Tuesday, May 8, 2012

Unexpected Ambush

I had to stop by my university's student health center yesterday to get a referral for an outside doctor (damn mandatory student insurance restrictions...don't get me started). In a nutshell, I have to make an appointment with a campus doctor first, and then my insurance will only cover a specialist if the campus doctor writes a referral. I guess the policy makes sense in that it lets general practitioners screen patients first, but for someone with chronic medical problems like me, it just means a lot of red tape. Plus, I've had some not-so-great experiences with my student health center, and thus do not have the greatest confidence in their diagnostic abilities. Or their adherence to HIPAA.

In the past few months, the campus appointment has just been a formality - I tell the doctor which specialist (ophthalmologist, cardiologist, gynecologist, etc.) I need to see, and he/she writes me the referral. Once, I simply e-mailed the doctor and she left me the referral at the front desk without even making me come in for the appointment. So for the most part, I've been able to avoid dealing with the actual doctors and nurses there very much.

Okay, sorry for all the boring background. The point is, yesterday I was planning to pop in, get the referral, and leave. I'd scheduled the appointment last-minute with the only available doctor, one I'd never seen before, but assumed it would be the usual drill. This doctor, however, was not about to let me off that easy. She was very serious, very thorough, and very unwilling to send me on my way without covering all her bases. Basically, because of my weight. Before each appointment, a nurse brings you back to the exam room, weighs you, and takes your vitals. When Dr. C came into the room yesterday, she saw anorexia stamped across my file and told me that I had lost X pounds since my last (unrelated) appointment in January. Then she gave me a not-short, not-cheery lecture.

It caught me really off-guard, and it also made me really defensive. I'm still not sure if I was just pissed about it because I get pissed when almost anyone confronts me about the ED, or if because she truly was out of line. While she is a doctor and it is her job to address medical issues, I had clearly stated that I was already receiving outside treatment for the anorexia and that it was under control. Plus, I was seeing her for a completely unrelated reason.

She probably thought that I was in serious denial or something because I kept brushing off her questions about my eating and weight. I could have pointed out that her nurses are idiots and weigh everyone fully clothed, including jackets and shoes - meaning that a weight in January means something very different than a weight in May - but I refrained. Really, I was just trying to wrap things up. I kept politely explaining that I already have a therapist, a dietician, and an ED doc who are all fully aware of my other medical issues, and that I was only there to get the damn referral.

Then she said, "I don't think your current treatment is enough. You can bounce around to different specialists all you want, but nothing will be resolved until you deal with the eating disorder."

And then I got mad because frankly, this woman knew nothing about me. I do not appreciate being told that I'm not dealing with the eating disorder when treatment has monopolized a big chunk of my life for the past two years. And do not imply, Dr. C, that I'm wasting my time by seeing specialists for immediate medical problems. Whether or not the anorexia caused them, they exist, and they will not be cured with weight gain. If an anorexic girl had a heart condition, would you turn her away and tell her to come back when she's Recovered? Or would you send her to the cardiologist?

Might weight gain strengthen my immune system and bolster my body against future illness/injury/complications overall? Probably. But that doesn't change the fact that I have multiple, chronic health problems that require treatment now, not in the months or years it might take for me to fully recover from the anorexia. I'm not in denial; I know that I have an eating disorder. It's understandable that a new doctor might be skeptical about a recovering anorexic who downplays a recent weight loss; eating disorder patients are not known for their honesty or forthcomingness - I fully admit that. But I felt that Dr. C was making invalid assumptions about my body and my recovery based on limited, inaccurate knowledge, and was disrespecting me and my treatment team by presuming to know better.

6 comments:

  1. If she really thought you were not dealing with your eating disorder, she handled it completely the wrong way. A person who is not dealing with something so serious needs support and medical attention for whatever ails them. She provided neither. She just gave you a lecture. You, who ARE in fact dealing with your eating disorder deserves the same respect but I go with her misguided assumptions to drive home the point that she was still wrong. The professional in me feels in some regard that a lecture can be a good thing BUT only in 3 instances: if you are a child or teen, if you are in denial of your eating disorder, or if you are not utilizing any other services or treatment options. You are none of the above. She was out of line. Did you actually ever get to leave with a referral?
    ((hugs))

    ReplyDelete
    Replies
    1. Hi Arielle - oops I forgot to include that but yes, she finally did give me the referral! (although only after making me get blood drawn...) I'm really conflicted about the whole thing because I know that she was concerned and had good intentions, but it felt more like a scolding than a medical intervention. Thanks for reading!

      Delete
    2. I agree with Arielle--sometimes lectures can be good, but it sounds like in this case it was really out of line. I had one of those at our campus health department years ago when I needed to get them on board with an aspect of the care I was involved in, (key word--involved in) and instead I got a lecture and kicked out of school. It still enrages me/makes me want to cry to think about it because of how patently unfair it was. Here I was asking for help in a specific way that went along with the help I was already receiving, and instead I got punished. I'm so sorry you had to experience this. It must have felt awful to not want to be rude but to feel like she was so off base and unfair in her criticism. I wish I could give you a big hug :(

      Delete
  2. I think that she was completely out of order. Obviously she thought she was doing the right thing, and credit to her because it makes a change from doctors who are just like "yeah it's not anorexia she's just trying to diet" but just because this woman went in the opposite direction does not make her any better. Have you thought about contacting someone you're comfortable with at the health center and making a complaint about her? I think you should. Unfortunately good intentions don't always pay off and in this case it looks like they did more harm than good.

    ReplyDelete
    Replies
    1. Hmm that's an interesting thought. I'm a bit reluctant to get the school any more involved with my ED treatment, just for privacy reasons, but if I have any more run-ins with campus doctors then I would definitely consider it. Thanks Lucy!

      Delete
  3. That sounds incredibly frustrating! I agree that I'm sure she was well-intentioned, but her involvement in the ED part of things should have ended when you explained to her that you're already working with several specialists who are specifically trained and experienced in the field of eating disorders. Besides, lectures are generally unhelpful. If a person is already in treatment (and is working hard and doing well, like yourself!), then a lecture isn't really doing much. If a person isn't willing to seek treatment, a lecture probably won't change their mind. I'm glad you ended up getting the referral, but I'm sorry it was a frustrating experience. Hopefully if you need to use the campus med center for future referrals, you won't have to see her again.

    ReplyDelete