Other Diagnostic Misses

     The irresponsible response of the nurse practitioner to my son's gall stones sent me on a trip down medical memory lane. Being blessed with good health, I had little experience with doctors as a child. But I wish my doctor or parents had taken my dislocating kneecap seriously so it could have been fixed in childhood. I still would have had an embarrassing scar, but I also might have had a chance for normal muscle development in my left leg, maybe even avoided what my husband calls "my funny walk". Speaking of knees

• The doctor I saw shortly after the epic dislocation when I lived in Denver, told me that if it only happened once or twice a year, it was no big problem. However, the orthopedic surgeon who repaired it said he had never seen such a loose knee. When he opened the skin, my kneecap popped off, giving entirely new meaning to the phrase "skinned knee".
• After we moved to Kalispell, I visited an elderly couple in our church who were having health problems. When Grace called the doctor on a weekend suspecting her husband had had a stroke, the doctor told her to bring him in on Monday. Admittedly, this was long before the miracle clot busting drugs we have now, but strokes were still considered a medical emergency, not a "see you Monday" kind of event. I have often wondered if that was Dr. Palchak,
• who was our family doctor for a short time. His reputation at the hospital confirmed my own experience that, if he didn't know what was wrong, instead of referring patients to specialists, simply ignored the symptoms. One victim of his lethal incompetence died because he ignored her tail bone pain until the cancer it signified was inoperable.
• Another bone-head call I saw while working at the hospital was when a doctor decided to experiment with a dying brain cancer patient. Since the brain itself does not have nerve endings, he decided not to write an order for pain meds the night I sat one-on-one with him. I never got to know the sweet, Christian man the staff described. I spent the night calming an incoherent man in excruciating pain.  
• For painfully inadequate treatment, last year I wrote a letter on my brother Roddy's behalf to the clinic he visited twice for a persistent cough. Like most people who actually pay for their physician visits, Rod does not go to the clinic if over-the-counter products are sufficient. Therefore, his two visits telling him to drink lemon tea with honey were about as effective against his cough as singing "Kumbayah". Roddy can cough or sneeze hard enough to cause problems with his neck. Finally, he made an appointment with his family doctor and got the prescription cough meds he needed, but he paid $108 dollars in copays for the three visits.
• My home care client didn't have to worry about copays and had many regular visits because of her diabetes, but seldom went to the doctor for other complaints. So when days of constipation prompted a visit to the walk-in clinic, I knew the nurse practitioner's conservative recommendations weren't going to be enough. By nighttime the discomfort was so bad, she used her Life Alert and went to the emergency room where she had to have an impaction dug out.
• Closer to home, several years ago my 83 year old Dad took my Mom to a doctor in Missoula because she could barely walk. Dr. Yawn (probably not spelled correctly, but fits her bedside manner) ordered knee x-rays, diagnosed the problem as arthritis, and sent her home. No walking aids. No pain meds. No therapy. No follow up. Just a woman who can't walk sent home for her elderly husband to cope with. 
• My father-in-law also had arthritis in his knees. His doctor recommended a double knee replacement. The doctor who replaced my knees said doing both at once doesn't double the difficulty of recovery, it quadruples it. Besides the difficulty of not having one good leg to stand on, he had a bad reaction to the pain meds, so they stopped giving him any. Double knee replacement. No pain relief. To make matters worse, the new knees didn't relieve the old pain so all that suffering was for nothing.
• Also for nothing, were the times I took several of our spare sons to the walk-in medical clinic in Evergreen. Generally, if they walked in complaining of, for example, a sore throat, the nurse would diagnose that they did, indeed, have a sore throat and send them home. I'm pretty sure what they wanted was relief from the problem, not a second to their diagnosis. As the person paying the bill, I definitely wanted more than confirmation of what we already knew.

     That is why I could not reassure Tracy that seeing a doctor for his stomach pain would be useful. There are too many unprofessional health professionals. My diagnosis is that they are either missing the brain cells required to understand treatment follows diagnosis, or have a heart defect--no compassion.