Having the backbone to challenge your doctor

The surgery last fall to correct my crooked spine miraculously changed the shape of my body. I hope the experience also influenced the life and career of at least one young resident.

Last fall, I had surgery to correct my crooked spine and halt its deterioration. It miraculously changed the shape of my body — in middle age, no less. (I grew an inch taller and got back my waist!) I hope the experience also influenced the life and career of at least one young resident.

The aftermath of my eight-hour surgery, including 17 days in the hospital, gave me a unique 360-degree perspective on how the health-care system affects not only patients, but also everyone who works in the healthcare industry, from nurses to doctors to residents.

First, a snapshot of my situation: My surgeon had estimated that I would spend five days in the hospital. However, I was approaching my third week because my bowels and bladder would not wake up — a not uncommon complication of major surgery that lingered extra long for me.

The doctors pushed every type of laxative and enema known to mankind. I must hold the world record for different types of enemas tried in a two-week period. Paradoxically the supposed solutions just kept making me sicker and sicker, more and more nauseated, without yielding the intended results.

So finally I went on strike and insisted on speaking to the doctor before trying another thing. It was the weekend, so the doctor on call was a first-year resident, a philosophy major from an Ivy League school. He awakened my drugged-out mind and was fun to talk to — until I had a medical concern.

Middle-aged wisdom: 1, first-year resident: 0

Despite my protestations that I knew my own body, that I knew something was wrong, that another enema or laxative would not help, he wouldn’t budge. He insisted that I try one more enema. I thought I was out of options until the nurse announced that I was going to get the diagnostic test I wanted after all.

It proved that I was right all along — something was terribly amiss. I had an ileus, a post-surgical complication in which the intestines shut down and don’t resume normal function.

The solution wasn’t fun. Fewer than two weeks after surgery, I was given an injection to awaken my digestive tract and — the difficult part — I wasn’t allowed any pain medicine until the ileus resolved.

Yet I thanked the resident for finally agreeing to the required testing. I understood that, no matter how painful the solution, I was finally on my way to getting better. He accepted my thanks.

“I thought you were right,” he said.

But by then, my husband had found out this was not entirely true. In the course of hanging out at the nurses’ station to check on my care, he found out that the only reason I got the test was because my nurse had pleaded with the resident until he reluctantly agreed.

First, do no harm

Most people would not concern themselves with who stood in their way and who to thank, but not me. The next time I saw the resident I confronted him.

“I’m old enough to be your mom, and I like you, so I want to set you straight,” I began. His face dropped. “I know I only got tested because the nurse insisted. Why, if you suspected I had an ileus all along, were you so resistant to ordering a test to confirm your diagnosis?”

“You don’t understand the politics” he answered. “I’m bottom man on the totem pole. The head resident and the whole spine team would have really dressed me down if I ordered a test and nothing showed up.”

I was outraged. “But you took a Hippocratic Oath.”

“You have no idea what I have to do to make it work with the senior residents,” he said.

“It’s no excuse,” I told him. “You have the makings of a good doctor. Don’t lose that potential and go to the dark side. It’s about patients, not your supervisors.”

He nodded.

Though I couldn’t be sure he really listened, he visited me each of my last three days in the hospital when he wasn’t on duty.

I’m hoping it was a sign that one new resident was back on track. Our confrontation won’t change the pressures and problems of a changing healthcare scene, controlled more by insurance companies and hospital politics than patient welfare, but if one young doctor learned to put patients first, it’s definitely a step in the right direction.

—

Lisa Meritz is a freelance marketing communications manager/writer (at Meritz Marketing) who lives in Philadelphia. Her work has been published in Philadelphia Stories, Metropolis, the Christian Science Monitor, The Philadelphia Inquirer, Philadelphia Daily News, San Francisco Chronicle, and more.