Medical professionals who are excellent, asses and part of a failing system

My posse and I trekked into the Twin Cities this morning (despite threats of dangerous weather that have come true all around Minnesota over the day) because of a malfunctioning G/J feeding tube that needed immediate replacement. The balloon part that inflates in my stomach to hold it all in place had deflated itself and the damn thing was trying to come out, which it cannot really do without also pulling away from where it enters my upper intestine (jejunum).

This deflation and migration caused me some discomfort but not any intense pain, the hospital that installed it worked me into the schedule this morning and it was easily replaced. I returned home before people started sliding off the icy roads and all is mostly well with my world.

But there's this little drama that plays out each time I get the tube replaced and I've only just today discerned the pattern among the cast of medical professionals I spend about a half hour with -- usually every three months. The nurse who comes to get me in the radiology recovery room (for outpatient procedures I am unfamiliar with) is always male, which is fine, but curious since nursing is a predominantly female profession. He's also always incredibly personable and relaxing to be around, which I appreciate since he is my host to Events That Thus Far Have Gone Smoothly But Do Involve Medical Risk. This host has been several different specific guys in the past year, all kind and competent.

The x-ray techs are also mostly male in this high tech procedure, though today there was one woman present other than myself and the nurse I brought with me from home. These x-ray techs do non x-ray-ish things like sterilize my stomach with Betadine and arrange the surgical drapes. I expect the specialization of the nursing and x-ray tech requirements somehow explains the male predominance I've observed, but I don't know exactly how or why.

The nurses and x-ray techs have all always been reassuring, professional, caring, kind, responsive -- everything you want in medical people. The doctor shows up for five minutes to yank the old tube out and thread the new one in. The guy I usually get calls me "sweetheart" and comes and goes rather politely but quickly. He seems skilled, and I appreciate that.

But here's the thing: He's a total ass to the other people and, in subtle ways, to my nurse. It's not one isolated incident. He's displayed asshattery on several occasions now, belittling the employees under him at the hospital and treating my nurse like she and others like her are either negligent or incompetent. Today's deflated balloon and faulty tube, he asserted to my nurse, was the fault of her and others in my employ who just won't leave it alone and must have manually deflated the balloon.

The doctor discussed this with my private nurse out of my hearing, basically giving her professional chiding and advice without ever once consulting me about my care. It didn't dawn on me until today that not only am I just a body on the table that he does a quick procedure to and then leaves, but he doesn't even consider me a partner in my own care of the equipment he installs in my body. Perhaps because I have a nurse, I don't know. Maybe it's part of his abrupt pragmatism and crowded schedule, but I doubt it's as simple as that.

Meanwhile, the other employees of the hospital that he seems to consistently belittle and treat like dirt continue to shower me with thoughtful care. It's unlikely he's like that just when I'm around once every few months, right? This is a working condition for these other professionals that serve me well and might someday decide that they don't deserve this crap and move on to another job.

There's gender, ableism and a kind of professional classism at work in these dynamics I observe, and it's taken me a year of quarterly encounters and some quizzing of my nurse to get a fuller picture of it, since I'm not privy to all of it that occurs even in my specific interests. And this is an example of medical competence, really. In all ways medical, it's basically a successful encounter. And yet that successful-ness seems precarious to me because of all the power dynamics involved with this one doctor, and that's been on my mind all day.

Genni McMahon, who blogs at Ilyka Damen's, has had much more dramatic, critical problems with medical care on her mind today. Read it all, but here's a taste:

My mother became very ill the night before last with a high fever, extreme body aches, and weakness. She’s 62, swims three times a week and uses her Nordic Track everyday. She’s a partner in an accounting firm, takes no prescription medicine, and is a health nut. She couldn’t get out of bed, so my sister and I went to her house and called her doctor; he’s a skilled physician, but like most of the system, he’s a doc for profit. His office told us to take her to the ER. There, we had a really bad experience and they managed to nearly kill her, which I’ll share in a moment.

First, though, let me say that in spending the entire day in an ER, with momentary breaks to go get things from my mom’s house and take a kid from one caretaker to another, I noticed what I think is the absolute cornerstone of What’s Wrong With Healthcare In America. I’m sure you’re curious as to my discovery, so I’ll let you experience it as I did.