Wednesday, November 07, 2007

An interesting meeting with a Doc

I'm a little unsure of my objectivity about the meeting I just had with this really nice high-risk OB.

He's kind, well-recommended, well-published, at my favourite hospital, willing to do whatever I need in terms of ultrasounds, prenatal care, amnio, phoning me with any results, and he passed my screening when I checked him out on Google and ten different other search engines and Lexis-Nexis. Plus he gets ADD because of some family issues and told me so, which really rocks. Makes life soooo much easier.

I was a bit hysterical during the visit and kind of lost it when he asked about delivery and inductions. I broke down when I told him I didn't really believe that I would make it that far, so I couldn't have that conversation yet. He agreed we could leave it alone for now. I forgot to tell him several important medical things, and I'm emailing him the pathology reports I left at home.

I think I was in denial about being in an OB's office and pregnant. There were a couple of innocent little preggos in the waiting room having some silly conversation about how much weight they gained and whether their hair still looked good. I REALLY wanted to tell them they were lucky they didn't have dead babies, so fuck their hair, but I held back. I thought it was admirable of me. Yes?

Anyway, my hysteria and temporary brain freeze convinced him I was in need of mental support. (Shit, failed the public nutbar test again...) I couldn't mention blogging, so I told him about my last Doc, who I did EMDR with, but she isn't allowed to see me because of program rules, so that won't work. He's referring me to another shrink who deals with reproductive life stresses, etc. but I'm not sure I feel like doing that, because I can honestly say that Dr.M. was the ONLY mental health professional I've ever met who wasn't mentally off themselves. It's like they all go into the profession to try and figure out why they are so fucked up, and come out thinking they are "cured", when really they are just in denial again. Plus, I have to deal with anti-ADD attitudes every time I meet a new Doc and I'm not sure I have the energy. Sigh....I'm taking this one under advisement.

You may be wondering, why do background checks? Well, I've met some wonderful Docs and some BAD Docs, and while every OB on earth makes mistakes and every OB has been sued, how they handle issues can really make a difference to a patient. As the wife of a lawyer I've learned that lawsuits never give you a sense of emotional satisfaction, and sure as hell never give you a sense of justice. (Money you can get, but that doesn't replace a dead baby.) Aaah, now honest admissions of guilt and apologies? The earnest pledge to learn from mistakes and do better the next time? Those are the things that have helped me to heal and move on when someone has wronged me in the past. Hiding, lying, obfuscating, dismissing my pain, always seems to leave me damaged and angry.

Seems obvious, no? Sigh, not always to members of the medical profession.

Anyway, I know some other people who have seen this Doc, including some women who have had successful pregnancies and a few who have had losses. And they all say that he is open and honest about what has happened and why, decisions that were made, and why others were not. In a high-risk OB practice, there will be dead babies, because not every pregnancy can be saved. And not every spur of the moment decision under stress will not always be right. It is inevitable that Doctors will be wrong.

When he made a mistake during a pregnancy with my close friend from my bereavement group, he admitted it, and deeply sincerely apologized. She went back to him for her subsequent pregnancies, both successful and it all went well. I've never heard of another person ever having an issue with him, and it may be irrelevant.

But this is my tiny sticking point. He DID make a mistake. A tiny one, one that any Doc could make, and it resulted in a miscarriage. And there are no perfect Doctors, anywhere. After many years of attending bereavement support groups and reading stories online, I know that I won't find a perfect one. I've heard the names of every Doctor & hospital in Toronto now slammed and blamed for killing someone's baby. It's like we all need someone to focus our anger on, logic be damned, and so we pick a random medical person who may have said or done something shitty, and we zero in on them like a laser beam. (And sometimes ignore the other medical or non-medical person who actually DID fuck up...)

That anger is not helpful for me anymore. I need to leave that kind of stress behind and focus on the here and now.

I need a doctor and this one fits the bill, now if I could just get over my magical desire to find THE PERFECT ONE.

Any assvice? I need it.


  1. Whew... I wish I could recall the name of the high-risk perinatalogist I saw Way Back When, so I could put him on some sort of "Do Not See" list!
    But unfortunately no one's going to be perfect, I know you realize that?!? So you just have to trust your gut instincts...

  2. I would say the doctor, especially the high risk one, without mistakes is either a liar or simply hasn't practiced long enough. It is admirable that he apologized and wants to learn. Josh's g'pa and I had an enormous argument once where he told me I was stupid to think an apology mattered. Seeing as I was the one well acquainted with an incredibly egregious case of malpractice, I think I know better.

    That's beside the point today though. You need to go with your feeling on this - can you be comfortable with him as your doctor?

    I am so with you on mental health professionals. We will be here for you every step of the way, no matter what. So glad it's going well so far.

  3. Could it be possible that your friend's miscarriage would have happened anyway? I am curious what his mistake was. Maybe he couldn't have saved that pregnancy.

    If you feel like you can communicate with him and he can keep up to your high expectations and demands, then I think you have the right doc.

  4. The doctors who take the riskiest cases are going to have higher loss rates and more mistakes than other doctors who play it "safer" and don't dabble in the high-risk people. So mistakes per se wouldn't dissuade me from using this guy, so long as I felt like I had a good report with him.

    Aurelia, if ADD is an issue in your life, aren't there people who specialize in dealing with that issue in adults? They shouldn't be "negative" or turned off by the way you express your emotions and thoughts, so that problem wouldn't be there.

    And as someone who had a very serious medical error occur in my care (something that led to a cascade of near-fatal problems and has ended my ability to have more children), I so agree with what you said about apologies. They don't compensate for the harm, but are probably more effective than suing is when it comes to actually getting over what occurred.

  5. I'm always full of assvice, thanks for asking.

    This post makes me so unbelievably sad. It is not right that you have to settle for less than 100% confidence in someone but I think he is your best bet. Though he isn't perfect he is "the perfect one" in that you know he is willing to do what you need him to do.

    Still I have to wonder why he needed to ask you about delivery at your first appointment. I hardly think your reaction is proof of 'nutbar' status. I've got the same take as you on mental health professionals but I have trust issues. Sometimes I wish I knew less and could trust my doctors.

    Also - yes, very nice of you to not tell those girls how little they will care about their hair if things go wrong.

  6. Well, I have no good advice...but you will be in my thoughts and prayers!!

  7. I don't think there's any magical advice, here. You've said it all - now it's a matter of "just" getting over it. Maybe you could distract yourself with hair-care advice? Hopefully you can keep the anxiety down to a dull roar, one way and another.


  8. First, I think it was very noble of you not to tell the women in the waiting room what you were thinking. I don't know how well, "Fuck your hair!" would have gone over...

    Second, if you could have another doctor you could consult with whenever you have a question or doubt about something your doctor recommends, that might make you feel more confident. We have it kind of built into the system, since I can see another doctor any time my doctor isn't in his office, for no extra charge... Just the other day I went to get a second opinion about when I should have my repeat glucose challenge - the second doctor said exactly what mine had said, which made me feel good.

  9. I can never resist a request for assvice...guaranteed to bring me out of lurkdom. I'm constantly trying to wrestle my inner perfectionist to the ground. She's such a persistant bitch.

    Last year when she managed to get the better of me in a weak moment, someone observing the evolving ugliness asked me if she could tell me something about perfectionists. My first thought "There's nothing you could tell me that I don't already know" Then she hit me with "The problem for perfectionists is that they have no standards"

    My mouth immediately opened to defend my inordinately high standards while my brain went "Busted". There was no point at which I ever felt satisfied that I, or anyone in my vicinity, has done a good enough job.

    It might not be what you need to hear, but it has made a big difference to me to be able to say "It's not perfect but hey, it's pretty damn good, and that's OK".

    Wishing you an easier journey ahead.

  10. I'm kind of a fatalist about this, in that I don't think that it matters all that much. Barring a real departure from the standard of care, there are probably a number of perfectly acceptable ways to deal with issues that come up in pregnancy. Sometimes, if the doctor had done something else, there would have been a better result, but there would have been no way of knowing that ahead of time.

    For example, preeclampsia is a balancing act -- weighing the risk to the mother and to the baby, who is not getting enough nutrients, with the risk of delivering very premature baby. Different doctors will draw the line at different places and some babies will die who might have been saved by a different approach. But that doesn't mean that there was necessarily anything wrong with the approach the doctor took, just that s/he guessed wrong.

  11. perhaps 'this is as good as it gets'...?

  12. Just saying hi, stopped by here from Lisa at Making other Plans.

  13. I don't have any advice on choosing a doctor, my first was terrible and I changed as soon as I could.

    I guess trust your instincts.

  14. Gasp! I never knew you were in Toronto!!! I had admired you through Manuela and recently peeked into your blog every now and then and then was very excited when I saw evidence of "life" and ... well 2 devestating experiences with LifeQuest and one successful attempt with MFC and I'm reluctant to blog because I am ecstatic but... you're in Toronto??? Man!!

  15. I very much understand the need to vette doctors before going to them. I have rare form of a common disease and the minute someone starts saying I don't need to see my specialist, well, I say "Bye-bye!" Not seeing a specialist early enough may be the reason I can't have children without IVF.

    I'm not a big fan of those who don't know how to say "I don't know." Or who are not willing to send you to someone who may know more.



  16. Maybe it would help if you asked yourself IF something happened while you were under his care, how would you feel about your decision? Would you still feel ok that he was your doctor?

    And my other assvice is, I think you should go with your instincts.

  17. What do you think he would say if you asked him "how often do you think you make mistakes?" I wonder whether hearing his answer to that question would make your decision easier.

    And I do so admire your restraint. The hair girls would've probably ended up with at least a dirty look from me. Or not, but then I would be steaming about it for hours.

  18. Fuck the hair.

    Secondly, there is no perfect doctor. There is only the one who is close, the one you can work with. This guy sounds pretty close.