Bedside Manner by Eva Langston

Every year I go to the gynecologist and have the same conversation.  It goes something like this:

Me:  “So, do you think I should go off birth control?”

Doc:  “Why?”
Me:  “Well, I’m not having sex with anyone.  Ever.  So it seems kind of silly.”

Doc:  “Mm-hmm.”

Me:  “I’ve been on it for ten years now.  Maybe I should take a break.”

Doc:  “It’s not good to go off and back on.  It’s better just staying on it.”

Me:  “Really?  It’s not doing weird things to my body, constantly pumping myself full of hormones?”
Doc:  “Nah, you’re fine.”

Me:  “Okay.  If you say so.”

From what I understand, the pill works by releasing hormones that are usually released during pregnancy.  Essentially, you don’t get pregnant because your body has been tricked into thinking that it’s already pregnant.  This means that for the past eleven and half years, I’ve been tricking my body into thinking it’s pregnant.  What will happen when I actually want to get pregnant?  Will my body accuse me of crying wolf and refuse to comply?

And, let’s be honest, the number of times that I’ve needed birth control for its intended purpose of preventing pregnancy is depressingly low.  I’m all about contraceptives for those who need it, but isn’t it kind of ridiculous that I’ve been taking a drug every single day for over a decade that I don’t actually need?  My doctors say no, this is perfectly fine.

Doctors often don’t take my concerns seriously.  Last year I had a strange growth on my leg.  I thought it was an ingrown hair and went digging around in it with a safety pin I’d dipped in rubbing alcohol.  Naturally, that didn’t make it better, so then I just waited for it to go away.  Five months later, it was still there, so I went to see a surgeon.  The conversation went something like this:

Me:  “What is it?”

Doc:  “I don’t know.  We’ll just cut it out.  Go set up an appointment with the front desk.”

Me:  “Well, now, wait.”  [I was beginning to feel panicky.  My legs were what I used to attract men.] “Cut it out, you say?  Is there going to be a scar?”

Doc:  “Yeah.  About two inches.”

Me:   “Will it be noticeable?  How are you going to cut it out?  Don’t we need to know what it is and where it came from?”

Doc:  “Nah, it’ll be fine.”

Me:  “Okay.  If you say so.”

After my experience with the surgeon, I began to notice how nonchalant all my doctors were about everything.  When I went to them with a medical concern, like should I go off birth control, or should I be worried about this weird rash, they waved their hands and made some sort of general, “don’t worry, you’re fine” type of statement, often accompanied with the offer to write me a prescription for something.  I suppose that, me being a relatively healthy person, my concerns seemed to them like small potatoes, but still, I didn’t like being treated as if my worries weren’t even worth discussing.

Lately I’ve been thinking that a doctor’s advice might not always be the best advice.  After all, they’re only human.  They don’t know everything.  Plus they’re often tired and overworked.  And they’re not immune to bias.  They’re swayed by drug companies and incentive programs and their own opinions.  And sometimes they’re swayed by what’s quick and easy.  Last year, when I complained of a reoccurring headache, all my doctor did was write a prescription.  It was easier for her to prescribe pills than to work with me to figure out what was causing the headaches in the first place.

My best friend from high school, Anita, is a midwife, and she believes that many doctors are not doing what’s best for women during hospital births.  The epidural, she says, numbs the woman so she doesn’t know when to push.  This often causes complications which can lead to a C-section.  When a woman is induced, this also tends to end in a C-section.  “Doctors love doing C-sections,” Anita says.  “Because they can schedule them.  They can do the procedure and go home.  It’s easier for them.”  Also, I found out, many health care providers pay doctors and hospitals more for a quick C-section than for a vaginal birth.  So doctors have incentives for recommending a C-section, incentives that have nothing to do with the health and well-being of a woman and her baby.  A C-section is a major surgery that takes much longer to heal than a vaginal birth, but when a doctor recommends it, the woman assumes that the doctor knows what’s best.  I imagine the conversation goes something like this:

Doc:  “Let’s cut you open and take out this baby.”

Woman:  “What?  Right now?  But I wanted to try for natural child birth!”

Doc:  “Here’s the nurse with the epidural.”

Woman:  “I’m not sure if I want the drugs.  Is it going to harm the baby?”

Doc:  “It’ll be fine.  We’re going to take you into surgery now.”

Woman:  “Is it going to take long for me to heal?  Am I going to have a scar?”

Doc:  “Eh, you’ll be fine.”

Woman:  “Okay.  If you say so.”

Of course I’m exaggerating, but I do think it’s true that many doctors don’t take the time to explain things fully.  They don’t always take the time to make sure their patients understand all the pros and cons of a certain drug or procedure.  After all, they are trained to provide drugs and procedures. They have seen so much – death and debilitation and terminal illness, that they mean it when they say, “eh, you’ll be fine.”  Because yes, there are many health concerns that are much, much worse, than the little ones I have.  But still.  It’s my body, and I have concerns about it, and I want those concerns to be treated with respect.

The other day I went to CVS and learned that I had run out of refills for my birth control.  I thought the prescription ran through October, but apparently not.  “Do you want me to call your doctor and see if she’ll refill it over the phone?” the pharmacist asked.  “No,” I said.   I was taking this as a sign.  It was time to stop taking a drug I didn’t need it.

I’m one week in to my life without birth control, and so far I don’t notice any differences.  Will my acne come back?  Will I start having longer periods with those horrible cramps I remember from my youth?  Will I meet someone tomorrow with whom I will want to eventually have unprotected sex?  Will I have to go to the gyno and ask to be put back on birth control?  Luckily, if I do, I imagine the conversation will go something like this:

Me:  “Are you sure it’s okay?  You said going off and on isn’t good.”

Doc:  “Eh, you’ll be fine.”

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4 thoughts on “Bedside Manner by Eva Langston

  1. In my experience, when you go off BC after a decade or so your body reverts back to many annoying teenaged habits. Major acne, your period shows up whenever, or twice a month, or not at all for a while. The hell of cramps returns. Natural is overrated.

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  2. I know exactly what you mean when you talk about bedside manner, and I can tell you I have experienced this first hand from a somewat unique perspective. I moved to the U.S. almost 10 years ago and It’s my home now. The country I love, and the one I root for in the Olympics. I come from a south American country where I lived all my life before moving here, and I come from a pretty wealthy family. So do all my friends. The most radical difference in the health system down there is that even thou doctors are as capable, as trained and as qualified as American doctors, they’re not rich. They’re somewhat wealthy, but not rich like in the U.S.

    I’m not saying all U.S. doctors are rich, I know there are many people who just graduated medical school a few years ago, work grueling shifts and are buried in student debt. But I’ve also met a few doctors in here that live in 5 million dollar homes and drive Ferraris. That simply doesn’t exist in the country I cone from, because there is a law in place that guarantees that health care is not a for profit business. This changes the dynamics between doctor and patient radically because when you ave a doctors appointment and you sit and have a conversation with your doctor is not like you’re talking to the pope. You’re talking to a semi-public servant that us there to help you, to get to the bottom of whatever is bothering you and who gets paid more than fairly for his troubles. (and drives a late model car, and lives a very comfortable life, in a very nice house. But not a ferrari, and not a 5 million dollar house). Just to give you an idea, a doctors appointment down there, is usually 1 hour. (here is 15 minutes). And the kind if relationship you can develop with yor doctor with 2 or 3 yearly 1 hour visits, is WAY different than the one you can develop in here with a yearly 15 minute visit. The non profit model also makes it that visits to the doctor usually cost nothing, and in the event f a major medical procedure, (I’m talking about open heart surgery, sometimes even out of town, so you can be aken care of by one of the best surgeobs in the country, even if they have to fly you or drive you there at your your insurance company’s expense) could mean 200 or 300 bucks out of yor pocket after everything is sad and done.

    My wife had a dentist appointment yesterday, to replace a filling, and during the procedure the dentist noticed one of her other fillings was starting to chip away as well. He said it was not a big deal, and it could be taken care of in 5 minutes by filling it with the white paste they used, and invited my wife to schedule another appointment next month to do so. My wife asked if he could do it right there and then, and he just laughed and said she needed to book another appointment. It was “standard procedure”. From his perspective, why put a dollars worth of white filling paste in my wife’s tooth basically for free, when he can milk the insurance out of several hundred dollars by making her schedule another appointment and charging consultation fees twice?

    There are thousands of things I love about America. Healthcare, s definitely not one of them.

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  3. The problem I think is, that even here in the UK, where we have a ‘free at point of use’ health service, there aren’t enough doctors, especially what we call GPs (general practitioners), to deal with the amount of medical complaints or perhaps complaints.

    NHS doctors get told each appointment should last no longer than 15 minutes. So not much time to debate options, or to consider your individual issues.

    That said, if you go in armed with questions (so as not to be bamboozled by the whole experience), and are cogent and calm (or teary), I have found my doctors to be almost always attentive and not too quick to prescribe, but equally, happy to prescribe when that is obviously the best option.

    I guess what I’m saying is we have to grasp the control back from the health profession, and accept that we know more about our bodies than they do, so we should tell them that, and then listen to their opinion, and then think that through. They are just trying to do a job, and each patient is one in a million, so those of us with a tad more compus mentus need to useit, if only to assist our hard worked medical professionals.

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