Wednesday, February 15, 2017

On my lack of faith in professionals, plus a new health concern

I don't have a lot of faith in professionals at the best of times. It seems to me that for every competent, caring person you  meet in any profession, there are four of five mediocrities who have no talent at all at - or passion for - what they're doing, who are just waiting around to collect their pensions, playing it safe, hoping nothing too challenging presents itself to show up how incompetent they really are. And for each of them, there are at least one or two total jackasses who stand as living arguments in favour of caution, who have risen to positions they barely deserve and who will make your life misery if given the chance, with bizarre personal issues, flawed logics, and indifference to your needs, which come second to their own ambitions and quirks.

Take dentists, for instance. I'm a difficult freeze, a sensitive guy, and have a less than outstanding track record when it comes to taking care of my mouth. I have had four or five root canals, one crown, five or six extractions - I forget, and don't feel like sticking my finger in my mouth to count the spaces. Plus I've had countless fillings. I have encountered a wide range of dentists, in getting work done: from magicians who have painlessly removed unsaveable teeth to a guy who, as I recall it, actually put his knee on my chest to give him leverage as he yanked this way and that to yard a wisdom tooth from my jaw (unfortunately, I didn't realize painless removal was an option, when allowing the knee/chest guy to operate on me). Meantime, in between either extreme, I've encountered more than one dentist who simply couldn't freeze me well enough to do the job, who blamed me for being too sensitive to operate on, who then charged me money for trying and failing to produce a single meaningful result. When I find a good one - and I credit Billy Hopeless here for introducing me to Dr. Donald Shuen, my current dentist, on Broadway, whom I recommend enthusiastically - I tend to stick with him, if I can, because they're the exception, rather than the rule, I've found. 

Or take doctors. I've had both my parents die within the medical system in recent years, and while I could point the finger in other directions, in both cases, I had pretty serious issues with the system, saw it as at least complicit in their deaths. If my father's polyps had been diagnosed and treated within a month, say, of his first going to the doctor, they wouldn't have metastasized and spread colon cancer to his liver. He could have helped his own case, of course, by not enduring a couple of months of constipation and discomfort before he even went to the doctor, and then, once the doctor decided a colonscopy was in order, he could have helped his case by being more of an advocate on his own behalf, pushing to get it done earlier, checking to see if spaces had opened, being a squeaky wheel; but he had utter faith in the system, you know? He was of that generation - he had faith in authority, faith in the powers that be; hell, he still believed in God. As things were, by the time he did have a colonscopy, he had to have a big chunk of his colon removed and was told the spots in his liver were untreatable and were going to kill him eventually, which they did. It might NOT have been that way, had they just maybe jumped him ahead in the queue a little, given how long he'd been suffering and how potentially serious the case was. Instead, from the first diagnosis ("probably polyps causing constipation") to the colonscopy and the "terminal cancer" one, six weeks passed. By that time, it was too late...

Similarly, if a cardiologist had been called in to consult with my mother as soon as she showed signs of heart stress - which happened three nights into her six week purgatory in the hospital, before she finally died, in April of last year - preventative steps MIGHT have been taken to keep her heart from failing. She was there for gallstone problems, and there were plenty of distractions - two serious infections, periods of delirium, and so forth - but once she'd had her second heart issue, and an angiogram and stent were tabled as possibly warranted, a doctor, behind my back, had a private conversation with my mother (who was barely competent, due to her old stroke, and barely able to understand what was being said to her, and who was also totally unable to explain to me afterwards what had taken place; it is a conversation I should have been included in, or at the very least, informed about as soon as it happened). As a result of that consultation,the procedure was completely taken off the table. I asked about it, thought it was still planned, talked to more than one person at the hospital trying to figure out what was going on. I didn't find out what had happened except by accident, when I ran into the doctor who had had this secret talk with her, and she told me about it, a week or more after the conversation had taken place. By that time, my Mom had had a third or fourth heart episode - probably her old bypass grafts failing, one at a time. By the time I got the angiogram/ stent discussion BACK on the table, and a cardiologist was called in, five weeks into her stay, it was too late: Mom was too sick to undergo the procedure, her lungs filling with fluid and other organs shutting down. She died three days after the cardiologist first came on board. Hard not to decide that the system, and that one fucking doc in particular, failed her utterly.

Of course, part of the problem with any criticism of the medical system is that there IS a system in place. It's practically designed to make it hard to blame any one person. My mother's doctors and nurses seemed to change on a near daily basis, called on to oversee one phase of her treatment and then replaced by someone else who had to start from scratch once a new phase was underway, or once she was moved to a new ward (which happened five or six times, sometimes seemingly quite arbitrarily). There were also a couple of really offensive moments early in her stay where doctors tried to pressure me into signing off on a Do Not Recusitate when all she was (seemingly) facing was getting a gallstone removed, where it was clear that their concern was not about her or me or anything other than the expense of having someone hooked up on their precious machines; the institution first and foremost serves the needs of its own maintenance, and only thereafter takes into account the needs of the public it supposedly exists to help. When I read about Vince Li being granted "absolute discharge,"  my first thought - after shuddering in fear - is to wonder how much of that is because there is too little money in the public coffers to monitor him? ...If the doctors who are signing off on him taking over the maintenance of his meds regime are mostly just concerned about freeing up resources so they can treat people who are more obviously posing a problem? 

Anyhow, with experiences like these, I don't have a lot of trust in professionals. Just because someone has a job doesn't lead me to assume that they're any good at it. And just because they had to pay money for schooling to GET that job... That also doesn't fill me with trust; I've been to university too, and seen the quality of the people in positions of power and authority, from tenured professors who ate cookies while giving free-associative lectures that no one could follow - crumbs spilling down their shirt front as they lectured and chewed at the same time - to complete and utter nutcases who scared me with the sheer force of their eccentricity. (And I'm not even talking about poor Hector Hammerly, here, who, while definitely a bit heavy-handed as a prof, was undeserving of the controversy and disgrace he faced; he was one of the better ones I had, actually). I've met some great profs in my experiences at SFU and UBC, but they generally stood as the exception, not the rule. And I know from the various outstanding grades I got in classes that I barely understood (Metaphysics? Are you kidding me?) that just because you succeed in a class doesn't mean you actually have ability. If you're smart and ambitious and canny, it isn't that hard to fake your way through the system and come out the other end with professional qualifications you barely deserve. I certainly didn't learn how to teach ESL by going to university - and I'm not even sure you could, frankly. No: I learned how to teach ESL by TEACHING ESL - it took time and experience to get good at it, not textbooks and tests and note-taking. 

Suffice it to say that I tend to evaluate people on a case by case basis, and to try to trust my own judgement; just because someone has a title, or letters behind their name, doesn't mean they aren't an utter idiot who will fuck you up three ways from Sunday if you put your trust in them. There are plenty of doctors and dentists and such who I see once and then vow never to deal with again if I can help it. If someone rubs me wrong - and plenty of alledged professionals I have met do just that - I try to take heed of my intuitions. Sometimes I have no choice but to put my trust in people who have more knowledge and experience than I do in a given field, but I try not to be too passive or blind about that trust...

Anyhow, the upshot of all this is that I'm a bit nervous, because I have a health issue that I haven't previously mentioned publicly. It's been going on since September. In that time, I have consulted with five doctors or more, some on multiple occasions. I was told uniformly that it was nothing. I was given blood tests. Swabs were taken. I had a swollen lymph gland, pain when swallowing, and a weirdly sore tongue, and all were persisting for weeks, but I was assured on more than one occasion it would go away, that it was a reactive lymph condition responding to some infection or other and that it could take weeks to settle down. When it didn't, some time in mid_December, I finally went to the ER at a nearby hospital and put on pressure to get a CT scan, to look at the lump in my throat, which was then my most notable symptom. After the CT scan, I was once again assured that all was normal and it would go away of its own accord. I busied myself with other things - other health worries (carpal tunnel), my new job, and my wedding plans. I allowed myself to trust that indeed, the doctors had been right, and nothing was wrong. I let my vigilance slip a little - and for awhile there, my symptoms even seemed to go away.

But the tongue issues recurred, and I finally, sheepish about having pestered him so often, went back to my doctor and asked him again what was going on; the lymph lump is gone, you were right, but I have this weird pain in my tongue and it just isn't going away...

And this time, something like four months since I began talking to him about it, now he can see something. Hmm, you have lesions there, come back in a week, and we'll see what happens, he tells me. 

So I do, and the lesions (and the pain) get worse. 

So now I'm consulting with an ENT, and am told that these lesions on my tongue might be cancer. They might be something else - it's a fifty fifty chance that they're cancer or something called lichen planus, he says. That was last week; I was told to come in the next week - tomorrow morning, as of this writing - for a biopsy. 

So that's where I'm at. I go in for an examination tomorrow morning. A wee chunk of my tongue will be taken and tested and hopefully before too long I will know what's going on. 

David M. told the audience at his tribute to Paul Leahy the other night, apopos of his performing the song, "You Need Your Tongue to Stand Up," that Paul first had lesions removed from his tongue in 1998. This was the start of his dance with cancer. He made a good go of it, lasted 20 years from that first surgery. As David was singing the song, I was adding 20 to my age, thinking, "I guess I can live with that, if I make it to 68."

Maybe it's nothing, folks, but I got to admit, I'm nervous. The ENT seems like a good man, thankfully (a bit like a Chinese David Carradine, but calm, attentive, and seemingly good-natured; my intuition is to trust him. My GP is all right, too). It might all be nothing, but then again, it might be bad. (Maybe my weight loss recently isn't due to healthier living?).

Wish me luck...

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