Wednesday, August 24, 2016

Why You'd Rather Have Dr. Asperger's Syndrome than Dr. Perfect Bedside Manner

Once upon a time I had a mammogram--and was reassured, as I always had been, until now. Dr. Perfect Bedside Manner never rushed me. She had my results in her hand and was smiling as I walked in. She shook my hand, offered me a seat, explained why I was just fine--"I have nothing but good news for you!"--and, after exchanging a pleasantry or two about my very good gynecologist, who recommended me, let me go. But then two months later I found a lump--technically a swollen lymph node--and the circus of my treatment--tests, tests, test, chemotherapy, baldness, old ladyhoodness, and other distressing symptoms, began.
To my gynecologist's surprise, Dr. Perfect Bedside Manner was not assigned to my case. The hospital has a team, and normally Dr. PBM is on it, and I guess they must have thought--no one offered an explanation--maybe they thought I would sue--that I would not be comfortable with a doctor who had failed me. It's a common failure, misreading a mammogram, but how would they know that I knew that? In any case, I was assigned Dr. Asperger's Syndrome, who walks like a Hollywood Frankenstein and has the bedside manner of a snail. His expression--that of someone who hasn't had enough sleep and needs a bathroom--never seems to change. 
Since the whole idea of chemotherapy, to shrink the lump before surgery, seemed not to be working--because I could feel the round, hard, lump after four rounds of epirubicin and cyclophosphamide--I made an appointment with him. If side effects were all I was getting out of chemo, I wanted out.  
Dr. Asperger's Syndrome, with none of the personal charm of Dr. Perfect Bedside manner, has other qualities. What he lacks in ordinary everyday politeness he makes up for in competence. He is the doctor who knows how to identify that single snowflake, the one he seeks, in a blizzard. 
Not long before my appointment I was waiting to speak to a receptionist when he happened to come down the hall. I'd met him twice before, so smiled and waved. He moved robotically down the hall, not seeming to see me. 
I was waiting in the same place the day I had my appointment. He strode down the hall toward the receptionist. This time I got a vague, startled nod as he continued walking. The receptionist guided us down the hall to an office and unlocked it; he left and let her take me in and question me about my insurance. By this time I was bald and wearing my wig. He'd met me before I lost my hair, so I wondered if perhaps he did not recognize me in my new blond haystack. About which he said nothing. He returned and asked something--perhaps "How are you" in such a flat affect that I felt nervous. I flipped off my wig, said, "Well, now we have the same haircut," and he didn't laugh, although actually we do sport the same military buzz cut. Equally gray, too. He stared intently at my offending scalp for a moment, as if calculating. After the interview, I imagined he was thinking, "She is not completely bald, therefore . . . ." or "Her stubbles seem exactly a quarter of a millimeter long, which indicates . . . ." He turned, scribbled something on a clipboard, and set up the ultrasound. I lay on the table as he slimed me with gel and started moving the arm of the ultrasound around my breast. I had questions and started asking them, but when I glanced at him, I desisted. He was leaning into the screen with an intensity that made me want to stop breathing. I thought the sound of my respiration would break his concentration. His eyes were wide and bugged out. "Speaking up now, " I told myself, "Would be like asking a man in the throes of a very good orgasm whether he'd remembered to pick up his shirts at the dry cleaner." 
Only when Dr. Asperger's Syndrome had completed his exam and tossed me a towel with which to wipe off the goo did I express my concern that the lump seemed bigger. The one at the edge of my breast.
"No, no! We'll take that one out later. The other one's smaller." He smiled in a cheery fashion and walked out. I thought of Lurch, the Addams family butler.
But I'm much happier with Dr. Asperger's Syndrome than Dr. Sweet Bedside Manner, who missed the diagnosis and left me unaware and untreated for two long months. 


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