Our Broken System Part 7: Plumbers, Ninjas, and Doctors

When my wife told me about her encounter with the plumber, all I could think was: \”What a jerk!\”  Then I was hit with an eerie sense of familiarity.  OK, it wasn\’t exactly eerie, but there was some creepy music in the background.

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We had a shower fixed about a year ago, costing us a bunch of money.  I would do it myself, but past experience gave me frightening images of water dripping through the ceiling, and bathrooms falling in to the middle of our garage.  I still awake with cold sweats from previous plumbing experiences.  So we found a plumber with good recommendations on Angie\’s List, so we thought we were safe.  But after paying a whole lot of money, we were left with a faucet that seemed like it was made out of a plastic-metal alloy and took about half a turn to get any cold water.  We were afraid to call the guy back, however, given how much he charged us for our previous encounter.  Despite the cheap faucet, we had no leaks and experienced no sudden appearances of bathrooms in our garage.

Then last week my daughter told us  the shower wouldn\’t turn off.  Through the fine art of faucet jiggling I was able to get the shower to stop (and she was quite impressed by my mad skills).  But another night\’s shower had the same complaint from my daughter, and my skills were not as mad as I was.  Since it had been about a year since our last repair, and since the faucet seemed chintzy, we called back the same plumber and he came over to assess the damage.  It seemed like it was his fault.

The plumber, being the trained craftsman he was, quickly found the source of the problem: us.

My wife explained what happened, as well as the elbow pain we all experience turning the cold water, and he shook his head.  He noticed the caulking around the cold water faucet was missing, and told my wife that someone had \”obviously\” done something to that faucet.  When my wife explained that my mortal fear of plumbing (and her mortal fear of my plumbing) made this an impossibility, he looked at her with a condescending skepticism.  It seemed \”obvious\” to him that either my wife was not telling the truth, or that a plumbing ninja had infiltrated our bathroom to remove the caulk without our knowledge.

Things got worse when my wife suggested that the hardware installed wasn\’t very high quality.  He seemed offended at the suggestion that he would use anything but the best.  How could a mere mortal non-plumber suggest that the shower that she uses every single day is anything but the best?  Her suggestion that it shouldn\’t take so much turning to get cold water was clearly a statement of ignorance, or a fabrication designed to slander this highly trained professional.

The good news was that it was just the white cartridge thingy that needed replacement and so it took only $75 to get rid of this jerk and get our shower back to its previous sorry state.  I suspect that because the faucets have so much play in them, my daughter cranked them harder than she should to turn them off and so damaged the cartridge thingy.  Either that, or the plumbing ninja was at doing more than going after the caulking.  I shouldn\’t think about it too hard, though, because I\’ve actually created leaks in pipes by prolonged contemplation.

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Unfortunately, this encounter with the demigod of plumbing reminds me a lot of what my patients get when they see certain specialists.  Several aspects of my wife\’s experience are eerily similar (there goes that music again):

  1. The plumber\’s reality trumped anything my wife experienced.  Despite the fact that she showers in it every day, she was not given any credit for her own experience.  The plumber\’s self-centered view of the universe made it impossible to consider my wife may know something about the shower.  In the same way, patients are treated like they simply can\’t be having the symptoms they are having because it doesn\’t make sense to the highly-trained and extremely intelligent doctor specialist.
  2. My wife\’s suggestion that the plumber may be wrong was something she was made to feel guilty about.  It\’s not just that she was wrong in her reality experience; she should feel shame for experiencing anything the plumber said wasn\’t true.  This is exactly the same as my patients who visit doctors with the same reality-distortion field.  They are bad people for experiencing what they do.
  3. Our experience with the plumber makes us want to avoid further encounters with members of the profession, and to seek alternatives if possible.  Why is it such a mystery that patients seek alternative medicine when they are made to feel stupid when they go to the doctor?  Nobody wants to be made to feel guilty for symptoms they don\’t want in the first place.
  4. We feel like our ignorance (and mortal fear) of plumbing is an opportunity this guy used to pass cheap material off on us for a premium price.  My patients come back from specialist, ER, or hospital visits with enormous bills and often feeling they are not listened to.

I don\’t mean to pick on specialists, as there are plenty of primary care docs who treat patients in the same condescending way.  Our profession has a bad reputation that we\’ve been working hard to earn, so I have to share the credit with doctors of all kinds.  I have patients actually tell me that I am \”the first doctor who has ever listened to me.\”  While I think that is an exaggeration, the perception is rampant: we docs are arrogant know-it-alls who charge too much.

So what next?  I am going to Angie\’s List and am going to write a bad review of our experience with this guy.  I owe it to other plumb-o-phobes so they can steer clear of this doink.  I can\’t do this without hearing the shrill cries of doctors detesting their patients who give them bad online reviews.  How can I complain about this guy?  What do I know about plumbing?  I should just be glad I don\’t have a shower in my garage!

We need to wise up.  Some of this arrogance stems from a system which turns patients into E/M and ICD-9 codes, forcing doctors to pay more attention to documentation requirements and achieving \”meaningful use\” than to what the patient says.  Doctors are sick and tired of the system, and sometimes facing a patient who blames us for the system that makes our lives hell gets under our skin.  But nothing excuses arrogant reality-distortion fields like this plumber and many docs emit.

Nobody wants to see a jerk.

7 thoughts on “Our Broken System Part 7: Plumbers, Ninjas, and Doctors”

  1. I once had a internal medicine doctor mock me for a question I asked despite the fact that it was a valid question. My response was adios chica. Your’s isn’t the only shingle in the neighborhood. Shortly afterward I had a hospitalist tell me that beta blocker were inappropriate treatments for LQTS. Google it dude! If I can get better advice from the internet than from you there is something seriously wrong with your education. Yes, doctors are usually highly intelligent and educated professionals. But they should use some of that brain power to learn a little of the social graces. It’s too bad this post can’t make it to the require text books at medical colleges.

  2. I’ve been trying for half an hour to type up a lucid, *concise* reply to your blog entry. I just can’t do it. Either as a nurse, a family member, or a close friend, I’ve seen for myself or else heard about too much that falls in the category of “arrogant reality-distortion fields” to keep from typing up examples at great length. And to be fair (but making it so much worse for the patient), docs are not the only guilty parties here: PhD’s, social workers, RN’s, PT’s, OT’s — there’s always someone in every healthcare field who will not set aside their preconceived notions long enough to hear out a patient, who, surprisingly enough, often is the best person to give an account of how he or she feels, and what things in life (meds, eating, breathing, etc.) seem to bring on the problem s/he seeks help for. 
    The problematic HC professional doesn’t even have to be tyrannical or a snide, sarcastic game-player. Sometimes a patient will be smothered in condescending kindness while being told they can’t possibly have the problem that in fact they do have, as shown by the tests that eventually get done when the sick person uses all their energy reserves to demand that thus-and-such be checked. (The PCP often just doesn’t have enough hours in a day to advocate and coordinate for any but the worst-off patients, and stay sane at the same time. And then, there are turf wars to deal with…red tape…obstacles around every turn.)

    Yes, sometimes the patient needs to be redirected when you do the history and PE, or mental status exam, whatever; but if something is really, really important to the patient/client, *please*, healthcare providers, hear him out. With consideration and thought. You might wind up sparing someone years of trouble. And you might find yourself not having to be constantly hounded by aggravated, even desperate patients, nor so gun-shy about possible litigation from someone you totally alienated. Win-win.

  3. JenniferDavisEwing

    My current neurologist is guilty of so much of this! He wanted to put me on Trileptal, after I’d had a bad experience with Tegretol (they’re related).  He blew me off, and insisted I “try it anyway”.  When I went back for my six month follow up, he actually seemed surprised when I told him I’d had the problems I’d expected to have, and I wanted to get off Trileptal and try something else.  It would have been so much easier for both of us if he’d just listened to me the first time!
    On another occasion, I told him that if I missed my midday meds, I would have breakthrough seizures in the middle of the night.  For some reason, he fixated on “midday”, and wanted to set up a “home study” EEG.  Puzzled, I asked him if it might not be a better idea for me to have a sleep study done.  He blew me off again.

    Years ago, I was trying to find a gynecologist because I was having prolonged menstrual bleeding (ultimately, I bled heavily for five weeks  [yes, you read that right], stopped for a week, bled heavily for another five weeks, stopped for a week, and after that my cycle normalized again).  I had just started the second episode of prolonged bleeding, and I was trying to explain to the receptionist that I needed to see someone right away.  She refused to schedule it as an emergency, and insisted I wait another two weeks.  I arrived in the office to discover his focus was more on obstetrics and less on gynecology, which would have been nice to know when I was trying to find a doctor.  He comes into the exam room, and is immediately very angry with me because “I can’t examine you when you’re bleeding!” I looked at him, incredulous, and said “Why do you think I’m here?” He refused to read my history, refused to let me try to explain, and refused to examine me.  I was sent home with no answers.  My current gyno, the one who did my hysterectomy back in ’04, tells me I should have reported him.  She’s probably right, but that’s water under the bridge now, my experience with him took place more than ten years ago.

  4. Ultimately, I think people need to slow down and listen more, in any profession.  Sadly doctors who don’t listen can end up doing great harm.  Most others just come off as jerks.

  5. It was solely by chance that I happened on your website, and
    was so happy I did, as your take on current issues is apt and engaging   Your comparison of the arrogant  plumber with some medical specialists was
    certainly on target. 

     

    Lots of people are not listening, and more and more are
    joining their ranks.   In this complicated, compartmentalized age
    there is only so much in our daily lives we can understand and fix.   Yes, we
    are at the prey of these unhelpful helpers.  And they are not penalized. as we go back to
    them.  And it is an unhappy fact that in
    medical practice an otherwise wonderful attentive doctor can be forced to pay
    more attention to checklists and codes than to the living person in front of
    him. It is a very strange predicament.

     

     

    But this issue – the big one- is our cultural mindset which
    supports this behavior.  We are all
    beginning to  act defensively.  We are doing it more and more.   We promote contention (see it onTV) and
    litigation (read about it in the papers.) Putting aside our egos  and listening to one another has never been
    easy, but it is now becoming rarer and rarer.  

     

    Probably the most revolutionary thing each one of us can do
    is listen, really listen.

     

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