Before I go, I have something to say

The Perks of Being Fired by My Doctor

Have you ever been fired by a doctor? When it happened to me, six years ago, I was devastated. Not only would Dr. Doe (name changed, pronouns scrambled) no longer see me after three years of treating my headaches, he would not allow any of his colleagues to see me, either. Now I know that he did me a favor. How? Read on.

My dismissal helped me realize that my pain was not ordinary. When a doctor tells you not to come back, it could be a sign your condition is something special. This may not be the kind of specialness I would have asked for, but confirmed I had the headache from hell, and the pain was not – ha, ha – all in my head.

This forced me to look not for the most convenient care, but for the best care. Granted, I’d rather see a doctor just across town, but that can be limiting. It’s a shame the health insurance we depend on is more intent on “insuring” the livelihood of certain practitioners than on ensuring optimal patient care.

Being fired moved my rose-tinted perception of doctors down a notch or two. Back when I applied for a job as hospital librarian, I laughed when asked if doctors intimidated me. “I’ve been working with college faculty for decades,” I explained. Higher degrees are impressive, but I knew those people were no better, smarter, or more perceptive than me. Professors tend to confide in librarians (in me, anyway), so I knew their weird hobbies, troubled kids, lousy fashion sense, technical blind spots, and so much more. Doctors, it turns out, are a lot like them. Worthy of respect? You bet. Commanding fearful worship? No way.

Losing local care introduced me to some great cities, adding Ann Arbor, Sioux Falls, and Madison to my favorite places to hang out and eat dinner. Medical tourism has its perks.

That ouster by Dr. Doe’s office forced me to find a world-class headache center within driving distance. The Michigan Head Pain and Neurological Institute hospitalized me three times in a unique Head and Neck Pain unit at a small hospital in Chelsea. There I received the around-the-clock attention my pain warranted. I also made a lifetime friend there, one who really gets the misery of chronic migraines.

Being banished from Doe’s practice made clear that chronic headaches require not just one specialist, but many, working together. Dr. Doe offered me drugs to prevent headaches, drugs to abort a headache in progress, and nothing else. At MHNI and St. Joseph Chelsea hospital, they threw everything in their arsenal at my pain – physical therapy, surgical nerve blocks, chronic-pain counseling, lifestyle education, Botox injections, referrals for special eyeglasses – enough interventions to let me say I’ve tried them all. They taught me how to conserve my energy for the things I’m most passionate about, how to keep my pill regimen organized, and how to ask for help without feeling like a loser.

In the end, being excommunicated by Dr. Doe was a great boost to my medical care. After years of frustration and anger – driving me first to report her to the Iowa Medical Board, and later to a healthcare attorney, all to no avail –  my anger turned to sympathy. I understand now that when Dr. Doe fired me for being a difficult patient, the problem wasn’t my failure to respond to her treatment, but her discomfort over not being able to cure me.

I know where Dr. Doe earned his medical degree, and I know that med students at that school take the modernized Hippocratic Oath as part of their “white coat” ceremony. Among other things, they vow that “into whatever house I shall enter, it shall be for the good of the sick to the utmost of my power.” I’m probably kidding myself when I imagine that Dr. Doe recognized he had reached the limits of his ability and was directed by his conscience to free me from his (and his colleagues’) care because they could go no further. Or maybe he blamed me for his shortcomings, and wanted me to suffer. Whatever his reasons, I forgive him, and, headaches or not, I’m no longer miserable.

That doctor gave me one more gift by cutting me off, and it has served me well. She taught me that I need a nice doctor. Choosing only doctors who are kind, compassionate, humble, and receptive, no matter what health crisis brings me to them, has not only made me feel better about our relationships, but also has genuinely helped my healing. We all know about the Placebo Effect, which finds measurable improvements in patients taking sugar pills they believe are the real thing. I’d like to propose another: the Kind Doctor Effect.

This is not just pie-in-the-sky thinking. A comprehensive study published in the medical journal PLOS One in 2014 concluded that a positive doctor-patient relationship can have statistically significant effects on “hard health outcomes,” including obesity, diabetes, hypertension, asthma, pulmonary infections, and osteoarthritis pain. The research looked at thirteen clinical studies where doctors were randomly assigned either to provide their normal methods of care, or to take additional steps to provide more empathetic and patient-focused care. And that additional care made a measurable difference.

As my quest for relief  continues, my standards have grown higher. Recently, I established care with an M.D. in Madison. Although an internist, he has a deep understanding of chronic headache, and a gratifying dedication to helping those in its clutches. Near the end of our first appointment, he looked me in the eye and told me, “I want you to know, I won’t give up on you.” My aching head felt better already.


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