Guest editorial by World – famous psychiatrist to physicians, Dr. Pannikatakus
I hear from physicians what, to no one else, they tell. Their secrets. Their fantasies. Their failures. Their sick little ideas.
Case # 42
Into my consultation room she comes, this doctor. All riled up and fidgeting.
“I don’t understand people,” she fumes, pacing back and forth on my new oriental rug.
“Lie down,” I say. “On the couch. Tell me about it. Tell me your greater story.”
“How can people be so stupid choosing a doctor?” She rants. “They certainly don’t decide the way we physicians decide.”
“You are thinking, perhaps, of a specific ‘people’?” my incisive skill directs her.
“My own sister,” she blurts. “She has some menstrual pain – don’t we all? – and she called me for advice.”
“Good,” I say to encourage. “Good. Go on.”
“So I told her to go to an Ob-Gyn doctor. I gave her three names. All good physicians whom I know. They are well trained and scientific. They would pursue testing in a logical sequence and find her diagnosis. I’ve watched them do it for others before.
“But. Does she go to one of them? No. Some girlfriend of hers tells her about this – – – this – – – surgeon. I know him. He just LOVES to cut. Cut, cut, cut. Cut and stitch. Then bill the insurance. Bill, bill, bill.”
“Yes,” I interrupt gently. “Yes. But tell me,” I say, “about your sister.”
“So she said to me: ‘he’s a nice guy. Everyone likes him.’ ”
Here I see that my patient has spittle flying from her lips.
“ It’s true he’s a nice guy,’ I told my sister, swallowing my vomit, ‘but that has nothing to do with medical skill.’ ”
“ Then my sister said: ‘my girlfriend went to him. And you know what he did?’ ”
To myself I think: I can guess, It all, I have heard. But I don’t say anything; I just let her tell me. That is how I am trained.
“So my sister told me that he operated on her girlfriend, and that, after surgery, he sent her the most beautiful bouquet of roses.
“ ‘Roses!’ my sister said, all starry-eyed. ‘For a patient! How many doctors do that? What a good doctor,’ she said to me. ‘What a nice guy.’ ”
“I tried to tell her: No, I said. Sending roses is not a medical skill. It’s a marketing ploy. You need a good doctor, not a good schmoozer.”
“The right thing, you said,” I reassure her. “So what makes you so upset?”
“She went to him anyway. He opened her up. No work-up. No tests. Just – – – zip – – – slice – – – mess around inside – – – stitch.”
“ Did he send flowers?” I ask before I can shut myself up.
“Oh, yeah. And he gave her his elbow to help her walk down the hall, instead of having the nurses do it. And you know what she said? ‘What a good doctor,’ she said. Like she never heard a word I told her.”
“Is she better?”
“Of course not! Once the pain of surgery disappeared, she found the menstrual pain still there. Right where she left it.”
“Unhappy,” she must be.
“Oh, no. She told me she wasn’t going to mention it to him. You know why? ‘I don’t want to disappoint him, he did such a good job’ she said. ‘Such a good doctor.’ So now she’s asking if there’s a cure for menstrual cramps.”
Here, my patient is up and pacing on my new rug again.
“If I need a physician, I want competence. Knowledge of the scientific process. A diagnosis before treatment. Don’t you?”
“Me?” I ask “You ask me?”
“Yes. You. If you needed a physician, you wouldn’t choose by personality, would you?”
“Of course not,” I say. “A scientist, I am.”
“These Quacks are a Public Health menace,” she mumbles.
Her anger, I can sense it cooling like lava into the ocean. “So what did you tell her?”
“I gave her a bottle of Black Cohosh. I figured, what the hell. She believes in this kind of stuff, and, unlike the surgeon, at least it won’t hurt her. But I feel like such a Sell-out.”
“But you did no harm,” I reassure her. “Time’s up. Come back next week. Several sessions, you will need.”
Sex, Drugs, and Public Health 