Why is the doctor ignoring my symptoms?
Why is the doctor ignoring my symptoms?
Why is the doctor ignoring my symptoms? Rachel Smith describes in a short play how an ER doctor and nurse ignored her symptoms despite her medical history of cystic fibrosis.
Setting: A calm hospital emergency room in a bay with three beds, two occupied. A thirty-two-year-old woman, Me, is hooked to a machine. Pulse Oximeter reads 88%, Blood Pressure reads 80/65, Heart rate reads between 50 and 41. Every time the heart rate slows below 45 the machine beeps a warning. A nurse comes over, eyes Me, hits the button to stop the beeping, and walks away without saying anything.
(Enter Doctor) He is a fit-looking man in his late forties. Shirt-sleeves are rolled up above his elbows. A stethoscope hangs around his neck. His eyes are half-closed and his facial expression is one of apathy.
Doctor: Alright, Ms. Smith. It says your doctor told you to admit yourself through this ER? But your doctor doesn’t have privileges at this hospital yet.
Me: (hugging knees against chest to alleviate stomach pain) Yes, I know. He said he’s in the approval process but he wanted me to come in to this hospital because he thinks you can help me better. He says he thinks it’s my pancreas, possibly pancreatitis. I’m losing weight and having horrible pains.
Doctor: (makes a skeptical face) (glances at the machine because it’s beeping again about low heart rate) (taps button to stop beeping) Tell me, Ms. Smith, is this situation making you feel depressed?
Me: Well, I guess. I mean it’s upsetting that…
Doctor: And tell me, how much are you eating?
Me: I’m eating everything. I’m eating all of the time and still losing weight. That’s why I’m so frustrated. My doctor…
Doctor: (makes another skeptical face) Uh, huh. Well, depression is not uncommon in this situation. I’ll write you a prescription for Zoloft.
Me: (level glare directly at the doctor ignoring my symptoms) I don’t think my depression is disproportionate enough from my current situation to warrant medication.
Doctor: Well, you just told me you were depressed.
Me: Would you please call my doctor or check the fax machine. He said he would contact the hospital to let you know why he wants me admitted.
Doctor: I’ll admit you but he doesn’t have privileges here so I don’t know why he told you to come here.
Me: Because I’ve lost thirty pounds in two weeks. I’m not digesting any of the food I eat. I feel weak and can barely make it to the bathroom without getting winded. He said it might get to the point I need a feeding tube.
Doctor: Well, if you eat something it might help.
Me: I eat all of the time. I eat everything. I told you, we don’t know why I’m losing weight. It’s why he wants more tests done, a test that can be done at this hospital.
Doctor: (stands, frowning) Fine, we’ll get you upstairs and get you something to eat.
Me: Please, just contact my doctor.
Me: (cursing quietly as he leaves the room) For God’s sake! Why is the doctor ignoring my symptoms?
Setting: A hospital room.
Nurse: (Begins strapping cuffs onto Me’s lower legs)
Me: What are you doing?
Nurse: It’s to prevent blood clots.
Me: I can stand up and move my legs.
Nurse: (shrugs and stops strapping the cuffs) Okay, then let’s get your medication.
Nurse: The doctor wants you to take this Naproxen and Heparin.
Nurse: It’s to prevent blood clots. And Naproxen is for stomach pain.
Me: I don’t want either. Naproxen hurts my stomach and I can move my legs. I don’t plan on laying in this bed 24/7.
Nurse: (shrugs) I’ll let the doctor know you’re being non-compliant.
Me: Why is the doctor ignoring my symptoms? Can you please tell the doctor to check the fax machine for my records?
Nurse: (shrugs and leaves)
(Two hours later)
Doctor: How are we feeling?
Me: Frustrated. Very frustrated. Have you contacted my physician?
Me: I just called him and he said he faxed over all of his notes and the tests he thought I should get.
Doctor: We don’t have anything from him. And since he doesn’t have privileges here yet, he doesn’t have the authority to ask for tests.
Me: He’s trying to expedite this process and he thought this was the better hospital in town. He knows what resources you have and thought since some of my other specialists are affiliated here this would be the fastest way to get me help.
Doctor: Have you eaten anything?
Me: (trying not to hiss) Yes. If you’re not going to work with my doctor, I want to leave.
Doctor: (gives trademark skeptical look) I’ll permit you to leave after you give a stool sample. I’ll run some scans on enzyme levels from the stool in the very off chance it is your pancreas. I see they’ve evaluated your gallbladder and stomach before. Those appear fine.
Me: My liver enzymes were off and my ferritin was high with previous blood work.
Doctor: Are you in the medical field?
Me: (sighs) I’m a physical therapist.
Doctor: (smirks) Oh. Well, there’s nothing unusual I can see.
Me: Except me losing thirty pounds in two weeks and having constant nausea and diarrhea?
Doctor: Well… (sets clipboard aside, leans forward) have you had trouble with eating disorders in the past?
Me: (flat affect) No.
Doctor: (tilts head) Really?
Me: (flat affect) Really. I’ll call my Mom and tell her to bring me a second dinner and I’ll eat all of that and it will run through me just like everything else. Have a nurse stand in the room all night if you need to. There is something wrong with me.
Doctor: (leans back and folds arms) I’ll order the tests. Try to get some rest. No need to get worked up.
Setting: A hospital room
Discharge Nurse: Okay, the doctor wants me to go over everything so you can be discharged.
Discharge Nurse: How are you feeling?
Me: The same as when I walked in.
Discharge Nurse: (Head dips forward, then eyes glance up from paper) And have we eaten anything?
Me: I ate everything that was brought to the room for me. My mother brought an additional meal. Parmesan crusted chicken, mashed potatoes and broccoli. I ate all of that too.
Discharge Nurse: (Eyes the open door of the bathroom)
Me: I didn’t throw up if that’s your next question. The stool sample is in the hat in the toilet. I just want to go home and get away from this place.
Discharge Nurse: (shuffles papers, hands over prescriptions) Here is a prescription for Zoloft and Percocet.
Me: I’m not going to fill them.
Rachel T. Smith
Rachel T. Smith is an American writer and physical therapist on a temporary assignment in Germany.