Who needs med school when you’ve got wi-fi?

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There was a House, MD episode in which a couple thought their son might also have a uterus.  Even though they were seeking House’s help for this child, they immediately began to dang near tell House what to do.

“We think he has a blind uterus; he should have an MRI,” they said.  House asked another doctor on his team if she’d talked with the parents.  The parents stepped in, replying that over the past several years, they’d educated themselves.  To which House, without missing a beat, fired back the title quote.

I could’ve kissed him.  But I should’ve paid more attention to what happened next, because I would’ve learned how to correctly deal with being faced with the same uneducated-yet-know-it-all personality type.  House indeed ordered their MRI.  Not because he thought they needed it.  Another doctor on his team said, “you just said an MRI would be a waste of time,” to which House replied, “so is arguing with them.”

Next time, I’ll follow his lead.  This time, however, I hadn’t.  Yesterday I took a permanent Vow of Silence (and a permanent leave of absence) on pretty much all forums (Facebook or otherwise) dedicated to the self-treatment of health problems.

You might know the type of discussion forum I’m talking about.  Then again, you might not, so I’ll explain.  If someone has strange symptoms or hears about a disorder they think they might have (Candida, Leaky Gut, ADD, parasites, gluten intolerance, MS, multiple chemical sensitivity, just to name a few), the first thing they do is deposit themselves in their computer chair and get down to Google business.

Google doesn’t disappoint, either.  Information overload appears on  your screen within fractions of a second.  Usually, near the top of those search results, are Discussion Results–as in, you can click on the link to read about people discussing this condition.  It’s the epitome of desperation.  Two-year-old discussion threads are instantly revived by a lone, “has anyone found the answer yet??” or, “are there any doctors out there?”

Followed by crickets, of course.  Because looking around, it doesn’t take long to realize that hardly any other doctors will chime in on a discussion, especially not for free.  The laypeople seem perfectly content to duke it out for themselves, spinning themselves up into mental pretzels until they become desperate enough to end up where they belong: in the office of a state-licensed professional.

Well, I had a different outlook.  I have the semi-unique perspective as both a doctor and a patient.  I, too, was plagued by mysterious symptoms that I didn’t understand.  They kept building and wouldn’t go away.  I, too, was trying everything I could think of.

Finally I said screw it; I’ll become that doctor I can’t find.  And I went to school.  Did I do it for the money?  No, I did it for me.  I wanted to heal myself without continuing to shoot in the dark, not knowing what I was doing.  And I knew there were others out there like me and I didn’t want them to feel like I did anymore, either.  I wanted to be one of those extra-qualified doctors because I had Been There and I Know Exactly What It’s Like.

I’m also in the semi-unique position of having too big a heart, too big a mouth, and too active a case of ADD, the latter of which dictates I break away from my work and get lost of Facebook or something similar for a while.  This is a recipe for starting to get involved with those condition-based self-help groups (you know, support groups for Fibromyalgia, Autoimmune disorders, or thyroid issues, etc).  I wanted to rescue them, to give them a compass, to point them toward the light so that they wouldn’t have to be in the dark anymore.

It’s amazing how argumentative they get.  You make a simple point about making sure that the remedies you’re taking are pure and potent and that you trust their source and BAM, the die-hard Wal-mart set comes out that brags about ordering (potentially counterfeit) products online.   The kiss of death was accidentally letting the phrase “us practitioners” (or something similar) slip out.  Suddenly everything I said was suspect, like I was somehow trying to make money off those people.  I could feel them giving me the stink-eye through their text, practically proclaiming me a witch in 1690’s Salem.

Um, if I’m just after the money and if I’m trying to comb the self-help groups for patients, why am I not mentioning my practice or location?  Why am I not even using my real name on Facebook, nor revealing it in conversation?  What is it about “be sure you can trust your source” that somehow says, “I’m secretly trying to get you to buy from my clinic”?

Between this and several other experiences on various groups, I came to the realization that these people don’t even want any direction.  They’re perfectly content, marrying themselves to their disease labels, eliciting sympathy from those around them, wasting hours on Facebook and other discussion sites lamenting that they feel like shit yet again, and clinging to any crappy over-priced, under-studied, mass-produced-in-China they can get their hands on.  I swore off all of it–for good.

Oh the humanity!  What will those stranded people do??  Breathe.  Don’t worry, it’s OK.  They never actually wanted a doctor’s advice anyway.  I should know; I tried to give it to them.  For free, with no strings attached.  They’d rather wallow and commiserate.  Maybe if and when they get desperate enough, or when the friends’ or family’s patience starts wearing thin, they’ll finally be motivated to get off their dead ends and make a real change.

Then I came to some additional realizations…

I’m lucky I’ve always kept my advice vague.  For a doctor to give advice any more specific would 1) instantly and completely devalue his or her services (knowledge and time are the only things a doctor has to sell), 2) jack up the general public’s expectations concerning the flow/sharing and cost of information, leaving them to expect free advice, and 3) potentially set that doctor up for serious trouble down the road; even if nothing bad happens, s/he could be charged with practicing telemedicine without a specific additional license (and hefty licensing fees) to do so.

And then I also realized that it would be tacky and irresponsible.  If you’ve never laid eyes on the patient, read any intake forms, run some labs or performed a physical (or preferably a combo of the above!), then you have no clue what’s causing their symptoms and you don’t know the true nature of their problem, and thus you’re ill-equipped (at best) to address it properly.

And of course, during my first such experience a couple years ago, I did find that my advice was not really valued.  My audience wanted specifics, and I’m sure they got a little miffed when I gave them fascinating in-depth background information and then simply pointed them in the right direction, encouraging them to seek out a licensed practitioner in their area  (“look for a doctor who does ‘X’ test”).  I even offered to help them find the best qualified licensed practitioner I could find.

Not one took me up on what I thought was a relatively generous offer.  Not one.  Instead, people gravitated toward another member of the group, the only doctor I’ve ever known to give free specific advice on the net.  Talk about walking on thin ice; doing this could’ve ended this person up in very hot water – we’re talking remedies, formulas, specific brand-names, and indeed individual dosages.

I got less and less comfortable sharing cyberspace with people like this (be it the over-giving practitioner or the cling-on mental pretzels), so I left that group completely, writing a short, sweet, dignified farewell post.

The group’s reaction to my public resignation surprised me.  Out of over 400 or 500 people on that forum, only 18 cared to comment, thank me for my contributions/time/expertise, or wish me well.  Just, wow.  (That just goes to show us all that doctors don’t do anybody any favors when we let them pick our brains for free.  They just don’t seem to care, so you can’t even derive any marginal self-satisfaction of helping someone from it.  Leeches will simply take from you until someone even more generous comes along; then they spit you out and run over to the next one, drooling.  And the only way they’ll stop is if all doctors stop, too.  All of us, and now.)

Yesterday’s departure from a different group was much quieter and more sudden.  I saw the old pattern of stubbornness from difficult, unappreciative women (these people are overwhelmingly women), knew where this go-nowhere black hole of a path would eventually lead, and went straight up to the control bar at the top of my screen and removed myself.

People who already think they know everything have essentially stopped learning.  They’ve also stopped growing, changing, evolving, and living.  They’ve made themselves a snapshot, fossilizing themselves in what they are today.  That’s it for them.  House was right; it’s useless to argue with those people.

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