One of my many doctors suggested that I write about my stress. My health problems have led to stress which, as I’m sure you’ve heard, can exacerbate health problems. Great. So this is me writing about my stress and the cluster-f*ck healthcare industry that causes me more stress.
Most of us have experienced a major stressful event in our lives – and one of the main causes of our stress in America seems to be our health or lack thereof. An NPR survey on stress found that 49% of respondents reported having experienced a major stressful event in the past year, and 43% of those respondents cited health-related problems as the main source of stress. Stress affects every minute of every day (check out this article detailing some personal stories). In my own life, at any given moment, a significant chunk of my brain power is consumed by my health problems – thinking of new ways to try to get healthy, feeling the underlying current of chronic pain, fighting the anger, wondering if what I’m doing at any given moment is detrimental to my health, telling myself not to stress because stress makes illness worse, which stresses me out.
I think the worst thing about serious or chronic health problems is the strain that it puts on relationships. People ask how you are and what you’ve been doing, and sometimes all you can think about is your most recent doctor’s visit and the countless hours you have spent on medical research. No one wants to hear about those things. So you stumble over your words and eventually select some other random detail of your life to tell people about, even though it usually has little or no relevance to how you are actually doing and how you’ve been spending your time. And of course this stresses you out even more because you worry that people can see right through you, but you also don’t want to be the complainer of the group. You want to be authentic and have meaningful relationships, but no one wants to hear about your health problems, and in all reality, you don’t really have anything to say anyhow except “this sucks.”
With so many of us suffering from serious and/or chronic health-related stressors, you would think we would have a better way of helping people cope. But in the end, I don’t want to cope. I don’t want to talk to people about this. I don’t want counseling (though I’ve done that and am about to sign up for another round). I don’t want sympathy or empathy. I want to be well. I want to go about my day and be able to focus on my career and my relationships instead of reluctantly watching as opportunities slip away from me because my mind is somewhere else. In situations where I previously would have spoken up with an idea or a question, I stay silent because it feels like it would take too much energy – and most of my energy is already spoken for. It’s like I’m in a marathon and know that if I don’t conserve my strength now, I will end up collapsing before the 5-mile mark. I’m well aware that our capitalist society would tell me to suck it up, but we need to start admitting that people cannot be everything and do everything when they are experiencing a serious stressor in their lives, health-related or otherwise. We need to start promoting more self-care and admit that taking a step back to care for yourself is a strength not a weakness.
When it comes down to it, the only thing that will help me and all of the others like me who are dealing with chronic/serious health problems is a revamp of our healthcare system. While doctors are pretty good at dealing with the common cold or a broken bone or even a heart attack, I have found them to be lacking in their ability or willingness to problem solve health concerns that are out of the norm or challenging. And you probably need a referral to go see them, which means you have to ask one of the doctors you’ve already seen. These phone calls and visits usually don’t go very well, because doctors can’t seem to accept that they might not have all of the answers or that another doctor might have a different plan of action that works better for the patient. Getting a referral or getting your doctors to send records to a new doctor sometimes ends up being needlessly more stressful than the physical pain itself. And maybe if I wasn’t already stressed and fatigued (remember: marathon), dealing with rude doctors and nasty office managers wouldn’t be such a big deal. In any case, here’s how it went last time I had to make one of these calls:
Me (on the phone): “Hi. I came in awhile ago with __________ condition. You sent me to see Dr.__________, which helped a little, but I’m still having the same problems. I would like to go see Dr._________, but they say I need a referral. Will you ask the doctor if she will write me a referral?”
Doctor’s staff (in a really mean tone): “It’s not going to be any different. The only things you can do for your condition are ______ and ______. They’re going to tell you the same thing.”
Me (voice shaking because I’m so angry): “When I talked to the office assistant at Dr.______’s office, she said that they have other ideas that don’t involve _____ or _______. I would like to pursue my options.
Doctor’s staff (in the same nasty tone): “Well, I’ll ask the doctor, but I don’t know if she’s going to write you a referral.”
Interactions like this make me avoid going to the doctor or calling doctors. They are arrogant; they like to believe that they have all the answers; they blame you (the patient) when they run out of answers and sometimes are downright mean. This does not help my stress level, and it obviously does not help me get healthy.
Our healthcare system is fucked. I can’t talk much about my current health condition due do a pending lawsuit (#Igothitbyasemi), but let me give you a different example from my early 20’s of how ridiculous our healthcare system is. I was just out of college when I randomly started experiencing extreme nausea and general feelings of unease. I avoided work lunches with my bosses because I feared that the nausea would come, and I would have to excuse myself. I avoided going out with my boyfriend. I made sure to have a snack with me at all times because it sometimes seemed to help.
After a few weeks of trying to self-treat to no avail, I headed off to the doctor to find out what was causing my nausea. My doctor immediately stereotyped me and assumed that I was eating too much pizza as young people apparently tend to do. Contrary to his assessment, I was a pretty healthy young adult – I usually packed my lunches instead of going out to eat at work. I exercised regularly. I knew that the nausea wasn’t stemming from eating too much pizza, but I didn’t know what else to do, so I dutifully started a food log like my doctor instructed. I went back to the doctor a couple of times and found no answers. This dragged on for several miserable months until I finally realized (after a lot of research and thinking) that I had switched birth control pills a few months before all of this started. So I decided to stop taking the pills, and my symptoms completely disappeared. It was so simple that it was infuriating. I had wasted so much time. So why didn’t my primary care doctor think to ask me about my birth control? My guess is that he didn’t ask because he considered birth control to be something an OB/GYN handles.
And that is why we are all FUCKED. Our healthcare system is disjointed with specialists for this and that – and none of them know what the other is doing nor do they want to. At times, I have spent months doing research and scheduling appointments with various doctors to try to find the “right” specialist for a given condition. And what if you have symptoms that cross the boundaries of different specialist’s fields? Consider yourself even more fucked.
In America, we don’t treat the whole person, we treat individual symptoms. Something wrong with your vagina or reproductive system? Go see an ob/gyn. Have gastro-intestinal problems? We have a specialist for that. Spine problems? That’s a different specialist. Joint pain? Another specialist. Feeling dizzy, anxious, mentally cloudy? No one’s really sure who treats that, and it could be caused by any myriad of disorders, so you better go see a psychologist. When in doubt, your doctor will send you to a counselor because obviously you are stressed and are having psychosomatic symptoms. Don’t be fooled, the idea of “hysteria” has never really left our medical system. Best case scenario, your doctor will offer you a medication (regardless of whether there is any evidence that it is effective). Odds are that a pharmaceutical company has essentially bribed your doctor to prescribe this medication. Last year (March 2013), The Economist reported that:
“In 2012 pharmaceutical companies spent more than $24 billion marketing drugs to doctors, according to Cegedim Strategic Data, a research firm; 35% of doctors accept food, entertainment or travel from the pharmaceutical industry, said a survey by Deloitte last year, while 16% accept consulting or speaking fees. In most states, doctors take regular courses to maintain their licences. In 2011 drug and device companies sponsored nearly a third of the medical training tracked by the Accreditation Council for Continuing Medical Education.”
Thankfully, the Obama administration pushed through the Sunshine law which will hopefully bring more transparency to these interactions (thanks Obama!). But it doesn’t fix the problem that we have moved from a system where everyone had one doctor to a system where everyone has 5+ doctors for each different body part, and none of them want to talk to each other or hear about symptoms that fall outside of their specialty despite the fact that every part of my body is connected to all of the other parts. Butterfly effect anyone?
We need to demand a system where our doctors treat the whole person: where they involve us in medical decisions by helping us to evaluate the pro’s and con’s of our OPTIONS, where our doctors TALK TO EACH OTHER, and where they are willing to admit that they might not have the answers and that maybe other doctors might have additional insight and ideas. In the variety and vastness of life experience and knowledge, there is no way that every doctor knows everything about every condition. And that’s okay! Your role, as a doctor, is not to know all of the answers, but to help me find the answers through any means necessary. And sometimes that means helping me find another doctor who might know more or know about different options. Your role is not to belittle me for seeking out additional options or to blame me for my health problems just because you can’t figure out how to help me.
I’ve been seeing a plethora of blogs and articles about how fighting stress and maintaining a positive attitude can bring about positive health effects. And of course, I want to take every step possible to minimize my stress (that’s why I do yoga and write posts like this). However, we need to be careful to not blame the patient for having stress especially when it stems from health problems and is exacerbated by a shitty healthcare system. Maybe we can help the patients to be less stressed by creating a better system, not blaming them for their health problems, and treating them a little more kindly in our daily interactions.