Ideally we would live in a world where you could trust your doctors and actually tell them all the relevant information about what has going on with you and your health. The idea being the better informed your doctor is the better he or she can advise you on your health. But this isn't the world we live in for a lot of reasons, many of which I won't get into. E.g. pharmaceutical industry, health insurance industry, etc.
I was reflecting on this issue last week when I went in to the doctor to obtain a benzodiazapene prescription. I wasn't entirely forthright with my doctor. Ideally, I would've said my OCD was keeping me up at night. But instead, I said I was stressed about work and was having trouble sleeping and that in a week I'd be fine--I just needed something to get through it. It wasn't a lie, but the truth is more complicated. I'm not out of the woods yet (and at the time I knew I wouldn't be). My doctor doesn't know I have OCD because I don't feel like there's a reason for him to know unless I decide to take medication for it.
So, why the lack of honesty? Well, for one, young women aren't taken particularly seriously by doctors (or anyone for that matter, I sometimes feel like). I told my gynecologist in college that I thought my birth control pills were making me depressed. She replied to me that I probably felt down because I ate too much Halloween candy, not even asking if I had eaten any Halloween candy, which I don't. I don't eat candy at all and haven't since I was 10 or so. I told her this, and only then did she reluctantly switch me to a different pill. There have been a few times which I was told I might have an STD, when I knew that I didn't. "Well," the doctor would say, "I'd really like to do such-and-such test anyway." I would reluctantly agree because if I didn't get the test the doctor probably wouldn't let the matter go. (Also, I have contamination fears, so it's hard for me to say no to a test. After all, maybe I did get herpes from a toilet seat.)
One could say it's just me who feels this way about doctors, but a lot of other young women I know feel the same way (and some young men too...). The author of The Woman Who Thought Too Much mentions that when she was in her 20s, she would tell doctors she was depressed and they would tell her to go out and have some fun, date more, have a good time. When she told doctors in her 30s that she was depressed, they would say, okay, let's have you do a round of CBT, oh, and here's some Prozac.
In addition to being young, a woman, and unmarried, I don't really want to add crazy to that list. I don't have any confidence that an MD would a) understand OCD or b) treat it sensitively. So, I don't tell my doctor I have OCD. If I did, I might in addition to being taken less seriously also get repeatedly asked to take drugs.
The thing is I find this kind of problematic. When you go to a doctor you are essentially communicating that you need or want help--you are in some sort of situation where you don't know how to proceed or are concerned that without their treatment injury and/or death might result. (Well, doctors are also gatekeepers for prescription drugs, so you may be going to get a drug that you would otherwise be unable to obtain. In this situation, deception makes total sense.) It seems imprudent on a fundamental level to purposefully not communicate what may be pertinent information. The thing is if you don't know how to proceed, you might not even know what is or isn't pertinent information.
Furthermore, particularly if you're having some sort of mental crisis, you may not be fully equipped to make good decisions. I know when I feel particularly bad, I am willing to do many things that I would otherwise think were stupid in order to get relief.
But the reality is that I don't trust my doctor. I don't trust that pharmaceuticals will always help me. They may, in fact, harm me. Maybe in some sort of severe health crisis I would have to trust my doctors because I would have no other options. But for now, I'm in charge. I navigate my own care, which means I make my own stupid decisions. I decide what's relevant, even though I may not be the best equipped person to do so.
It's a sucky situation to feel like you cannot put your care in someone else's hands.
I was reflecting on this issue last week when I went in to the doctor to obtain a benzodiazapene prescription. I wasn't entirely forthright with my doctor. Ideally, I would've said my OCD was keeping me up at night. But instead, I said I was stressed about work and was having trouble sleeping and that in a week I'd be fine--I just needed something to get through it. It wasn't a lie, but the truth is more complicated. I'm not out of the woods yet (and at the time I knew I wouldn't be). My doctor doesn't know I have OCD because I don't feel like there's a reason for him to know unless I decide to take medication for it.
So, why the lack of honesty? Well, for one, young women aren't taken particularly seriously by doctors (or anyone for that matter, I sometimes feel like). I told my gynecologist in college that I thought my birth control pills were making me depressed. She replied to me that I probably felt down because I ate too much Halloween candy, not even asking if I had eaten any Halloween candy, which I don't. I don't eat candy at all and haven't since I was 10 or so. I told her this, and only then did she reluctantly switch me to a different pill. There have been a few times which I was told I might have an STD, when I knew that I didn't. "Well," the doctor would say, "I'd really like to do such-and-such test anyway." I would reluctantly agree because if I didn't get the test the doctor probably wouldn't let the matter go. (Also, I have contamination fears, so it's hard for me to say no to a test. After all, maybe I did get herpes from a toilet seat.)
One could say it's just me who feels this way about doctors, but a lot of other young women I know feel the same way (and some young men too...). The author of The Woman Who Thought Too Much mentions that when she was in her 20s, she would tell doctors she was depressed and they would tell her to go out and have some fun, date more, have a good time. When she told doctors in her 30s that she was depressed, they would say, okay, let's have you do a round of CBT, oh, and here's some Prozac.
In addition to being young, a woman, and unmarried, I don't really want to add crazy to that list. I don't have any confidence that an MD would a) understand OCD or b) treat it sensitively. So, I don't tell my doctor I have OCD. If I did, I might in addition to being taken less seriously also get repeatedly asked to take drugs.
The thing is I find this kind of problematic. When you go to a doctor you are essentially communicating that you need or want help--you are in some sort of situation where you don't know how to proceed or are concerned that without their treatment injury and/or death might result. (Well, doctors are also gatekeepers for prescription drugs, so you may be going to get a drug that you would otherwise be unable to obtain. In this situation, deception makes total sense.) It seems imprudent on a fundamental level to purposefully not communicate what may be pertinent information. The thing is if you don't know how to proceed, you might not even know what is or isn't pertinent information.
Furthermore, particularly if you're having some sort of mental crisis, you may not be fully equipped to make good decisions. I know when I feel particularly bad, I am willing to do many things that I would otherwise think were stupid in order to get relief.
But the reality is that I don't trust my doctor. I don't trust that pharmaceuticals will always help me. They may, in fact, harm me. Maybe in some sort of severe health crisis I would have to trust my doctors because I would have no other options. But for now, I'm in charge. I navigate my own care, which means I make my own stupid decisions. I decide what's relevant, even though I may not be the best equipped person to do so.
It's a sucky situation to feel like you cannot put your care in someone else's hands.
No comments:
Post a Comment