My Change of Heart

In dealing with members of the medical community over the past 11 months, I have had a change of heart. I no longer want to be a Physician Assistant. I do not feel I can become a member of this community with any of the positive feelings I once had for the profession and that of its parent profession, the physician. I cannot put myself into a position of demanding respect when I have so little for some of those who have "touched my life" in recent months. It was difficult coming to this decision but something I think is for the best in the long run. I love to buck the system, be radical and try to effect positive changes in ANY system I think needs improvement, but I just don't have enough energy, willpower, or fight left in me for this particular battle.

I had actually been pondering this for a while now, but it was cemented after a visit to the emergency room in the wee hours this morning. After losing a significant portion of my field of vision in my right eye with painful eye movements, vertigo, nausea, vomiting, and a catastrophic headache, a handful of basic tests were performed and I was told there was nothing "severe" wrong with me.

Your diagnosis: You have a headache. Yes, that is exactly what my discharge paperwork says. I probably would never have figured that out on my own and I have been gobbling down 4000 mg of acetaminophen a day as a dietary supplement.

Return if you have a significant change or worsening of symptoms. Why? So you can charge me some more money to tell me again that there is nothing wrong with me? No thanks. I came to you once because of "a significant change or worsening of symptoms" and you did nothing the first time; do you honestly think I am stupid enough to fall for that one twice?

Please contact your primary care provider for further follow-up. It is a vicious circle:

• Copay $20 to internal medicine/PA: "I don't know what the problem is, let's run some tests and you have to come back in a couple of weeks."
• Copay $20 to internal medicine/PA (two weeks later): It's all in your head, you need to see a psychiatrist." (I ranted about this one before.)
  
• Copay $20 to neurologist (six weeks later): "Let's run some more tests."
• Copay $20 to neurologist (two weeks later): "You have a syrinx but it's small and shouldn't be causing your symptoms. Let's run some more tests and send you to a neurosurgeon."
• Copay $20 to neurosurgeon: "Your syrinx is too small to operate, we just need to monitor it and can do surgery when it's larger. Go back and see your neurologist."
  
• Copay $20 to family practice physician to become established in his practice: "Let's see what the neurologist says."
• Copay $20 to neurologist: "Let's send you to Cleveland Clinic."
• Copay $20 to specialist neurologist at Cleveland: "We don't know what's causing your problem, let's run some more tests and then you can follow up with your local neurologist."

That next appointment with my neurologist is 3 weeks away, and the tests recommended by the specialist will not be ordered BEFORE that appointment, so there is another $20 copay for that visit and then another $20 copay for a second to get the results of the tests that need to be ordered, all spanning an additional 6 weeks. I have a crisis in the meantime and go to the emergency room ($50 copay), only to be told they don't know what the problem is and I need to see my primary care provider and my neurologist.

So. . . That is $190 out of my pocket so far for office visit copays (that doesn't count deductibles and copays on testing, just office visits, plus lost time from work) and I still have no hope of securing a diagnosis and am just being referred in circles, all the while worsening in my condition. Why is it that when a doctor doesn't come up with a straight and simple answer in the first 5 minutes, they just give up?

In my final buck before giving up and floating away into the distance, I scheduled an appointment on my own to see an ophthalmologist (another $20 copay), 10 days away. If he cannot help me find an answer, I am done trying to find it. Now I understand why so many patients with chronic illnesses frequently suffer from depression: The medical profession forces it on them and patients just get discouraged and tired of hearing over and over "I don't know." I can handle an "I DON'T KNOW," as long as it is accompanied by "BUT I WILL WORK TO FIND THE ANSWER." I have yet to hear that.