Tuesday, March 25, 2008

Our Visit to MD Anderson


A little over a week ago, David, Emma and I went to MD Anderson Cancer Research Center in Houston for a second opinion regarding my case. I am in remission now and we wanted a second opinion on how to remain in remission. My oncologist here in Austin encouraged us to go.

I could tell we were dealing with something much, much bigger than my clinic here in Austin by simply the amount of paperwork involved. In preparation for our visit, I filed out numerous medical history forms - both online and hardcopy. I had all of my medical records sent to MD Anderson from all of my Austin and Baylor doctors. I collected all of my CT and PET scans and reports on a disk. I interacted with several MDA new patient personnel via phone and email for a week before my visit. I felt like I was applying to grad school all over again. We had high expectations.

These high expectations were shot down after only a few minutes with our doctor. (Folks in the South often soften criticism of others with ‘bless his/her heart,’ so here we go…) Bless his heart, this doctor was one of the most arrogant, patronizing people David and I have ever met. We were asking questions about the potential relapse of a life threatening disease here and we get attitude?

David and I have been in and around academic circles, so we are familiar with attitude that comes with tenure, publishing, grants, fellowships and so on. We can deal with attitude if we get information. This was the most galling and frustrating point. This doctor could not answer any specific questions regarding my case because he would only comment on tests, scans, or treatment done at MD Anderson. Since this was my first visit, all the information we received was very general in nature. It was clear he had not read my file.

Here are some Q & A examples to give you a flavor of our meeting….

Q & A EXAMPLE 1
David: Do you recommend that Gigi participate in a clinical trial to prevent relapse?

Doctor: Of course, I recommend all my patients participate in trials to advance science.

David: Yes, but will it benefit Gigi specifically?

Doctor: I have no idea. That's why it's a c-l-i-n-i-c-a-l t-r-i-a-l (spoken very slowly with every syllable carefully enunciated).


Q & A EXAMPLE 2
Gigi: Am I eligible to participate in this clinical trial given my situation?

Doc: I have no idea. What is your situation?

Gigi: Well, let’s see. I was diagnosed with large cell, intermediate grade, B cell, stage 3-B non-Hodgkins Lymphoma.

Doctor: You must also be considered high risk according to the International Prognostic Index which is based on 5 factors.

Gigi: So, am considered high risk?

Doctor: I have no idea.


Q & A EXAMPLE 3
Doctor: Do you have any other questions?

David: Well, are there any other questions we should be asking?

Doctor: Looks like the high in Houston will be about 80 degrees today. (Doc then stands up and walks out the door.)


I am so glad David was in the room with me. I would have felt very, very bad had I been alone. With David with me, the whole interaction just became comical. As soon as the doc left the room, I put my hands up to my face and shook my head a la Jon Stewart from the Daily Show. Then David and I just laughed. Thank goodness for laughter.

The next day, I called the patient advocate to express my concern. This woman was great. She listened. She sympathized. She apologized. She said this doctor’s style can be abrasive, but that she has seen him go beyond the call of duty for his patients.

There were some good things that came out of this meeting. I am now in the MD Anderson system. So if I do relapse and need to return, I am already set up as a patient. Moreover, perhaps there was a reason this well published, nationally recognized lymphoma specialist seemed annoyed with us taking his time: I am in remission! He sees patients that are in active treatment fighting for their lives. I am not very interesting to him because there is not much he can do for me now. And what a blessing that my case no longer causes doctors to jump into action. Yes, I am in remission. My life is no longer in jeopardy. The doctor was probably like, “This is ridiculous. You are in remission. Step aside, lady. I need to go save some lives now.”

Godspeed, doctor guy. Godspeed.

4 comments:

Anonymous said...

Sorry, but my take on this doctor is that he is an a**hole.

I'm really glad that David and you can laugh about it. And I think you are probably right that he didn't think it was important to interact with you, because you're in remission. But, on the other hand, maybe you'd do better with a kinder doctor.

My mother's doctor was always decent with her, and he (Jeffrey Crawford) is and was (if I remember correctly) the chief of medical oncology at Duke University Hospital. Kindness is something that is also possible, even among great physicians.

So, I'll keep my opinion of this guy... and just be glad you can laugh about it!

Love, Tandy

sally said...

Hi. Let me not mince words. I hate him. Good for you for your and David's attitude, and I agree with your point about being in remission and therefore less acute to him. But come on, what a jackass, especially considering the prep work you had to do just to see him, on your own doctor's recommendation. This guy needs another really good complaint to add to his file. Being brilliant doesn't give anyone a free pass to be an ass. ps: Did he really say that about the weather!?!? Hold me back!
Love, Sal.

Anonymous said...

Not to defend him in any way, but it could be he was afraid of a law suit. I know as a teacher I have to watch what I say about "inattention" (oops! can't say that word) because the parent can come back on the district for payment. The teacher was making a "medical diagnosis". We have to dance around the issue and many, many times the parent does not get it.

I'm glad you don't need to deal with the jerk. There is still no excuse for a highly educated doctor to act socially retarded.

Anonymous said...

Hi Gigi et al,

There is absolutely no excuse for a physician to act in that manner (and he is not even a surgeon). I don't care if he saves a hundred lives a day because he is such an accomplished individual, he had no business treating you in that manner. I can't see how your being in remission should affect his interaction. It would have taken the same amount of his valuable time for him to treat you in a respectful manner.
Let's hope that that is your only encounter with him.
Evie and I think of you and David and Emma often and are faithful fans of your blog.

Larry--David's father (not your David)