I can give you a clear example of that. When I was 13, in 1960,
watching TV in a dark room, I stood up and stretched (strained) and
walked to the kitchen, where I passed out and my head hit the floor.
In a city of half a million, my GP had me get an EEG which they said
was "normal for his age group", and he prescribed Mebroin
(methobarbital and diphenylhydantoin), so I took that for a few weeks.
I didn't faint again but my mother wasn't happy. She asked the GP for
me to see a specialist. He said "Well, if you want to".
So he sent me to a neurologist and he added a second drug. My mother
asked him if was habit-forming, and he said, "What do you think we're
doing, Mrs. Mother, running an opium den?"
So I took both drugs for a few weeks and my mother still wasn't happy.
She asked the GP for a second specialist, and maybe the doctor didn't
like that either, but otoh, this time she was second-guessing someone
else, the neurologist. I guess my home town didn't have many
neurologists because this time I ended up with a neurosurgeon. He
had me get another EEG while he was there and he had me stand and
stretch, and hopefully pass out. I didn't pass out and the EEG
reading was messed up by all my movements, but he slowly took me off
both drugs, and that was basically the end of it.
There's another chapter to the story when I was 19 but it's not really
on the subject**.
By now you've probably figured out that I never had epilepsy, it was
just orthostatic hypotension, which, for the benefit of others here
maybe 1/3 of the population has. Light-headed right after standing
up.
In defense of the doctor, he never charged us. My mother didn't know
why. Maybe because she was a widow, maybe because her first husband
(who also died) went to the same med school he went to. I saw the
dr's ledger one time and 1/3 of his patients that day he was seeing
for free.
My mother said that his wife was rich, but we agreed that that
wouldn't stop a lot of people from charging full price anyhow.
He also never required an appointment for anything afaik, Come in that
day. OTOH, he would examine my mother with the door open and a clear
view from the waiting room. My mother would go over and shut the
door, but my aunt wouldn't put up with that and changed doctors.
But it was nice. One time my mother and I are in his office, and I
say to him, "I don't think my mother has had her polio booster" and he
nods at the nurse who goes to the fridge, gets the vaccine, fills a
syringe and hands it to him, and my mother gets her shot, within two
minutes of my first words. No charge. (My mother thought polio
shots were only for children. She was old enough and should have
known that FDR was 39 when he got polio. )
> One of the few good things to be said
>for today's health care delivery environment is that many more
>physicians today understand the importance of informing patients about
>their condition and making patients more active, participative partners
>in their care (at least the better physicians do so).
>
>> I notice that the TV commercials for AARP Medicare supplemental ins.
>> say that a referral is very rarely required. That means someone
>> can call the specialist directly, iiuc? (I have that insurance
>> but hadn't seen that commercial when I bought it. I don't remember if
>> I noticed it in the web description.)
>>
>
>One of the biggest problems with health care delivery these days is the
>lack of coordination among all the professionals who may be involved
>with a particular case. No one has the big picture and no one is able
This is distressing but it's good that you warned me. No one else
has. I'll be more alert.
>to communicate the complete picture to the patient and/or family. This
>situation has been aggravated by insurance companies and changed
>community practice standards that no longer require a patient's primary
>care physician to refer their patients for specialty care. Each
I didn't know that either.
>professional participating in the case acts in isolation unless they
>take the initiative (and time, and today more than in the past, time is
>money) to determine who else is doing what and proactively communicating
>with the patient's "regular" doc, or if there was none, at least with
>the admitting physician in the case of hospitalized patients. The worst
>problems occur with the patients that most need coordinated care, i.e.,
>the sickest, most complicated, hospitalized patients. Of course, the
>policy of directed referrals is not without shortcomings. I could write
>an essay on the politics of referrals and of how either patients or
>colleagues are supposed to objectively know which practitioners are
>truly competent.
My brother's a radiologist at a hospital and I needed an orthopedic
surgeon once, and he said, "I don't know who's good. I only know,
probably, who hasn't been sued since I've been here. So he referred
me to the top-ranking guy. (I ended up not having that surgery
anyhow)
>Anyone who either trashes the existing health care delivery system by
>targeting one or two specific components, or says they have a simple
>panacea for all that is wrong with the system is at best naive, possibly
>just ignorant, and at worst, speaking from a badly biased politicized
>high horse. As with essentially all complex systems, the problems are
>complex, as are the potential remedies.
Okay. I"ll bear that in mind.
**The final chapter. Six years later, when I was 19 I had a summer
job and would spend the coffee break daydreaming. When the break was
over, I was often in a stupor and it took a long time to wake myself.
When I saw the GP for some reason I told him, and he said, "Do you
want to get to the bottom of this, Do you really want to get to the
bottom of this", so of course I said yes. And he referred me to a
the head of neurology at the U. of Illinois Med School, who had helped
in the development of the original EEG. This guy was so busy even his
secretary didnt' have time to talk to my mother. ot
But I went. He told me to get no more than 3 hours sleep the night
before so he could do the EEG while I was sleeping. At the end he
said "You don't have epilepsy and you never did." I told him my blood
pressure theory and he called a lab in the building but they couldn't
be ready until Monday. His secretary suggested a polygraph, so that's
where I went the next day. Before he even started the guy came into
the waiting room and told my mother, "Don't worry. We had someone
here last week and it was all in his mind." He ended up telling the
doctors that I was malingering (though I wasn't.) I saw the report.
Several times he misquoted me or quoted me out of context to totally
distort what I said. It didn't affect my medical care, but it
bothers me if either of the doctors thought I was lying.
This was Leonard Harrelson. He's dead now but he was famous in the
world of so-called lie detectors I thought he was the lowman on the
totem pole and that's why he was the one who had to come in on
Saturday, but actually Keeler had retired and he was head of the
company. He was so gung-ho he probably liked working on Saturday. It
was the Keeler Polygraphic Institute (so-called) and he was Keeler's
favorite guy, who married Keeler's daughter. If you go to Amazon
and find the book he wrote and read the reviews, you'll see what a
fraud three people say he was. And that was my experience too.
Without a doubt. (I've been meaning to add my own review)
http://www.amazon.com/Lietest-Deception-Polygraph-Leonard-Harrelson/dp/0966178807
click on reviews. OR
http://www.amazon.com/Lietest-Deception-Polygraph-Leonard-Harrelson/product-reviews/0966178807/ref=cm_cr_dp_see_all_btm?ie=UTF8&showViewpoints=1&sortBy=recent
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