The Intrusive Patient
C. S. JENNISON is a Vermont housewife who has written many light articles for the ATLANTIC.
Doctors are busy men. And dedicated. In the town where I live, which has a population of around thirty thousand, the yellow pages of the telephone book list three hundred and five medical men. All busy. All dedicated. Aside from the dentists, chiropodists, optometrists, veterinarians, and podiatrists (whoever they are), the list include one hundred and fifty-one physicians and surgeons. My arithmetic is always open to question, but by concentrating awhile on these statistics, I arrive at a ratio of roughly one physician or surgeon for every two hundred potential patients. It seems to me that this number ought to be enough to go around, except possibly during a typhoid epidemic, which we haven’t had lately. Nevertheless, the figure is far from adequate.
Apparently, either more people are getting sick nowadays, or else I have been put on some kind of secret medical blacklist, because I find it increasingly difficult to worm my way into a doctor’s office, whatever the provocation. Take, for example, the simple business of a routine annual physical. When I finally get that long-awaited appointment and stride triumphantly into the doctor’s waiting room, my triumph quickly dissolves. As I glance around at the forest of patients sprouting from chairs, tables, and windowsills, absentmindedly twirling their hats in their hands or bravely thumbing through old copies of Life, my sole emotion is one of empathetic hopelessness. Along with worrying about all the other patients, I s art wondering whether the doctor will ever get home for dinner that night, or even that week. When I realize how I, myself, am adding to his already overloaded schedule, I feel not only thoughtless, I feel downright ashamed.
As a result I’ve almost decided to give up my annual physicals. I know all the magazines and posters suggest a yearly medical appraisal, a preventive sort of affair that picks up a case of bubonic plague or whatever in its initial stages, when it is readlly curable. In other words, before anything is actually wrong. Although in theory this is a great idea, the first question that invariably greets me when I nervously seat myself in the physician’s inner sanctum is: “And what do you have wrong with you, Mrs. Jennison, that prompted you to seek medical assistance?" Talk about feeling like an ass. There I sit across from the weary dedicated M.D., trying to explain to him in halting sentences that I don’t exactly have anything wrong — not yet, anyway; I just thought it might be wise to— And here my voice dwindles off into a jumble of incoherent excuses. Obviously, if I don’t have anything wrong, I’m not sick. In a mounting panic of apology I have my blood pressure taken (blushing in advance at the certain knowledge that it will be normal), get weighed (knowing from my morning’s glance at the bathroom scales at home that my weight hasn’t varied a pound in the past year), and stumble out of the room as quickly as my weak knees will permit.
Everyone thought the age of specialization would relieve the strain on the doctors somewhat, but it doesn’t seem to have helped appreciably. A doctor can narrow his practice down to, say, skin troubles, but no one can deny the fact that everyone has skin. There are three dermatologists in our town and, as earlier stated, thirty thousand people. Figure it out. One man for every ten thousand potential patients. That’s too much epidermis for anyone to cover. Fortunately, skin problems, like the common cold, are seldom fatal, however disagreeable they may happen to be. As a consequence, a gentleman in the dermatitis field — better known as the Old Skin Game — can usually recommend zinc ointment and advise the patient to return in two weeks. This is a decent and universally accepted method of postponing the issue, and, besides allowing the ailment time to heal itself, gives the poor overworked doctor a chance for a much-needed breather.
Not always, to be sure. The other day I walked into the dermatologist’s office and found the patients stacked up like cordwood. The nurse announced that all appointments would be a little late because her employer was busy removing forty warts from an elderly woman, a situation that would probably make him miss his lunch hour. I finished reading two 1950 copies of Vogue while I was missing my own lunch hour, and when I eventually got in to see the dermatologist, he looked so wan and hungry that I reluctantly decided against giving him a piece of my mind on the subject of the zinc ointment placebo treatment. I was itching pretty badly, and I knew the zinc ointment would spread my rash because I’d already tried using it. But I took a tube anyhow, just to be pleasant.
The age of specialization, though difficult for the dermatologists, is even more trying for doctors in the undercover areas, such as the gall bladder region. There are five gall bladder men in town, which means — with the ever present thirty thousand inhabitants — six thousand gall bladders per doctor. That’s a lot of gall bladders for one man to superintend. What’s more, each gall bladder specialist, along with his legitimate patients, is bound to get a flock of misguided vagrants who wander into his precincts through ignorance and error. I have tried to avoid such unnecessary impositions by studying a medical book I bought twenty years ago, a publication known as the Modern Home Guide To Medicine. But even though I am getting to be a reasonably good diagnostician, I goof now and then and think maybe my gall bladder is kicking up when I really have indigestion or acute appendicitis; and I make one of those mistaken appointments that clutter up the gall bladder man’s life before I finally get the right man for the job.
The Modern Home Guide To Medicine has taught me a good deal. True, the book was published in 1940, prior to the advent of wonder drugs and tranquilizers, but over the years I have come to consider this more an advantage than a restricting factor. In the days before I gained any real confidence in my medical prowess, I used to bother the doctors with a number of ailments and infections that I was told would respond to the new miracle medicines. They responded, all right. When I was given oral Aureomycin for strep throat, I grew mold in my mouth; when I took Mil town for nerves, I acquired a glandular disorder and dizziness; when I took penicillin for flu, I developed hives and nausea; and two other tranquilizers caused an internal cyst the size of a grapefruit that took eight weeks to dissolve, and a two-month bout with jaundice, respectively. I felt mean and heartless enough having to bother the doctor who prescribed treatment for the original disorder on each of these occasions; but I felt even worse having to call in the extra five or six specialists required to cure the cure, so to speak.
Once in a while I run into a situation where the book is no help, like the time I wanted to get polio shots for my three daughters and myself. I asked a nice doctor I met at a cocktail party if we could come to his office for four polio shots, and he looked stricken at what was plainly one of my more glaring faux pas. He said he’d be happy to give me a polio shot, and possibly my eldest daughter, who was twenty; but the ten-year-old should probably go to a pediatrician, and he couldn’t think of anyone offhand who could treat the sixteen-year-old. because she was in the wrong age group for most doctors. He pointed out, brightening up a little, that the town would be giving injections at the auditorium in six months, and he advised me to get the problem taken care of then. When I explained that two of my daughters would be away at school if I waited that long, he looked so sad that I decided to close the interview. Next day, I piled the girls in the car and drove twenty miles to a country doctor who attended all comers on a strictly unbiased basis, in the order of their arrival. Luckily, the doctor had some serum on hand, and the four of us got our polio shots in due course. But I was so undone by a carpenter who had tangled with a power saw, a man who expected little of life and sat quietly waiting his turn in the chair beside me while he bled all over the waiting room, that I never went back to the country doctor again.
Another occasion when the medical book was no help was last October, when I developed eye trouble. The difficulty wasn’t with the book. I simply couldn’t see to read the print. I was going to a psychiatrist when my vision first started to blur, and he insisted that my failing eyesight was strictly psychosomatic. (I might mention here that I don’t feel so badly wasting a psychiatrist’s time, although I’m fully aware of the fact that it’s valuable. At least, I consider thirty dollars an hour valuable.) He suggested that I keep myself occupied. Read, type, paint, or play the piano, he said. I found this suggestion a bit hard to follow in view of my particular problem — that is, no eyesight — so, much as I hated to be sneaky, I decided to go over the psychiatrist’s head and consult an oculist. (Mind you, I’m not downgrading the psychiatrists. I remember when a friend of mine consulted one of these gentlemen about her fainting spells, and he told her the trouble was all in her head. He was right. She had a brain tumor.)
In December I phoned the eye doctor and was told by his secretary that the first appointment she could give me would be in March. I must have sounded distressed, because she asked whether or not my problem was an emergency.
Well, of course, there was no real emergency; I just couldn’t see.
When March rolled around, the doctor examined my eyes and prescribed bifocals. My distance vision was adequate, he announced obscurely; still, I would undoubtedly need distance correction before too many years, and I might as well get used to bifocals as soon as possible. I wanted to ask if I couldn’t have plain old reading glasses and wait to get bifocals until I needed bifocals. However, the oculist looked so harried and pressed that I knew he would never get through his busy day if all his patients wasted his time asking silly questions.
Two or three weeks later I picked up my bifocals and found they were no good for typing, painting, or playing the piano. Because of the continual up-and-down shifting of vision at the typewriter and piano, with no difference in distance between the typewriter keys and the typewritten sheet, or the piano keys and the music, all I ever saw was that little gray bar in the middle. As for painting — but why go into that? I called the oculist and was given another appointment for May 2, at which time I left my bifocals to be changed into reading glasses. Although it is June as I write this, the glasses aren’t ready yet, so I am using a big magnifying glass I bought at Wool worth’s for reading.
Probably I’ll get the glasses in another week or month or so. But even if I don’t, I’m certainly not going to bother the oculist again. Or any other busy, dedicated doctor, for that matter. It makes me feel too selfish. In fact, the only doctor I don’t feel selfish about seeing is Ben Casey Wednesday nights.