I’ve barely sat down. I’ve mentioned some issues with chest pain and vomiting – the chest pain new, the vomiting persistent over several years. Still, she is certain. I am not.
“Are you sure? It doesn’t seem like -”
“What you’re describing is gastritis. It’s from your medication.”
“It started before -”
“Look, hop up on the table.” She palpates my abdomen. She is thorough, professional.
She sends me home with prescription strength antacids and a promise to “handle the rest” in a month once the gastritis eases.
A month passes. It was not gastritis.
I resort to google and friends who have had similar symptoms. I delve into literature, I look for options. I realise the chest pain is just muscular, a strain of some kind that started after I began a new kind of yoga and started a new job at a funny-shaped desk. A good friend helps me work through it by lending me their expertise in anatomy. It heals with time and care.
Without the chest pain mimicking heartburn, it doesn’t look at all like I have gastritis. Suddenly the vomiting slides back into the same symptom pattern I’ve always had, the one that doctors have variously told me is “probably autoimmune”, “just stress” (with one telling me that it “comes out physically in women”), “allergies” and my personal favourite: “your PTSD has a mind of its own”.
Back to the gastritis doctor. She recommends an NSAID for the pain. I point out that NSAIDs interact with my other meds, a cycle that ends with me having no platelet function and a ridiculously long steroid course to get it back. She looks at me, astounded.
“You figured that out on your own?”
Yes. I did. But only because none of you would help me.
She suggests codeine, a medication which worsens my digestive symptoms. I mention this and she raises an eyebrow, sceptical. I am battling not to point out that less than a minute ago she was agreeing with me about the NSAIDs. She agrees that codeine can often do that (I know this, multiple doctors have confirmed it for me) but is still obviously shocked that I have any understanding of my own care.
I have to. Because none of you will.
I’m describing one doctor, but she’s not the first or last. Before I figured out the NSAIDs, I mentioned the possibility to another GP. He tapped four keys on his keyboard and informed me with a lofty attitude that “nothing in the literature” mentions such an interaction or set of side effects. False – it’s well documented. Gastritis Doctor confirmed that, too.
I’m not saying this to discount doctors’ medical knowledge or expertise. I have had good doctors too, but the thing which made them good general practitioners was a set of characteristics which is frustratingly rare:
They listened. They didn’t assume. They tested. They researched. And they gave me tools to research and participate in my own care.
That last one is crucial. By giving me tools to self-manage, I didn’t end up on WebMD with a severe case of hypochondria, and they didn’t have to do all the work alone with a full patient load of other complex cases. By going through test results with me and explaining them, they empowered me to take responsibility for my own symptoms. What’s more, it was less work for them, because I was tracking changes in symptoms, medication interactions and anything else you don’t need a medical degree to understand.
The best health management I’ve had has been when I’ve had a team of professionals, two of whom were GPs who “specialised” in women’s health and gastrointestinal, respectively, plus a physio, a psych and public hospital specialists. Each of those professionals collaborated with the others and weighed in on their piece of the puzzle. They didn’t get frustrated or roll their eyes when they heard I’d been to see the other one – they gave them a call to talk my care through. They made sure my meds didn’t interact. They gave me studies to pass on to each other (no lie, I read them myself, and they all knew I would).
I can hear my doctor friends in my head right now: “But not all patients are like you! Not everyone is proactive, not everyone has the capacity to read research or friends who can explain the medical language to them. And most of the time, it is gastritis!”
That’s all well and good. But if that’s the case, then I know you’ll forgive me when I say as long as you treat me like I don’t know what I’m talking about, I’m going to have to do the same to you.
Back to google.