged certainty that they’re right about everything, and when somebody like me comes along to stand up and point out their errors, they try to silence us just like my friend’s boss did.
And how did that story end? My friend bought me lunch on Friday, laughing because the company president had just fired his boss.
Your doctor has no boss—unless you become one. If we formed a union of patients, we could turn the medical system around.