Today I went to an appointment with my neurologist. It was uneventful, but interesting in the larger scheme of things.
We talked about my surgery last month, and how I’m running 30-35 miles per week, and swimming too. He asked about new pain (some minor tension where the prosthesis went into my left temple) or concerns (none to speak of). No more medications, and I’m back to work full time too. Good stuff. The doctor was very cordial and positive.
The interesting thing is that the first few times I visited him, he was very detached, and fairly dismissive. In fact, during our first visit, he spent a good bit of the appointment reading through my files while Kris and I sat and waited. He didn’t ask me much of anything, and only asked Kris a couple of questions. I left feeling like a hopeless case, since he’d pretty much dismissed my presence. At the end of the appointment, he remarked "well – we’re out of time, so I can’t really examine you, but you don’t look like you’re up to it anyway".
He was right, I wasn’t up for much at the time. The sad thing is that the first time he’d really spoken to me was about 45 minutes into the appointment, and it was dismissive.
The second and third visits were pretty similar. I recall asking for clarification about something, or expressing some confusion about a recommendation he made once, and he rationalized it as him being a smart guy who’d dealt with these things for a long time. Another time I remember sitting there with Kris while he read through the papers quietly, and then asking Kris whether she wanted to neck. After all we were just sitting there waiting anyway, so why not have some fun? The doctor didn’t even bat an eye – he stayed busy reading through the papers.
Things changed after I improved (following the first cranioplasty). He spent time talking to me, and asking questions about how I was feeling. In fact, the past few visits have included lots of connected conversation, answered questions, and explanation of his recommendations.
I imagine it’s difficult for a doctor when your patients are not doing well, and have varying levels of cognitive abilities. And doing that for years must cause some amount of emotional detachment. I’d have to say though that I’ve not been a difficult patient. I took good care of myself, followed recommendations, and have a very supportive wife who acted as a good caregiver during that time.
Speaking as someone who’s turned the corner on recovery, it would have been an easier trip if my doctor treated me like a human being all the way through. Human beings with Traumatic Brain Injuries have many fears and concerns – because much of what we’re experiencing is new and very frightening.
If you happen to be a doctor reading this, please take it to heart. Showing a consistent and caring bedside manner makes a huge difference to your patients.