Oct 122014
 

An ongoing project.

As many of you know, I grumble about medical people. I’ve seen more than my share of crummy quacks.

But my internist for the last 15 years was an exception. My suffering, both physical and mental, would have been so much greater if not for him.

He died last month, and I’ve been raw with grief.

Prior to finding him in the late 90s, I’d gone through a succession of lazy judgmental doctors. I was an artist and did not hold a conventional 9-5 job. I tend to come across as a little batty to medical people. I’d been getting sicker and sicker. One doctor told me all of my gastrointestinal problems were evidence that I didn’t cope well with stress and needed to be on Prozac (it later turned out I had celiac disease). Another told me I was like “a Victorian lady.” A bit too delicate and hypochondriacal.

At the time, my throat was swollen halfway shut all of the time. I’d gone to a local allergist who’d told me it could be any one of “hundreds of things.” It was pointless to try to figure it out. But if I started having trouble breathing, I should go to the ER. And that was all he could offer me. The doctor who’d made the Victorian lady comment prescribed a heavy-duty antihistamine that I later discovered was most often meant as a sedative.

I was telling some of this to the woman who cut my hair back then. She told me she liked her doctor. He took people seriously. He’d come up here recently from LA and was now chief of staff at the local hospital. He’d help. I was skeptical. But I was also desperate. I made an appointment, expecting to, yet again, get the brushoff and be told I needed Prozac. I remember telling a friend the night before that I was about to try a new doctor. “Whatever you do,” she urged, “don’t tell this one anything about your background! You know what they’re like…” I agreed that, indeed, feigned normality was my only hope of getting unbiased care. I’d try my best.

This new doctor’s reaction to my symptoms was “Oh my God! You’ve got a serious problem! Dangerous! We need to get to the bottom of this.” He assured me he would find out what was causing the swelling and the other sick-making stuff. In the meantime, he got me on some non-sedating meds and insisted I start carrying an anaphylaxis kit, just in case.

I walked out almost in a daze. A doctor who was taking me seriously? This didn’t happen. He discovered that I was allergic to milk, something that I almost found hard to believe. I also had other food allergies. Once my allergies were discovered, the alarming swelling and the chronic eczema I’d had for years vanished.

I later saw the chief of Allergy and Immunology at a major teaching hospital. She told me I was deluded. I could not possibly have those food allergies. She would know. She ordered me to consume milk for the health of my bones. She was so adamant that I doubted my own sanity. That night I ate ice cream. And swelled up and got rather sick.

I reported this later to my internist. He narrowed his eyes with disapproval. “Nothing…  from…  the… udder… of… a… cow,” he slowly hissed while shaking a finger at me. “You really listened to that woman?!”

Around this time, I began to develop indescribable pain through my right, dominant arm and hand. It was incapacitating. As an artist, this was a career-killer. The pain spread to my other side. Other inflammatory problems blossomed. Life was not good. But I was far more fortunate than most, especially around here, in similar situations. I had a doctor who genuinely believed in easing suffering. He tried and suggested practically everything, made referrals and tried different combinations of medications. If he couldn’t cure it, he was at least going to do everything he could to keep me as functional as possible.

My internist had enormous physical challenges of his own and knew what it was like to suffer from a patient’s perspective. He was an extraordinarily empathic doctor.

Over time, he became as much a friend as my doctor. He came to my art shows and I went to his spoken word/music performances. We used to talk so much about other things — politics, usually — that I’d ask, laughing, if he’d mind if I interjected with a medical question. This, in the age of 8-minute doctor visits.

He gave me most of the pharma packaging I use for arts and crafts. Leaving an appointment, I’d sometimes feel mildly self-conscious clutching a bag full of pharma industry sales paraphernalia.

He liked to encourage artists.

He once gave me one of his own antibiotic pills from a recent hospitalization. He explained that the single pill was worth $200. I painted it gold and placed it on velvet inside a pill bottle cap. I presented it back to him at my next appointment along with a miniaturized bound copy of the annual financial report of the pharma that had produced it.

The $200 Pill

We had an unusual doctor-patient relationship.

It’s not that I agreed with everything he did or suggested. I still smile when I think of one time when we were having a shouting match because I’d disagreed with one of his recommendations. As our argument escalated, his nurse — long accustomed to his conversational style — cheerfully strolled in and, over our bickering, announced she’d forgotten to take my blood pressure. She then proceeded to do just that, smiling, as we continued to shout at each other.

The memorial gathering for Dr. David Gans was this weekend. There were so many mourners, the room overflowed to standing-room only.

True to his spirit, there was a giveaway table in back loaded with gifts for the assembled.

Everyone was invited to help themselves to the pharmaceutical industry trinkets that had been collected from his office. (For those of you not in the U.S., you probably can’t believe most of this stuff.) Tears turned to smiles as people walked off with pharma-branded mugs, clocks, toothbrush holders, mini golf clubs, toys, cup dispensers, paperweights…

Staring at the table, my husband Victor whispered in my ear, “better get some bags from the car.”

I pictured Dr. Gans laughing.

New tool holder

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  10 Responses to “Thanks Dr. G”

Comments (10)
  1. We could do with more people like your lovely doctor. Maybe we have a good guy here…reported on a news item last night, the tale of a heart specialist who has, at his own expense, outfitted one of those enormous trucks (a semi?) as a mobile heart clinic to access patients in The Outback. For people enduring long waits and extremely long journeys just for diagnosis, this must be wonderful.For some, earlier diagnosis will mean earlier treatment.
    I hope you do get another doctor prepared to put in the “hard yards.”

    • Your guy does sound like a generous soul. As you know, access to any kind of care at all, let alone competent and humane care, is getting pretty grim here. We’ll see… Thanks for the good wishes.

  2. Dr. G sounds like a wonderful human being! Thanks for sharing the richness in the story of your relationship. It warmed my heart. Other people, especially empathetic, caring ones, can be such a blessing in our lives. I am so sorry for your loss.

    • Thanks Amy. This was actually a condensed version. I had to keep going back and removing stuff so it didn’t turn into a novel. He was one of those people who truly seemed larger than life. And, yes, was indeed a blessing to me. I seriously doubt I ever could’ve even been on the computer long enough to have a blog at all if not for what he did for me.

  3. Great post! I’m so sorry for your loss of an excellent doctor and a great friend. The world definitely needs way more people like him…not to mention Humboldt County. Have a safe trip this week. xo

    • Thanks Connie. And, yes, as you know… the situation in Humboldt is indeed rather grim. I really don’t know what we’re going to do.

      I wish I weren’t going–the thought of another medical excursion the way I’m feeling now is more than a bit much. But the appointment was really hard to get. Alas. Thanks for the good wishes… as always.

  4. Inarticulate but heartfelt hugs.

  5. I’m so sorry for your loss Ellen. I have some idea of how you feel as Ian and I have been seeing the same CFS specialist for 18 years. About 12 years ago he had to stop practising for about 3 years and it was impossible to find anyone who knew what they were doing, although a few were convinced they did! Up to that time, I had been making slow progress.

    I hope you can at least find someone sympathetic and caring soonish. It is awful to feel completely unsupported. The truth as I see it, is that nobody has “the answer” to these conditions at this time, but it does help to feel you are at least being “heard”, and someone who understands that “First, do no harm.” means emotional, as well as physical.

    Thinking of you, xx.

    • Thanks Amanda. It’s awful, isn’t it? The well just have no idea the terror of being so dependent upon someone else just for your day-to-day ability to function at all. I hope your guy stays as healthy as possible!

      It makes things feel so rather complicated…. I’m bereft on multiple levels. My doctor was just so amazingly supportive, whether it was purely on a medical level, or fighting my insurance company so my expensive medication would be covered, or making referrals, or being emotionally very supportive… Even just to be taken seriously and believed — to be treated compassionately as a rational human being — is such a huge thing, as you well know. My doctor ultimately didn’t know what was wrong with me, and he certainly didn’t have all the answers. But he had enough self-confidence to admit to what he didn’t know, rather than declare I must be crazy (as they so often do).

      On top of it all, we also have a severe doctor shortage here. Even the clinic of last resort that supposedly takes everyone won’t take me as a patient. There’s a significant possibility I might ultimately wind up having to get my primary care 300 miles away, in spite of the fact that travel is quite difficult for me now. And that still doesn’t even mean I’ll be treated humanely. I’m really scared.

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