Doctors are not scary bogeypeople!

May 28, 2009 5:14 AM

What is with Askmes where a three year old could tell you that the answer is "DOCTOR NOW NOW NOW"?

These seem to be posted all the time, but this recent question is a particularly egregious one.

What is the explanation? Are people afraid of doctors? Do people not know that the profession "medical doctor" exists? What would cause a person, upon discovering that they have an acute medical condition, think "I will wait a few days and then ask some strangers on the internet" rather than "perhaps I should go to the ER and have a trained professional treat the gaping wound with blood spurting out of it"?

I would not be surprised in the least by a question "I was declawing my cat, and she swiped at me and forcibly circumsised me; there is blood gushing everywhere and I'm feeling weak. HALP ME METAFILTER, what homeopathic remedy should I use?"

posted by dmd to Etiquette/Policy at 5:14 AM (160 comments total)

They're in denial and they want a stranger on the Internet to tell them "No, that's normal, don't worry about it", because the idea of actually having something REALLY WRONG with them is terrifying.
posted by dunkadunc at 5:21 AM on May 28, 2009 [10 favorites]

Word.

but... I've seen plenty of doctors who don't seem to give much of a crap and act like you're wasting their time. perhaps some people are just trying to make sure they avoid this. it's easy to be worried you're overreacting about something... like the opposite of hypochondriac :]
posted by greenish at 5:23 AM on May 28, 2009 [5 favorites]

Yes, people are afraid, and sometimes need outside help to make themselves go to a doctor. Also, doctors can be intimidating (and expensive), and they want reassurance that they really DO need to go. I don't know about you, but I've met some specialists who really need to work on their "bedside" manner also (I've changed doctors for that reason sometimes). People also sometimes want to have some questions prepared that they can ask the doctor when they do go. You should cut people some slack. I've been there myself, so I try to.

AskMe also gets some fairly sketchy other types of questions as well (relationship filter). At least with the medical ones, the answer can be straightforward (doctor now) and perhaps do some good.
posted by gudrun at 5:25 AM on May 28, 2009 [1 favorite]

1) Not everyone has health insurance.

2) Doctor's visits are often a lot more productive if you have information ahead of time.
posted by creasy boy at 5:25 AM on May 28, 2009 [13 favorites]

I don't have health insurance, so going to the doctor is rarely the first thing that occurs to me in questionable health situations. I do have some friends in medical school though, so neither is asking random strangers on the internet.

People are just rather galling. What.... Is up‽...With that?‽?‽
posted by carsonb at 5:27 AM on May 28, 2009 [3 favorites]

They could be in a context very different form your own.

They may live in a remote area without regular access to modern medicine. They may be extremely poor. They may live in a country where there is no proper modern medical infrastructure, and a visit to the hospital is only an opportunity to be fleeced and infected. They may be a foreigner without knowledge of the local language, and without a trusted local to translate and look out for them.

Not everyone is living in a modern country with top notch affordable health care at hand 24/7.

People are hopeful. Who the hell knows, it just might be "yes, as a doctor I have seen this swelling frequently, it is called 'acute local dehydration'. It is a simple matter of drinking 2 litres of filtered water each day for a week, and it will go away." If that's the case, the Internet people can save you a lot of time, stress, and money.
posted by Meatbomb at 5:32 AM on May 28, 2009 [9 favorites]

Not everyone is living in a modern country with top notch affordable health care at hand 24/7.

true. a large majority of mefites are american, for example.
posted by UbuRoivas at 5:34 AM on May 28, 2009 [181 favorites]

There are lots of reasons people could want to talk to someone before going to a doctor or in lieu of a doctor. They could have no insurance. They could have shitty insurance. They could have a shitty doctor. They could live in a place where the whole practice of medicine has devolved into a patient paying a hefty premium so somebody can poke them in the belly for 2 minutes and tell them that the tender spot is a bruise (maybe it is maybe it isn't, but how would you know in 2 minutes?) and then then spend two hours filling out paperwork for the patient's HMO to refuse to pay for.

People could think that they might get better without a doctor's intervention and they just want to make sure their inclination is correct. They could be afraid as speculated above. They could dislike doctors. They could dislike getting sick in the doctors office. They could hope in their heart that so long as there is no diagnosis of a problem there is no problem. They could be making up AskMe questions for attention....

There could be any number of reasons.
posted by Pollomacho at 5:37 AM on May 28, 2009 [5 favorites]

I think you ought to work on your bedside manner, dmd.
posted by kuujjuarapik at 5:40 AM on May 28, 2009 [2 favorites]

No, the americans are lined up behind door #3: "They may live in a country where there is no proper modern medical infrastructure, and a visit to the hospital is only an opportunity to be fleeced and infected."

They do have the best doctor-to-daredevil ratio in the world though...
posted by Pinback at 5:41 AM on May 28, 2009

Well dmd, some MeFites experience doctors as being arrogant, rude, and condescending. Fortunately, your calling them idiots will put an end to that.
posted by applemeat at 5:51 AM on May 28, 2009 [4 favorites]

It's ok, I won't have a doctorate until next week. I'll work on my arrogance after that.
posted by dmd at 5:58 AM on May 28, 2009 [2 favorites]

dmd: What is with Askmes where a three year old could tell you that the answer is "DOCTOR NOW NOW NOW"?…What is the explanation? Are people afraid of doctors? Do people not know that the profession "medical doctor" exists? What would cause a person, upon discovering that they have an acute medical condition, think "I will wait a few days and then ask some strangers on the internet" rather than "perhaps I should go to the ER and have a trained professional treat the gaping wound with blood spurting out of it"?

I would not be surprised in the least by a question "I was declawing my cat, and she swiped at me and forcibly circumsised me; there is blood gushing everywhere and I'm feeling weak. HALP ME METAFILTER, what homeopathic remedy should I use?"

If you consider the situation for even a moment, you'll see that you're just being condescending in many cases if that's your response. As much as you may see our little corner here as all-important, many people go to a doctor in addition to asking us about these things; knowing how often people seem to leave things out, I imagine it's the case in a large percentage of these anonymous questions that the asker is planning on visiting a doctor soon but forgets to mention it, and thereafter has no simple way to follow up. And I can tell you, having watched friends go through it: when you're concerned that you may have a medical condition and you're anxious to figure out what it is, waiting until next week for that appointment to find out if you're going to be maimed for life or something is not fun.

Or, as has been pointed out, sometimes people just don't want to face the fact that they really need a doctor; or they would like to know what to tell the doctor when they do see her.

In either case, when you're in that place, the very last thing you need is someone blathering (as I often see people do in these kinds of askme threads): “Good god, you're a holy fool. You must have rocks for brains. Why don't you go to a doctor?” I swear, it's like we're treading that ice thinner and thinner every time; the first comment in these questions is always something to that effect, something aghast and mildly insulting, and always gets about a billion favorites. I'm certain jessamyn has had to delete hundreds of those things.
posted by koeselitz at 5:59 AM on May 28, 2009 [19 favorites]

koeselitz for metatalk king.
posted by Potomac Avenue at 6:05 AM on May 28, 2009 [3 favorites]

I know a number of people who think along the lines of: "It may hurt, it may interfere with my enjoyment of life, it may be really annoying, it may be scary. But as long as I don't see a doctor and get it diagnosed, there's not really anything wrong with me."
posted by Plutor at 6:06 AM on May 28, 2009 [1 favorite]

What is with Askmes where a three year old could tell you that the answer is "DOCTOR NOW NOW NOW"?

Seriously, the answers to your question are not hard for anyone with a brain and a heart to figure out.
posted by mediareport at 6:10 AM on May 28, 2009

It's ok, I won't have a doctorate until next week. I'll work on my arrogance after that.

That plan has worked for so many in the past! /sarcasm
posted by Pollomacho at 6:15 AM on May 28, 2009

Sorry for being an asshole with this question. Not sure what was going through my mind.
posted by dmd at 6:18 AM on May 28, 2009 [1 favorite]

What's with trolls getting so much attention?
posted by Stonestock Relentless at 6:19 AM on May 28, 2009

I'd say this post would be better as an askme, but it's too chatfilter.
posted by cjorgensen at 6:24 AM on May 28, 2009

I rarely read medical questions, because they give me flashbacks to unpleasant aspects of jobs I used to have. So I am basing this on a population of "people who call or go to pharmacies in Kentucky to ask questions" rather than "people who come to AskMe to ask questions". But I suspect the motivations are similar.

(In the United States) Even for people with perfectly lovely insurance, obtaining medical treatment is typically time consuming and unpleasant. You go there. You wait. You're poked and prodded. You wait some more. People you don't know ask you very personal questions about your body. If you are already not feeling well, in the short term you will be far happier laying on your couch at home. If you have an acute ailment of the variety that can be treated in a physician's office, you may be so lucky as to get an appointment today or tomorrow, or maybe next week, or maybe they are all booked up until a couple of weeks from now. Now throw in the financial disincentives that many face. Hell, I never see a physician unless I know it's not getting better on its own AND my mom tells me I should.

And if the answer is "go to the ER stat", it will be even more time consuming, unpleasant, and potentially expensive.

The other thing is, health literacy is surprisingly low. I have fielded some wildass stupid unreasonable questions and had to end phone calls with IMMEDIATELY DRIVE YOUR CHILD TO THE ER I AM HANGING UP NOW SO YOU CAN GO GO GO NOW. But even people who are neither stupid nor unreasonable often just don't know what's an emergency and what isn't. How do you know when something is a medical emergency or not? How about, say, when someone is having difficulty breathing? That seems simple enough. Well, not really. "Difficulty breathing" could mean anything from a lifethreatening anaphylactic reaction go go go to the ER now, to a horrible cough that's unpleasant but can certainly wait til in the morning. And when did you learn? The first time I ever had a UTI I was, oh, 19 I guess? I had no clue at all whether dysuria and hematuria meant "freak out enough to go to the ER" or "freak out enough to go to the student clinic this afternoon". And I was a dumb 19 yo, but not uncommonly so. So I called my mom and she told me what to do. And for whatever reason these people are asking Ask instead of their moms.

Anyway someone's probably responded more coherently in the time it took me to form complete sentences 'cause I've been awake a very, very long time, but there you go.
posted by little e at 6:46 AM on May 28, 2009 [8 favorites]

Because AskMe is the internet version of calling up your mom and saying 'x hurts, what should i do?' before you invest in 1) the time off from work to sit in a dr's office for 2 hours for a preliminary consult; 2) the money for a co-pay if you have insurance, the full cost if you don't; 3) the stress of leaving work immediately and going to the emergency room vs knowing you can wait a day or two to get to a GP.

Pretty obvious, really.
posted by spicynuts at 6:49 AM on May 28, 2009 [6 favorites]

Oh and by the way...doctors ARE scareybogey people...they prick you with shit, make you get naked, induce anxiety with big, latin words, and then have the potential to tell you that you are dying/need something amputated/have to be sick the rest of your life. Ok, doctors themselves aren't scarey bogey people, but the situation over which doctors preside - that is a scareybogey situation. If it wasn't, there wouldn't be such a thing as White Coat Syndrome.
posted by spicynuts at 6:51 AM on May 28, 2009 [3 favorites]

People have different thresholds when it comes to fear of what they see and feel happening to their bodies. For some a rash is enough to send them to a doctor, for others a tender swollen abdomen is just something to keep an eye on, maybe ask about on Metafilter down the line. I don't have a problem with it.
posted by fire&wings at 6:51 AM on May 28, 2009

Nthing the "no insurance" comments.

For some people losing a limb is less scary than going to the ER and racking up tens of thousands of dollars (or worse) in medical bills they'll never be able to afford to pay off. Not having insurance in this fucked up country is terrifying, damnit.

What, going into that kind of debt is automatically worth it? You do realize some employers check for that kind of debt via credit checks as a condition of employment, right? It looks particularly bad if it's gone to collection.

It's even more terrifying going to an ER without insurance because you might catch anything from TB to MRSA while visiting the ER. Have you been to a modern urban ER as a patient, lately? I'm not even slightly germ-phobic compared to most people but modern ER wards are fucking gross and make me want to coat my entire body in sanitizer.

And good luck spending less than 8 hours in that smudgy, sticky germ box unless you're currently severely perforated and bleeding out on the floor.

It's ok, I won't have a doctorate until next week. I'll work on my arrogance after that.

Heh. From my perspective as a patient in the US, outside of insurance issues the arrogance of doctors is often the number one problem with trying to visit and speak with a doctor. You (or any other soon to be or current doctors) might want to start working on that now if you're going to work with the public as a practitioner.

Real life health care isn't an episode of House. Such smug arrogance won't automatically lead to a brilliant and personally rewarding diagnosis of some rare, interesting disease just before the end of the show, making the gruff, insolent doctor correct and somehow more lovable despite the fact that they're still the gruff, insolent doctor with shitty bedside manners.

An arrogant doctor just adds to the patients worries. "Should I really trust this guy? Apparently he doesn't give a shit. Woah, he totally just ignored everything that nurse just said to him and barely looked at the chart! What the hell did he just prescribe me? I'm not taking a damn thing until I can get online and look this shit up. Oh, great, side effects may include 'abnormal fetal tissue growths of the face'? Why didn't he even bother to mention that at all? Fuck this, I'm going to go eat hot chili and garlic and Echinacea until it goes away."

Ignorance and fear are only some of the reasons why people in the US rely so heavily on stank-ass hippy snake oil remedies. Other reasons include insane costs even with insurance, and a distinct lack of preventative health care in this country. People are trying desperately to not get sick in the first place. Suddenly a few bottles of fish oil capsules and vitamins, and a basket of veggies and good food seem like a safe, sane bargain compared to getting prescribed antibiotics for a mild head cold by a distracted, arrogant doctor. Or worse.
posted by loquacious at 6:51 AM on May 28, 2009 [29 favorites]

Not just a lack of insurance, but also a lack of empathetic sick time policies. My (contract) employer, for instance, won't let me charge partial days. If I write down that I was here for 7.5 hours, that's 0 hours as far as they are concerned. No leaving early to go to do the doctor for me!
posted by DU at 7:05 AM on May 28, 2009

Whoof. I'm glad this was (based on his head-hanging above) a learning experience for dmd, and even though it started out so nasty and trolly, I know it can be useful for other people too.

Obviously, otherwise-perceptive people can have a blind spot when it comes to imagining the effects (both immediate and lingering) of experiences they've never had. If you have no idea what it's like to be uninsured and penniless, and/or in a job or situation where you're simply not able to "just take time off," and/or with access to the internet but not to medical care, I hope you never have to find out firsthand -- but I hope you can imagine those possibilities and their implications with compassion.
posted by kalapierson at 7:11 AM on May 28, 2009 [3 favorites]

There are a lot of reasons most of them have been summed up above by people who were more polite than I would have been. The general broad reason is: because people are different from you. Which is probably what draws a lot of us to MeFi in the first place, maddening as it can be sometimes.
posted by jessamyn (staff) at 7:12 AM on May 28, 2009 [7 favorites]

Numerous reasons -

1) It's really not that vital to see a doctor many times. I self-treated a gunshot wound a long time ago. Spurting blood and all. It was no big deal.

2) Doctors can't be trusted. People want to some idea what's going on before they go see a doctor.

3) It's a total, 100%, undeniable, ripoff. I'd like some agreement I really need to go before I invite the medical industry to steal my money while insulting my intelligence and treating me like a lab rat.
posted by y6y6y6 at 7:29 AM on May 28, 2009 [13 favorites]

I only go to the doctor if a condition has gotten so bad that continuing to live with it is worse than the experience of dealing with a doctor.

I can count on one hand the times in my adult life when this line has been crossed.
posted by Navelgazer at 7:33 AM on May 28, 2009 [6 favorites]

Ok in the middle of that rant I got distracted remembering all the crazy shit. I would like to state more emphatically that in my experience, a LOT of reasonable, intelligent people don't necessarily know much about medical things and practical aspects of navigating the healthcare system. If you've been pretty healthy and your family's been pretty healthy it's information that's pretty easy to miss out on.
posted by little e at 7:34 AM on May 28, 2009

in other words, dumb askme questions about bleeding cat circumcisions or whatever do not mean someone is dumb
posted by little e at 7:38 AM on May 28, 2009

dmd, honey, I am internet-diagnosising you with 'teh stressors." Step away from the "WTF" until you've defended.
posted by desuetude at 7:45 AM on May 28, 2009 [1 favorite]

Physician, heal thyself.
posted by Burhanistan at 7:47 AM on May 28, 2009 [1 favorite]

Reminds me of what my second grade teacher used to say: "Remember kids, there are no dumb questions. Only dumb kids."
posted by Floydd at 7:59 AM on May 28, 2009 [1 favorite]

What's with the MeTas where a three year old could tell you that the answer is "NOT EVERYONE IS IN THE SAME BOAT AS YOU, TRY SOME EMPATHY, JEEZ"?
posted by Alvy Ampersand at 8:02 AM on May 28, 2009 [2 favorites]

Wait, can we go back to the point where y6y6y6 self-treated a spurting gunshot wound? What?
posted by ChrisHartley at 8:06 AM on May 28, 2009 [5 favorites]

Has there ever been an askme about removing a bullet? Because I searched and can't find it. Can't see a doctor, obviously. And I already used my question this week.

hurry pls
posted by Eideteker at 8:08 AM on May 28, 2009 [3 favorites]

Wait, can we go back to the point where y6y6y6 self-treated a spurting gunshot wound? What?

See, now that's dumb.
posted by electroboy at 8:08 AM on May 28, 2009

What is with people whose website is them and their significant other? Don't they have an identity beyond being part of a unit?

What is the explanation? Are people afraid of being alone? Do people not know that professional therapists exist to give them their own identity? What would cause a person, upon getting married, to so totally connect their existence to another and then publicly proclaim that on the internet rather than have a website about themselves instead of them and the other person, who doesn't have website herself?

See, you can take just about anything about a person you don't know and twist it in a way to put them down, especially on the internet. I think it's great, really great, that you learned that lesson at some point when pursuing higher education.
posted by Brandon Blatcher at 8:09 AM on May 28, 2009

By the way, the proper MeFi response to your hypothetical cat circumcision question is to ignore the gushing blood and possible remedies and demand of the OP:

WTF, why were you declawing your cat while naked?
posted by pixlboi at 8:09 AM on May 28, 2009 [1 favorite]

WTF, why were you declawing your cat while naked?

Don't judge me, pixlboi.
posted by electroboy at 8:11 AM on May 28, 2009

3) It's a total, 100%, undeniable, ripoff. I'd like some agreement I really need to go before I invite the medical industry to steal my money while insulting my intelligence and treating me like a lab rat.
posted by y6y6y6 at 7:29 AM on May 28 [2 favorites +] [!]

awesome.
posted by docpops at 8:11 AM on May 28, 2009 [2 favorites]

Cat blood is hell to get out of cashmere.
posted by dmd at 8:13 AM on May 28, 2009

As someone who just finally got back to a doctor for a checkup for the first time in almost seven years, I can assure anyone who isn't yet convinced that it can be a scary experience.

Waiting on them to call me back with my blood work was terrifying; despite the fact that I'm in ok shape and lead a pretty low risk lifestyle, I became more and more convinced with every passing day, that the reason that they weren't calling was because they didn't want to tell me about the cancers and brain worms that were undoubtedly boring holes though me.

By the time they did call, I was convinced that I had leprosy, hoof and mouth, small pox, and high cholesterol, and that the only reason my phone was finally ringing was so that the health care provider could advise me as to which coroner I should be making an appointment with.

I think the lady I spoke with must have been pretty used to that reaction because she was very charitable about explaining that in all likelyhood, I'd live.

She had no comment on the brain worms though.
posted by quin at 8:13 AM on May 28, 2009 [2 favorites]

She had no comment on the brain worms though.

That's what the brain worms want you to think.
posted by dmd at 8:15 AM on May 28, 2009 [5 favorites]

Also, in terms of context: Yeah, it's definitely the "we're all in different boats" explanation.

I'm 30, and I don't think I've gone a year my entire life without some acute illness requiring rapid medical intervention. So I'm a bit more used to the idea of seeing doctors than most, I guess.
posted by dmd at 8:17 AM on May 28, 2009

God, what a stupid question.

IF ONLY it were possible to get to a doctor every time I thought I needed one. For a lot of people, medical care is a major purchase that has to be planned in advance, that can be a disastrous expense if it hits without warning.

If you don't want to see these kinds of questions, dmd, I've got a simple solution: Put me on your insurance plan. I'll cover the copays and never annoy you with an AskMe again.
posted by EatTheWeak at 8:17 AM on May 28, 2009 [4 favorites]

Not everybody is old and wise. Some people have mostly been healthy, and have limited experience with the health care system. If only there were a place they could go to ask a community full of smart helpful people for advice, hey, wait a minit.....



AskMe works very well. Appropriate advice was given. Got a problem with that?
posted by theora55 at 8:33 AM on May 28, 2009

little e reminded me of my first UTI (what's up with age 19, anyway?), which turned into a kidney infection and a fun trip to the ER during finals week, because I didn't quite get that what was happening was serious, the student health center was closed, I didn't have a regular doctor, and I was in a goofy living situation. never underestimate "young and dumb." probably would've done better if there'd been AskMe back then.
posted by epersonae at 8:33 AM on May 28, 2009

Hey folks, the whole "people are different from you" thing is a two-way street. No need to be harsh to dmd when he's already very graciously taken the "Oh, wow, I hadn't thought of it that way, my bad." position.
posted by SpiffyRob at 8:35 AM on May 28, 2009 [13 favorites]

"See, now that's dumb."

Why? No organs hit. No major veins or arteries hit. Wound is clean. Entrance and exit reasonably small.

Here is what the doctor would have done: Clean and sterilize, do some stitches, apply a dressing, bill me $2000. Turn me over to the cops.

The only thing I did differently is not do the stitches, and not waste time talking to the cops. And saving $2000. How is that dumb?

A few years later I went to the doctor for a rather large ax wound, because it really did need stitches. It was an awful experience, and I left wishing I'd done the stitches myself. If it happened today I'd likely come to AskMe to see if anyone knew what I should have the wife pick up at the drugstore so I could avoid screwing up the stitches.

My point is that this is one reason people ask questions like this - Because doctors are not the obvious first step that the medical community has brainwashed us into believing. Once you get over the idea that it's secret knowledge, and there's no way you should risk thinking about your own health, you'll have a better understanding of what's really going on with your body.
posted by y6y6y6 at 8:37 AM on May 28, 2009 [9 favorites]

SpiffyRob, redemption is usually more of a bug than a feature of MeTa callouts.
posted by Burhanistan at 8:37 AM on May 28, 2009

And in case you were wondering:

The "Oh, wow, I hadn't thought of it that way, my bad." position.
posted by SpiffyRob at 8:38 AM on May 28, 2009

I hear you, Burhanistan, and I've certainly been guilty of continuing the post-redemption beatdowns as well. But, you know, hugs.
posted by SpiffyRob at 8:40 AM on May 28, 2009

y6y6y6: Doctors generally are able to sew up bloody wounds far more skillfully than those who are currently suffering from them. It's a crazy logic loop, I know.
posted by Burhanistan at 8:41 AM on May 28, 2009 [3 favorites]

I think I understand what's going on with your body, y6: you need to remove it from the proximity of people who shoot you and hit you with large axes.
posted by mygothlaundry at 8:41 AM on May 28, 2009 [22 favorites]

y6y6y6, there are at least half a dozen "that's what she said" goldmines in your last comment.
posted by SpiffyRob at 8:41 AM on May 28, 2009 [2 favorites]

Fair enough, SpiffyRob

two-way street hugs all around!
posted by EatTheWeak at 8:42 AM on May 28, 2009

Quick bro-hug with two back pats!
posted by Burhanistan at 8:42 AM on May 28, 2009

I'd like to comment on the "arrogance of doctors" thing above. I have quite a few friends who are doctors, and I've had two medical conditions in my life (Wolf Parkinson White Syndrome and Sleep Apnea) that have required me to see A LOT of doctors, either in a trauma situation or in GP to Specialist situations. I have never, ever encountered an arrogant doctor and that is from California to Michigan to Boston to New York City (home of arrogance). What I have encountered is an extreme tendency to not recognize that I am the expert on my own body and what is not right about it, given I've lived in it since birth. The noticeable effect of this is dismissal of anything that may require looking into a diagnosis that is not the most immediately obvious from the 5 minute, hurried gathering of symptoms at the outset.

Now, this is not entirely a doctor's fault but is more an offshoot of how shit is set up in this country, but the result for a patient is the need take on the load of work of managing one's own health care like it was a business. You need to push hard, be aggressive, educate yourself, force second even third opinions, consistently stick to your guns on your own gut feeling about what is right and wrong, etc etc. This is a full time job. If you don't have even the slightest luxury of time to run the quest for treatment like a second job (flexibility of hours at work, a boss or employer that understands and is willing to give slack, a family or partner than can pick up the daily responsibilities of life while you work on this second job, etc etc) then it is going to basically impossible to do justice to yourself.

This problem of doctors being so stretched by volume due to insurance companies that they don't actually have the time to do the real work of diagnosis rather than the patient assuming that burden is, in my experience, the cancer that debilitates all care. I don't think it's arrogance...it's lack of time. Subtleties and details are ignored or slip by and things that are tricky diagnoses that might not have very obvious symptoms can't be handled in 15 minutes. Also, patients have a broad range of skill, from totally shitty to obsessively detailed, at explaining problems, symptoms, pain, etc. 15 minutes is not enough time to deal with the personal quirks of patients in the process of separating the wheat from the chaff of what is going on or to tease out the real issues by making a patient comfortable or helping them explain themselves.

In short, I do not envy doctors. Particularly those that really really care. Because there are a lot of them.
posted by spicynuts at 8:45 AM on May 28, 2009 [11 favorites]

> I only go to the doctor if a condition has gotten so bad that continuing to live with it is worse than the experience of dealing with a doctor.

Same here.
posted by languagehat at 8:46 AM on May 28, 2009 [3 favorites]

Let me add that going to the doctor when you're fat is extra-fraught. You could be sitting there with a spurting gun-shot wound and the doctor might very well say, "Hmmm, you need to lose weight..." It took me months with my doctor (I've now switched doctors) to get appropriate treatment for a knee injury because the doctor was so fixated on my weight. I have three little kids and I suffered months of unnecessarily impaired mobility because of she would not refer me to a specialist. She kept saying, "He won't be able to do anything for you unless you lose weight." Eventually I demanded the referral, she reluctantly gave it, I had a simple outpatient surgery, and IT FIXED ME. When I think of how hard last year was, and how many times I had to say no to the kids...man, it really pisses me off. And it pisses me off that I didn't leave her practice months earlier.

I had an acquaintance (deceased now) whose doctor was so thrilled by her unexplained weight loss that he missed a cancer diagnosis despite unequivocal test results.

So many reasons why people don't trust doctors. A good doctor (I have one now) is a wonderful thing. But they're hard to find and the search is painful and expensive.
posted by not that girl at 8:51 AM on May 28, 2009 [16 favorites]

It's kind of dumb because the answer is almost always the same. Yes, you should see a doctor. People frequently do ask "How do I afford a doctor, I have {X medical condition} and need {drugs/treatment/reassurance} but {no insurance/no money/not a resident}", but that's a different question. Without qualifiers the answer is almost always the same.
posted by electroboy at 8:52 AM on May 28, 2009

I think one problem is that in America you can't go see a doctor whenever you want, so you need to ask metafilter if you're going to die, and hope they tell you, "No, that's cool."
posted by chunking express at 8:53 AM on May 28, 2009

"Doctors generally are able to sew up bloody wounds far more skillfully than those who are currently suffering from them."

Thus, AskMe.

You weren't there. I was. I have no doubt - none, zero, notta - that I could have sewn up the wound as well as the sadistic bastard in the ER. And it would have hurt a hell of a lot less.

So I'm going to call bullshit on your "generally". People may lack the knowledge or the fortitude to do their own stitches. But most of that is cultural brainwashing.

I have do doubt there are good reasons to go to the doctor. But I also have no doubt consulting AskMe is frequently a good idea.
posted by y6y6y6 at 8:54 AM on May 28, 2009

And y6y6y6, did you read that question? That dudes symptoms sound crazy, and I think the secret knowledge doctors posses could probably tell him what's up.
posted by chunking express at 8:56 AM on May 28, 2009 [1 favorite]

"you need to remove it from the proximity of people who shoot you and hit you with large axes."

Done and done. But life is so much more boring now.
posted by y6y6y6 at 9:00 AM on May 28, 2009 [2 favorites]

You weren't there. I was. I have no doubt - none, zero, notta - that I could have sewn up the wound as well as the sadistic bastard in the ER. And it would have hurt a hell of a lot less.

Well, they do say that one of the ironies of incompetence is that the incompetent don't possess the required knowledge to realize they're not competent.
posted by electroboy at 9:05 AM on May 28, 2009 [3 favorites]

nothing to do with the post...but, what the heck does it mean when someone says Word and then goes on to post... whatever this trend is, i've missed it...?
posted by HuronBob at 9:05 AM on May 28, 2009

Word.
posted by electroboy at 9:09 AM on May 28, 2009

The girl I nanny for is about to turn three, and she can't say "Go to the doctor." It's not in her vocabulary yet. She CAN, however, sing the entire theme song to "Dora the Explorer."

I imagine that this wouldn't really help if your arm was falling off, but it's pretty adorable.
posted by grapefruitmoon at 9:11 AM on May 28, 2009 [4 favorites]

what the heck does it mean when someone says Word

It's a short form of "word up".
posted by quin at 9:12 AM on May 28, 2009

In my opinion, this whole discussion is irredeemably tainted by survivor bias, because it's missing the legions of people who were all like, " Eh, doctors - who needs 'em, amirite?!" and then died from internal bleeding shortly thereafter.
posted by chinston at 9:17 AM on May 28, 2009 [12 favorites]

I had no idea that programming was such a dangerous job, y6y6y6.
posted by desjardins at 9:20 AM on May 28, 2009 [2 favorites]

As a medical transcriptionist, I find myself waking up at 3:00 a.m. wondering if my headache is the result of my ingrown toenail becoming infected and sending an embolism to my brain; or if the hip pain i felt on the way home this afternoon is the result of aseptic necrosis; or if the reason I don't want to go to the party tonight is that I have narcissistic personality disorder. So I can kind of relate to wondering if maybe a complaint doesn't rise to the level of physician consultation.
posted by troybob at 9:25 AM on May 28, 2009 [5 favorites]

what the heck does it mean when someone says Word

It means "I tell you what."
posted by ROU_Xenophobe at 9:36 AM on May 28, 2009 [1 favorite]

It can also mean "Hey Levar Burton, check out my red leather codpiece".
posted by electroboy at 9:47 AM on May 28, 2009

Cameo - Word Up

It's basically the same as saying "This." or "QFT" or what have you.

By the way, anyone who hasn't watched that Cameo video, do it right now. A weird, quasi-narrative thing featuring LeVar Burton as a detective!
posted by SpiffyRob at 9:55 AM on May 28, 2009

I couldn't have possibly predicted the need to preview there.
posted by SpiffyRob at 9:56 AM on May 28, 2009 [6 favorites]

Cameo's "Word Up" is the only song that I've ever sung karaoke to.
posted by Burhanistan at 9:56 AM on May 28, 2009 [1 favorite]

Even though, man, it sure would have helped with my busted-ass link. I'm not having a good day w/r/t commenting here.
posted by SpiffyRob at 9:56 AM on May 28, 2009

I have never, ever encountered an arrogant doctor and that is from California to Michigan to Boston to New York City (home of arrogance). What I have encountered is an extreme tendency to not recognize that I am the expert on my own body and what is not right about it, given I've lived in it since birth. The noticeable effect of this is dismissal of anything that may require looking into a diagnosis that is not the most immediately obvious from the 5 minute, hurried gathering of symptoms at the outset.

With all respect, that sounds like the very definition of "arrogant".
posted by Rumple at 10:11 AM on May 28, 2009 [2 favorites]

> Now, this is not entirely a doctor's fault but is more an offshoot of how shit is set up in this country

It can be, and often is, both. Anyone remotely interested in this stuff should read this amazing piece by Atul Gawande. (I don't know if it's been posted on the blue; if not, it should be, but I wouldn't dare do it myself because of all the "How dare you post something from the New Yorker??" assholes.)
posted by languagehat at 10:11 AM on May 28, 2009 [2 favorites]

> With all respect, that sounds like the very definition of "arrogant".

Also, what he said.
posted by languagehat at 10:11 AM on May 28, 2009

Hey, I've seen a LOT of medical drama shows. Maybe they're filled with lies, but every single one has featured some new intern doing stitches in the ER because it's "not that important".

If I had the ability to do my own stitches, than I probably would, depending on the injury. I trust myself more than I trust some sleep-deprived, completely stressed hospital noob.
posted by graventy at 10:17 AM on May 28, 2009

I've always figured "word" was short form of saying "You are speaking the Word", as in the Word of God. And the "up" (in the spirit of "straight up" and "on the up-and-up") was an emphatic redundancy, like saying the "the God's honest truth".
posted by team lowkey at 10:23 AM on May 28, 2009

Wow, my radar is completely off. I was SURE y6y6y6 would turn out to be a sockpuppet for sixcolors.
posted by misha at 10:24 AM on May 28, 2009 [1 favorite]

Because they look so similar, some people might have AskMetafilter confused with the Shirky-Surowiecki Wikilinic featuring The Wisdom of Crowd-Sourced Medical Solutions without Medical Professionals.
posted by milkrate at 10:25 AM on May 28, 2009

Wow, my radar is completely off. I was SURE y6y6y6 would turn out to be a sockpuppet for sixcolors.

Aww Misha, please don't get my hopes up!
posted by applemeat at 10:28 AM on May 28, 2009 [1 favorite]

> With all respect, that sounds like the very definition of "arrogant".

Also, what he said.

Huh...either I have an extremely high tolerance for arrogance or I'm not explaining myself well enough. I've never said to myself "this guy is an arrogant douche and I don't want treatement from them".
posted by spicynuts at 10:31 AM on May 28, 2009

I'll see your Cameo and raise you a Korn.
posted by maudlin at 10:36 AM on May 28, 2009

I'll see your Cameo and raise you a Korn.

I'll raise you a zooming codpiece intro (warning: terrible).
posted by Burhanistan at 10:41 AM on May 28, 2009

Self-treated gunshot wounds and being hit with an axe....

y6y6y6, I have to ask, are you Batman?
posted by The Whelk at 10:46 AM on May 28, 2009 [2 favorites]

lying awake
in my hospital room
Silas Creek Parkway
is my only view
and the doctor just came by
and told me the news
I need a second opinion
I don't believe
that it's true
posted by Devils Rancher at 10:47 AM on May 28, 2009

Yes, that came on at random whilest reading the thread. Seemed apropos.
posted by Devils Rancher at 10:48 AM on May 28, 2009

Because you can never have too many red jockstraps.
posted by Sys Rq at 10:59 AM on May 28, 2009

I agree with you... But, I must say that in the last five years I've only had the doctor actually help me once (outside of just having a checkup), everything else has been, "oh don't worry about that, just XYZ" (which is what I was doing before hand) or, "I don't know what that is, but it shouldn't worry you", or, "we could fix that but it's just cosmetic". So nowadays I only actually go to the doctor if sometime is unequivocally wrong and I believe that I will get help. Want to know why males are stereotypically adverse to doctors? Cause the batting average is sometime pretty damn small.
posted by edgeways at 11:15 AM on May 28, 2009 [1 favorite]

I'll see your Cameo and raise you a Korn.

Isn't that mildly akin to saying "I'll see your ten and raise you negative ten?"

[MILDLY KORN-IST]
posted by SpiffyRob at 11:16 AM on May 28, 2009 [2 favorites]

So I'm going to call bullshit on your "generally". People may lack the knowledge or the fortitude to do their own stitches. But most of that is cultural brainwashing.

I have do doubt there are good reasons to go to the doctor. But I also have no doubt consulting AskMe is frequently a good idea.

You're being ridiculous, and it's not helping. While I will cede to you the possibility that a combination of fortunate circumstance and your possession of first-aid training were enough that you were able to sew up a gunshot wound without the need for a trip to the ER, it is completely insane to treat that experience as normative. If the wound had gone septic, or you'd gone into shock before finishing treating it, or if it had nicked something crucial and you didn't realize it because you weren't seeing all of it, or any of a hundred other things had gone even slightly pear-shaped, you would have been in a world of trouble. Congratulations for not being one of the small number of cases where that happens; let me suggest that it was merely a roll of the dice, and that it's wildly irresponsible to recommend that other people subject themselves to those same odds because you once managed to beat them.

People go to the doctor for the same reason people go to see a lawyer: because there is a small chance that a seemingly-minor problem is going to turn into a huge shitshow requiring large amounts of expert knowledge. While it is possible that you'll get through a divorce without any enmity, it's generally not a good idea, simply because of the stakes involved, and no thinking person would ever advise you to try. I think someone's goddamn life deserves at least that much consideration. That's why we pay professionals as much as we do: because they have huge amounts of training and experience in dealing with a specific set of problems.

There's a reason that practicing medicine without a license is illegal: if you fuck up in dispensing medical advice, there's a very real chance you're going to cause grave, irreparable harm to someone. I don't much like going to doctors, either, but the contempt that AskMe exhibits for them is one of its weakest points. Seriously, y'all rode ikkyu2 out on a rail for suggesting that people shouldn't be dispensing medical advice without a degree, and he was one of the most valuable things that AskMe had going for it.

AskMe is great for many things, but it is at its level worst when there are medical questions asked. What would possibly drive you to publicly speculate about how the OP should solve his health problem when the stakes are so high?
posted by Mayor West at 11:22 AM on May 28, 2009 [14 favorites]

I couldn't have possibly predicted the need to preview there.

I like the cut of your jib, SpiffyRob.
posted by electroboy at 11:30 AM on May 28, 2009 [1 favorite]

Seriously, y'all rode ikkyu2 out on a rail for suggesting that people shouldn't be dispensing medical advice without a degree, and he was one of the most valuable things that AskMe had going for it.

With all due respect, that is not how things went down. I generally enjoyed ikkyu2's contributions a lot -- more as a participant than as a mod -- but it seems that he had his own internal quandaries about how to participate here and the value of this community and his role in it. He was actually one of the best arguments for "why some people are afraid of their doctors" that AskMe had going for it. It took a certain type of person to really grok what he was saying and the manner with which he was saying it; people who took his contributions the wrong way did not enjoy or appreciate him at all. He left because he decided to leave. No one made him leave.
posted by jessamyn (staff) at 11:42 AM on May 28, 2009 [6 favorites]

Burhanistan: Physician, heal thyself.

VALIUM! —m-kss m-kss…
posted by koeselitz at 11:44 AM on May 28, 2009

> Huh...either I have an extremely high tolerance for arrogance or I'm not explaining myself well enough. I've never said to myself "this guy is an arrogant douche and I don't want treatment from them".

I think the problem is that you think "arrogant" equates to "arrogant douche from whom I don't want treatment." That's silly; doctors tend to be arrogant, but that doesn't automatically make them douches, let alone mean that no one should go to them. Cops and judges also tend to be arrogant; it's what the French jokingly call déformation professionelle.
posted by languagehat at 11:46 AM on May 28, 2009 [3 favorites]

I once didn't go to the ER because my lung was collapsed and my blood oxygen dropped low enough that I was in a mental fog. I knew I was sick (I'd been to the ER and the doctor earlier that week and had an appointment for the next day) but I just couldn't figure out if I should wait till tomorrow to go to the ER *RIGHT NOW*. It was finally decided by my husband when I started crying from the pain which caused so much more pain that I completely freaked out, and he put me in a car and drove me straight to the ER where they put me on oxygen and I felt like I was waking from a strange and terrible dream.

So, in short, sometimes people don't go to the doctor because being sick can impair your judgment.
posted by carmen at 11:57 AM on May 28, 2009 [2 favorites]

And no one calls home any more because of lots of reasons. Primarily something about afros and pupils.
posted by filthy light thief at 12:13 PM on May 28, 2009

With all due respect, that is not how things went down. I generally enjoyed ikkyu2's contributions a lot -- more as a participant than as a mod -- but it seems that he had his own internal quandaries about how to participate here and the value of this community and his role in it. He was actually one of the best arguments for "why some people are afraid of their doctors" that AskMe had going for it. It took a certain type of person to really grok what he was saying and the manner with which he was saying it; people who took his contributions the wrong way did not enjoy or appreciate him at all. He left because he decided to leave. No one made him leave.

Granted, he left of his own accord--I didn't intend that to be read as "OMG the mods banned him!" I was talking about the MeTa thread that finally sent him packing, following the even longer, more contentious one in the end of '07. The guy absolutely had a point: in a chorus of disparate answers, it's really easy to listen to the small contingent of people who say "it's fine, you don't need a doctor, you just need {St. John's Wort / a needle, some thread, and a steely constitution / to walk it off}", rather than to the actual answer, which is "we're not doctors, and this is clearly a medical problem; go find a doctor." But he was shouted down by an appeal to net-good-achieved, and by the contingent that believes that, on average, consulting AskMe is more likely to prompt someone with medical/psychological problems to seek real help than it is to give them a false sense of having found a solution from the laity. That's so far outside the ethical framework of what he does that had no choice but to pack up and move on. I'm actually surprised, after that MeTa exchange, that docpops and Slarty Bartfast and the rest of the MDs around here didn't leave, too.

I'll admit to some bias: I work with doctors. I'm a tech guy, with no medical background whatsoever, but three years of close contact with a number of them has given me some small insight into what it's like. Every decision your doctor makes carries with it the risk of killing or seriously harming you. That's a pretty crushing weight to have hanging over you, and I don't think it's something that exists in a lot of professions. So when I see my regular doctor now, and she's brusque, I assume it's for the same reason that air traffic controllers are brusque, and write it off accordingly. I took ikkyu2 in stride, because I suspect that being surrounded by death and disease for years at a stretch would make a guy a little rough around the edges, and I think his contributions far outweighed any of the gruff argument-from-authority stuff that people bristled about. Mine doesn't appear to be the prevailing wisdom around here, and that's fine, but I shudder when I see members here telling folks who might have actual, serious medical problems that they're fine and should just stitch up that bullet wound and keep a stiff upper lip.
posted by Mayor West at 12:28 PM on May 28, 2009 [5 favorites]

"y6y6y6, I have to ask, are you Batman?"

Actually I'm a short fat bald guy.

"let me suggest that it was merely a roll of the dice, and that it's wildly irresponsible to recommend that other people subject themselves to those same odds because you once managed to beat them."

I've suggested no such thing. I've suggested that asking some questions before rushing off to the ER is not automatically a bad thing. I've suggested that people can take some responsibility for their own health care more often than they seem to think. I suggested that the medical industry is happiest when you are a frightened little sheep, and that you don't need to buy into that.

The thread is about how it's stupid to think for yourself or ask questions. I've suggested that's incorrect.

"People go to the doctor for the same reason people go to see a lawyer: because there is a small chance that a seemingly-minor problem is going to turn into a huge shitshow requiring large amounts of expert knowledge."

No. Doctors and lawyers are totally different knowledge types. Anyone can easily gain the knowledge to evaluate and treat a large gaping wound, including stitches. But trying to defend one's self in a law suit, or sue a large corporation all by yourself, is nearly impossible.

"That's why we pay professionals as much as we do: because they have huge amounts of training and experience in dealing with a specific set of problems."

I'm glad you still have total and unwavering faith in that. I don't. Doctors go to school for a long time. That doesn't mean they are superheros. I've seen plenty of lives saved by doctors. I've also seen lots of times doctors nearly killed people by screwing it up.

And once again, I need to call bullshit. We pay doctors as much as we do because the health care industry get a free pass on business practices that would get any big corporation sued into the gutter.

I respect the profession. I go to doctors when needed. I think others should as well. But this thread is about running to the ER every time you start to question whether something is wrong. Screw that.
posted by y6y6y6 at 12:30 PM on May 28, 2009

"y6y6y6, I have to ask, are you Batman?"

Actually I'm a short fat bald guy.

Exactly what Batman would say.
posted by The Whelk at 12:38 PM on May 28, 2009 [2 favorites]

I suggested that the medical industry is happiest when you are a frightened little sheep, and that you don't need to buy into that.

Fascinating. What would you propose we call these sheep-people hybrids?
posted by electroboy at 12:43 PM on May 28, 2009 [4 favorites]

No. Doctors and lawyers are totally different knowledge types. Anyone can easily gain the knowledge to evaluate and treat a large gaping wound, including stitches. But trying to defend one's self in a law suit, or sue a large corporation all by yourself, is nearly impossible.

But they're not. They're both examples of extreme specialization, where the only way you're not going to get in way over your head is to have a working knowledge of lots of complex and interdependent parts. That is to say, they're both professions in which you would benefit greatly from having an advanced degree, and will likely find yourself in a great deal of trouble if you don't. At least if you lose that lawsuit it won't kill you.

I get that you don't like doctors, and I concur that running to the ER for a Z-Pak to treat your head cold is ridiculous. But it is equally ridiculous to advise against seeking medical attention for symptoms that the original poster himself suspected might be serious enough to warrant it.
posted by Mayor West at 12:46 PM on May 28, 2009

But trying to defend one's self in a law suit, or sue a large corporation all by yourself, is nearly impossible.

Probably a lot easier than successfully performing your own [insert virtually any surgical procedure] though.
posted by Pollomacho at 12:48 PM on May 28, 2009

I liked ikkyu2. However, ikkyu2, hrm, "demanded" is not the right word, but he really, really pushed for a "only doctors should be answering medical questions" stance. He decided he could not ethically participate in the situation, so he left. He was not ridden out on a rail. No tars, no feathers.

Additional, he was not always correct in his answers. I came across at least one instance; more probably exist. This is a feature of human beings — they are not always correct. Personally, between the choice of all medically-related AskMe questions only being answered by medical professionals and medically-related AskMe questions being answered by "the populace" and the medical professionals who can stand to not automatically be recognized as The Authority, I'll take the latter, every time. Ikkyu2 decided that he could only settle for the former.

Doctors make mistakes before: factual, procedural, ethical, logistical. This happens, since they are human. I've worked with/for doctors, had doctors as extended family, and have had doctors just screw up my health care, be completely wrong in conversations about medical topics, and make ethical blunders. Requesting that this non-zero error rate be ignored is the arrogance part.

That is only part of the situation which prompts questions to vex dmd, other parts being that health care is non-free in the United States, as well as people genuinely not knowing how much of an emergency something may be, and not wanting to be seen as a worrywart and a timesucker. As a factor of that, the ability to gauge pain is very important. Some people are simply not good at it. This can happen as a byproduct of a chronic pain condition. A small bone fracture can simply fade into the background and feel like a bruise. It's a complicated situation.
posted by adipocere at 12:49 PM on May 28, 2009 [4 favorites]

Metafilter: a seemingly-minor problem is going to turn into a huge shitshow requiring large amounts of expert knowledge.
posted by misha at 12:53 PM on May 28, 2009 [7 favorites]

He left because he decided to leave. No one made him leave.

Not even Tom Cruise?
posted by timeistight at 1:01 PM on May 28, 2009

You need to push hard, be aggressive, educate yourself, force second even third opinions, consistently stick to your guns on your own gut feeling about what is right and wrong, etc etc.

Hahhah!

And then when you do, the doctor dismisses you (particularly if you're a woman) as a hysteric, possibly borderline personality who is probably just faking it for attention or seeking pain medication, and writes this information in your chart.

God help you if you're a fat woman and you do this. You will, as someone said, never get to the point of your visit as they'll be too busy belaboring you for being fat.
posted by winna at 1:31 PM on May 28, 2009 [5 favorites]

winna - the facts you cite are depressing. The list you link to is fascinating! Uhm .... thank you?


... I wonder which of these acronyms I've been? Far as I can remember, I'm pretty charming under anesthetic ...
posted by EatTheWeak at 1:40 PM on May 28, 2009

Also, winna, you probably need therapy for bringing it up AGAIN, you hypochondriac!
posted by small_ruminant at 1:40 PM on May 28, 2009 [1 favorite]

'll admit to some bias: I work with doctors. I'm a tech guy, with no medical background whatsoever, but three years of close contact with a number of them has given me some small insight into what it's like.

I also work with doctors and have gained some insight. (You really want to hear the hard stories? Be friends with nurses. Jesus.)

That insight has made me even more strident in advising people to pay attention, be their own advocate, and do research to ask informed questions. This is something that AskMe does well. It's not anti-doctor to take an interest in how your body works.

Bad medical advice, quackery, and unwise reluctance to see a doctor in the face of a serious-sounding injury/disease is drowned out here by a chorus of Noooooooo, for fucks sake get to a doctor! This would be the system working.

But he was shouted down by an appeal to net-good-achieved, and by the contingent that believes that, on average, consulting AskMe is more likely to prompt someone with medical/psychological problems to seek real help than it is to give them a false sense of having found a solution from the laity. That's so far outside the ethical framework of what he does that had no choice but to pack up and move on. I'm actually surprised, after that MeTa exchange, that docpops and Slarty Bartfast and the rest of the MDs around here didn't leave, too.

And here, you've managed to call into question the medical ethics of two of our members and characterized lay discussion of medical issues as inherently harmful. Wow.
posted by desuetude at 1:45 PM on May 28, 2009 [2 favorites]

"I get that you don't like doctors"

I like doctors just fine. It seems like a noble profession.

I just think it's a good idea to ask questions, even on the Internet, and educate yourself about what's going on. Sometimes you can treat yourself. Seriously, you can.
posted by y6y6y6 at 2:14 PM on May 28, 2009 [1 favorite]

I just think it's a good idea to ask questions, even on the Internet, and educate yourself about what's going on. Sometimes you can treat yourself. Seriously, you can.

No one seems to be saying otherwise.
posted by Burhanistan at 2:16 PM on May 28, 2009

EatTheWeak: ... I wonder which of these acronyms I've been? Far as I can remember, I'm pretty charming under anesthetic ...

I shudder to think which I've been labeled with, but I know for a FACT I am incredibly creepy under anesthetic. Apparently, after I woke up on the table during surgery (mmm, perhaps a sign that doctors don't know EVERYTHING, like, say, how to keep someone from waking up during surgery), they knocked me out with so much juice that it took me hours to come to.

And when I was beginning to wake up, I started howling... "like a banshee," said the nurse/doc/whoever who called my boyfriend and said "you have to come and get her, she's scaring the other patients!"
posted by bitter-girl.com at 3:46 PM on May 28, 2009

As someone who has asked a question like this (though with markedly less troubling symptoms) and gotten a ton of annoying less-than-informative answers, let me elucidate a couple points:

1) An answer that is merely "Fuck! Get to a doctor! Now! Who knows what it could be" isn't helpful and comes across as panicky
2) Similarly, "Fuck! Get to a doctor! Now! You don't want to take any chances with your [whichever thing]" isn't informative. Of course I don't want to risk my left eye, the question wasn't "Do I value my left eye?"
3) If I've been experiencing a symptom for months or years without any other trouble, "Fuck! Get to a doctor! Now! You could already be dead" isn't going to be taken very seriously
4) An answer that is helpful is "It could be XXX which matches the symptoms you have and is potentially very serious, you should see a doctor because they can rule it out with a test"
posted by 0xFCAF at 3:49 PM on May 28, 2009 [1 favorite]

From the New Yorker article that Languagehat linked:

Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn

I've not finished it yet. But I'm tipping that the writer's shock revelation is going to be that most of those dollars are finding their way into the pockets of insurance company shareholders.
posted by flabdablet at 4:24 PM on May 28, 2009

You really want to hear the hard stories? Be friends with nurses. Jesus.

Agreed. Ye gods, man.

Bad medical advice, quackery, and unwise reluctance to see a doctor in the face of a serious-sounding injury/disease is drowned out here by a chorus of Noooooooo, for fucks sake get to a doctor! This would be the system working.

Fair enough. I won't argue that AskMe is generally a phenomenally useful forum for all sorts of questions, even health-related ones. But it's not foolproof. And when it doesn't work perfectly, people sometimes die from it.

And here, you've managed to call into question the medical ethics of two of our members and characterized lay discussion of medical issues as inherently harmful. Wow.

You're digging pretty deep to get that meaning out of what I actually said. The former would be true if and only if one of the two members in question had ever responded to a question about potentially serious symptoms with anything but 'this could be serious, go see a doctor.' They never, to my knowledge, did so. I have a phenomenal amount of respect for the doctors who post here, because they walk such a delicate line and still manage to be helpful to so many people. You'll probably notice that they tread pretty lightly in discussions of anything medically serious, for exactly the reasons I've outlined.

Nor is discussion inherently harmful. The more we all know about chronic conditions and general health-management, the better, and we should all be reading every bit of medical literature we can get our hands on. Hell, I work for a company that does exactly that. When a poster indicates that there's a possibility of a serious condition, which is potentially time-sensitive, that is not the time to be discussing long-term treatment options; it's the time to tell him/her to get the hell to a doctor.
posted by Mayor West at 4:43 PM on May 28, 2009

OK, that surprised me. I had not thought that I could read anything that would give me a worse opinion of the way the US health system is organized than I already had. Just did. Wow.

We are so lucky in this country. Thanks, Gough.
posted by flabdablet at 4:51 PM on May 28, 2009

And when it doesn't work perfectly, people sometimes die from it.

That's a pretty heavy cause-effect you're setting up there, and linking to one of the shittiest things ikkyu2 has ever said on this site. I'm not sure why you're picking that scab. Lots of people told Soulbee to go to the doctor, and gave her advice on how to do that. I know for a fact that AskMe, or the various people here, have also talked people down off the ledge. So sometimes people live because of it too. So what now?
posted by jessamyn (staff) at 4:55 PM on May 28, 2009 [3 favorites]

And when it doesn't work perfectly, people sometimes die from it.

Jesus. I was kind of hoping you weren't actually hanging your hat on that one. I respect ikkyu2 and miss his voice being in the mix around here, but that was one of the balls-out shittiest pieces off hostile misattribution of grief I've ever seen on the site and I'm still livid that he went there. It was an awful, bullshit thing to say, and I hope in the time since he left he has come to see that.
posted by cortex (staff) at 5:21 PM on May 28, 2009 [3 favorites]

2) Doctors can't be trusted. People want to some idea what's going on before they go see a doctor.

3) It's a total, 100%, undeniable, ripoff. I'd like some agreement I really need to go before I invite the medical industry to steal my money while insulting my intelligence and treating me like a lab rat.

I personally think that these two statements are questionable. My dad is a doctor, and he absolutely has the best health of his patients at heart. I know plenty of doctors who have gone above and beyond the call of duty to make people better. There are some real heroes in the medical industry. There are also some buttheads. Then there is a huge majority of in-the-middle people. Just like every other profession. There are teachers that can't be trusted, lawyers who can't be trusted, politicans that can't be trusted, Peace Corps volunteers who can't be trusted, and hey, even programmers who can't be trusted. Personally, I tend to go from a default state of an above-neutral level of trust in my fellow human being.

I've been really helped by doctors in the past when I needed it. It's possible that I've simply been lucky and haven't been shafted like other people have. But medical care, when you need it, isn't a ripoff.

However, I am absolutely certain that points 2 & 3 are major beliefs that lead people to ask random strangers on the internet before they consult an actual doctor.
posted by Deathalicious at 7:22 PM on May 28, 2009 [1 favorite]

Hospitals are where people go to die.
posted by bardic at 7:22 PM on May 28, 2009

Hospitals are where people go to die.

Interesting that you say that. I'm reading a book about the history of medical science, or medicine starting to be understood as a science. The author, Lewis Thomas, recounts his growing up as the son of a doctor back when being a doctor mostly meant making house calls and doing the occasional surgery. For the most part all they did was dignostic. At the turn of the century there were very few things that could be cured once you had them. He describes going to medical school around the time they discovered a cure for ... I think it was pneumonia or possibly syphillis. How, before that point medicine was all about determining what would go away and what would not go away and informing the patient of those facts. There was a sense that you stood with the patient through the course of their disease and were always on call to treat it. Residents were also technicians so you were there the whole way. Then medicines started getting really going that could cure things and it removed the human part of the equation a little, in favor of some speed of testing and some other things.

Up until that point, the hospital was pretty much where you went if you were dead broke or thought you were dying and that's it. It was full of crazy people and sick people. That changed around the 1940's and 50's [at least in the US] but that's just a few generations back and a lot of people still have that feeling only it's not necessarily borne out by data, but the same concerns (getting MRSA is real, as are the realities of insurance companies doing things that promote the bottom line but don't promote wellness) pop up generationally as well.

I recommend this book for anyone who wants to know what medical care looked like in the US in the teens through the fifties. It's called The Youngest Science and I'm enjoying it a lot.
posted by jessamyn (staff) at 7:30 PM on May 28, 2009 [11 favorites]

One thing I think I'm pretty sure of is almost every patient is scared, at some level, of whatever they're are in the office for. Anxiety and fear are corrosive. People drink themselves into cirrhosis and shoot heroin to stop it's reach, so if nothing else we should always keep in mind that whatever we may be concerned about isn't often what the pt. is worried about. Given the potential logistical and financial obstacles to getting a medical opinion, it's pretty forgiveable that people post their concerns here hoping for lightning to strike. The ensuing noise, however...

I miss Ikkyu2's contributions. If the metric for value here were true, no bullshit accuracy into medical wisdom, and also how a good medical mind actually works behind the curtain, warts and all, then he was turned up all the way to eleven.

Someone earlier mentioned the time issue, as far as the pressure to get more done in less time. It's true. You could never know how bad it's gotten. Money isn't the issue, either. There just aren't enough physicians in most communities to handle what is being asked of them by patients. Arrogance may be what you are seeing, but more likely it's just a mild case of burnout or plain fatigue setting in.
posted by docpops at 9:15 PM on May 28, 2009 [1 favorite]

they're are har har har. aargh.
posted by docpops at 9:16 PM on May 28, 2009 [1 favorite]

My grandma, for one, had her life extended a number of times through going to a hospital. Not the least of which was when she received a triple bypass along with a new heart valve. Which, when you stop to think about it, means some doctors took a heart valve from a pig, attached it to her heart somehow, and at the same time took teeny tiny veins and arteries that weren't working and rerouted them with teeny tiny veins and arteries that were. I don't know the details, but I'm pretty sure you couldn't stitch those things up with a needle and thread form a pharmacy. Near the end her lungs kept filling up with fluids, and she'd go to a hospital to get them drained. When the painful decision was made that she was firmly on the path of dying, that's when she no longer went to the hospital.
posted by Deathalicious at 9:22 PM on May 28, 2009 [2 favorites]

People may lack the knowledge or the fortitude to do their own stitches. But most of that is cultural brainwashing.

Is there nothing Dalton can't teach us?!?

Also, speaking as someone who 'ran off' ikkuyu2 - I'd be surprised if even he would characterize it that way; it certainly wasn't my intention - the hostility directed towards him was as result of him saying something far more contentious and shitty than 'Hey, leave the medical stuff to the pros, people.'
posted by Alvy Ampersand at 11:02 PM on May 28, 2009

Jesus. I was kind of hoping you weren't actually hanging your hat on that one. I respect ikkyu2 and miss his voice being in the mix around here, but that was one of the balls-out shittiest pieces off hostile misattribution of grief I've ever seen on the site and I'm still livid that he went there. It was an awful, bullshit thing to say, and I hope in the time since he left he has come to see that.

This is clearly a more sensitive issue than I had originally thought, and I'm really not trying to stir things up for the sake of pure argumentative douchebaggery, so I'll drop it after just saying this:

ikkyu2 chose a really shitty way of saying what he wanted to say, but I don't think his underlying point is invalid. We have no way of knowing what happens when someone posts an AskMe like these. Maybe they listen to the chorus of 'get to a therapist/doctor!' and maybe they're secretly looking for that one dissenting answer telling them that they're probably OK, and maybe it'll get better with some ginseng and vitamin C. My point is, I don't think AskMe wants to bet on what outcome is going to occur for anonymous asker X when he posts a question that indicates that he might have a serious medical condition, or might be suicidal. And since most of us aren't trained in the appropriate fields, I'd contend that it's a really bad idea for a guy off the street (which is what the community here is--overeducated people off the street, maybe, but without that MD, we're just rabble) to try to suss out whether he himself thinks the situation is serious enough to warrant immediate intervention, or whether someone just has a muscle sprain or a case of the Mondays. There's very little potential gain, and huge potential loss. I'll leave aside any contention of personal culpability, because you're right, it's not fair; I'm sorry for dredging up such a vicious accusation to make my point. From at least a legal perspective, though, it seems like you're setting yourself up for a serious problem if it ever comes out that someone posted a question here, was told (by however small a dissenting faction) that it wasn't serious, and then died from it. All our answers are © their original authors, and I'm also not a lawyer, but I'd be willing to bet that there are states where a grieving family could sue the hell out of MetaFilter, and that's the last thing I want to see happen.
posted by Mayor West at 5:38 AM on May 29, 2009

Mayor West--"a guy off the street" when it comes to legal advice--ought to follow his own suggestion.
posted by applemeat at 7:06 AM on May 29, 2009

I see independent research, not as a replacement to doctor visits, but as a very useful and important part of one's medical care.
posted by orange swan at 7:24 AM on May 29, 2009

I am curious as to how “the giving of poor but well-intentioned advice (/by admitted laypeople)” could constitute a cause of action and/or would not be protected free speech. (“Tort liability” and “jeopardizing one’s professional license” are two different things.) Can anyone cite?
posted by applemeat at 7:24 AM on May 29, 2009

At the end of the day, there's a wide spectrum of things over which a sufficiently unreasonable and litigious person could try to sue Metafilter (or anyone/anything else that looked at them wrong). Matt's has talked with legal folks in the past, and has over the years made some general decisions to try and minimize reasonable risk here in a way that balances with the goals and structure and character of the community.

This place will never be anything like 100% litigation-proof—people can sue for stupid, unreasonable, totally unwinnable reasons because they've got a lawyer and a beef and nothing better to do with their time and money.

So I think the question here comes down to whether we want to impose a new and artificial and wide-ranging constraint on what people can talk about on askme just to try and push the line-of-hypothetical-unreasonable-litigation a couple notches farther along that fuzzy axis. That's a trade-off I'm not really excited about, though ultimately I'm going to trust Matt's decision-making either way on this stuff—I've never had any real gut problem with his decisions on this stuff, and as he is the person most profoundly affected by the ongoing health and viability of this place I think it's safe to say he's had good reason to take these sorts of things under pretty serious consideration over the years.
posted by cortex (staff) at 8:05 AM on May 29, 2009 [1 favorite]

This is clearly a more sensitive issue than I had originally thought,

Wait, the self-flaming out of one of the most respected members of the site related to the death of another beloved user who had used AskMe to ask about mental health issues... you thought this wasn't a sensitive issue?

Man, I don't know what's considered sensitive on your planet.
posted by grapefruitmoon at 8:12 AM on May 29, 2009 [2 favorites]

Man, I don't know what's considered sensitive on your planet.

If death by suicide isn't, the horrors that are must boggle the merely human mind. Probably something involving tentacles and hyperspace cubes.
posted by nomisxid at 10:23 AM on May 29, 2009

Woman goes into hospital for kidney stones, comes out a quadruple amputee
posted by desjardins at 2:12 PM on May 29, 2009

Doctors are not scary bogeypeople!

Sometimes, yes. Yes they are. Abso-mofuckin-lutly.

Haven't you ever seen one of the best black comedies about the health profession (it was written by Paddy Chayefsky): The Hospital?
posted by Skygazer at 3:57 PM on May 29, 2009

There just aren't enough physicians in most communities to handle what is being asked of them by patients. Arrogance may be what you are seeing, but more likely it's just a mild case of burnout or plain fatigue setting in.

This is very true.

I like the health related askmes because of the reasons listed above and mefi is pretty good at evaluating some of the ethics surrounding it here over the years.

The problem I have is laymen who seem to google their answer and then post a diagnosis. I don't like seeing people use medical terms they're only loosely aware of thanks to google and answering questions with an authority they do not have the knowledge to back up. That's arrogance and occasionally dangerous.
posted by dog food sugar at 6:59 PM on May 29, 2009

1) It's really not that vital to see a doctor many times. I self-treated a gunshot wound a long time ago. Spurting blood and all. It was no big deal.

Just so you know, if y6 ever is seriously injured? I'll be calling the ambulance and taking him to the doc myself. Gunshots are only self treated by crazy people and by people who are scriptwriters and believe what they see on tv.

Hopefully he'll have passed out so that we can have a full discussion after the medical treatment. And to be fair, y6 was extremely nice the time he had to take me to the emergency room some years ago. Maybe I just need to get myself one of those tranq guns like they used on Wild Kingdom...
posted by batgrlHG at 3:04 AM on May 30, 2009

Apropos what jessamyn said:

I have spent a considerable chunk of my life in hospitals, on account of other people.

On the one hand, I watched my Nana die (complications from injuries after a car accident, ending with pneumonia). I watched my mother die (breast cancer). I watched my sister survive (blood poisoning with doctors giving her a 1 in 3 chance of survival) but it took weeks of touch and go in ICU.

There have been other occasions when I've set foot in one, but all the really deep memories are indeed of someone going there to die. Rationally, I understand that hospitals are places where nasty things are caught early, and where with care people are healed and live. But in my gut, they're where you go to die. And I'm not an old timer with outdated memories from the early 20th century. I'm 39. I think this is a natural consequence of the fact that mostly, you don't end up in hospital unless you're in deep trouble, and if you're in deep trouble, marvellous as modern medicine is, a lot of the time you die.
posted by i_am_joe's_spleen at 3:35 AM on May 30, 2009 [1 favorite]

wow.

My first reaction to this question was that I thought we'd all heard enough about the US health care system to understand that the financial impact of "Just go to a dr/the ER" can be totally overwhelming for some people and possibly land them several thousand $ in debt. Even a trip to be told "take 2 aspirin, sleep, you'll be fine tomorrow" could cost more than some can afford.

dmd, as you now know, these types of questions come up all the time, and will continue to do so while people fear more about debt than they do about their health.

As far as doctor arrogance goes, isn't that part of their training? (joking, kinda)

I have huge respect ikkyu2, and I'm sorry he packed up & left & wish he'd come back. He could be arrogant, and to some extent I think people with his qualifications have earned it. Med school & neurology is hard.

I've had a few neurologists - the first one I like a lot. To me he seemed very humble & accomodating (may have been condescension, but never to the point annoying me). He frustrated me a bit as he didn't seen to "get" some of the things I tried to discuss with him. Maybe he was brushing me off, but I got the impression he just didn't have any answers so he would airy fairy his way through a discussion with me, which left me frustrated, but thinking he just didn't have a clue what how to answer my questions. He later got a sidekick who was even more with the airy fairy but actually told me he had no idea about what i was talking about.

I once met a very agigated person in the waiting room. This person had NOTHING good to say about old neuro and was speaking quire vehemently relating a conversation that had been had. "I don't like you, I know you don't like me...." It was pretty hard to listen to and this person was very irate about having to see this particular neuro. I remember thinking "wow - this guy is angry & this neuro just doesnt deal with angry - he sits & looks at angry & makes angry more angry". Maybe there was much more to it, but for me this was an example how some clients/patients just don't relate to some therapists.

Now I have a new neuro, who I pay lots of money to see (the previous one was free, but took many hours of travel & waiting - its cheaper for me to pay for private session that take 6 hours off work for a free public session). He knows my old neuro & says they have chatted about me. My new neuro is about 500 billion years old and is the cutest thing in the world. He is also sharper than anything else that is sharp and I think he's more on the ball than my old neuro in regards to issues that I'm dealing with.

Ikkyu2 has a certain right to be arrogant. he once pulled me up about something I said, and I think I told him I felt I was qualified enough to say what I said.

Sometimes doctors hide behind a wall of authority. We look to doctors to guide us & help us. My brain cannot comprehend the issues ppl in the US have to deal with in regard to healthcare.

I have MS, I've never paid for an MRI (I think I've had 3 or 4 since 2000), my daily injections cost the government $1000 month - I pay $30 after subsidies.I know I will be looked after for free if I need to be. I can't imagine living in the US with MS or any other serious medical issue.

Right now I worry about mefite pjern who was bitten by a spider in late April and having almost departed this planet, is going to be out of work for potentially 3 months and as has some mounting medical bills.

I know this probably isnt the place to do this, but fuck it. Phil is an awesome human being and he's quite clever with with his camera.
Go buy some prints or just toss handfulls of money in his paypal account.

Take care of yourselves, Americans, the rest of the world worries.
posted by goshling at 3:37 AM on May 30, 2009 [2 favorites]

Ikkyu2 has a certain right to be arrogant.

The problem I have with a lot of highly educated people like this is that they take the attitude they have with their speciality and let it carry over into all/most aspects of life. I don't remember Ikkyu2 here so I won't speak directly about that guy, but too often I run up against lawyers and doctors who are also condescending jerks about history, politics, whatever...
posted by Meatbomb at 4:27 AM on May 30, 2009 [4 favorites]

My first reaction to this question was that I thought we'd all heard enough about the US health care system to understand that the financial impact of "Just go to a dr/the ER" can be totally overwhelming for some people and possibly land them several thousand $ in debt.

Agreed. To tell the truth, some of the answers to these health-related questions remind me of people on here telling posters with iffy cars to take the bus until they can get it fixed, going on the bold presumption that everyone is from one of those precious enclaves in the US where there's actually reasonable public transportation.
posted by dunkadunc at 4:49 AM on May 30, 2009

Phil is an awesome human being and he's quite clever with with his camera. Go buy some prints...

Done and done. Awsome stuff, and thanks for the pointer.
posted by Devils Rancher at 5:47 AM on May 30, 2009

Take care of yourselves, Americans, the rest of the world worries.

I have a friend who recently went to the Philippines on vacation with her husband. She's worked in and around the medical profession, mostly as a researcher, so she knows the field. 2 days into their trip, her husband developed acute abdominal pains that were correctly diagnosed as appendicitis by a clinic in the boonies where they had gone to snorkel, & they returned to Manila where he had his appendix removed & spent 5 days in the hospital recovering. She said the hospital was clean & modern, she was treated attentively & with respect by the hospital staff during the procedure, and one of the technicians even showed her the removed appendix, figuring she'd be interested, as a professional. The surgeon checked on him every day, gave and gave them his cell number.

Total cost: $6000.00. Even though they have health insurance in the US, they probably came out ahead, even considering plane tickets.
posted by Devils Rancher at 5:55 AM on May 30, 2009

Thank you for the link, goshling. There are some great images on there - hoping to buy some as soon as Phil confirms that he can ship here.
posted by paduasoy at 5:56 AM on May 30, 2009

Goshling: Go buy some prints

Jern has some seriously beautiful work up there. Wow.
posted by Skygazer at 12:10 PM on May 30, 2009

So when an IRL person comes to my IRL house and asks "Wow, where did you get that kick-ass Chevy photo?" I can say:

"Well, there was this Metatalk thread about an AskMe question posted by someone who wasn't sure if they should see a doctor about this strange swelling... hey... where are you going?"

I love this place.
posted by Devils Rancher at 8:38 PM on May 30, 2009 [4 favorites]

Burhanistan: "Cameo's "Word Up" is the only song that I've ever sung karaoke to."

Please please please please let there be a video of that somewhere.
posted by The corpse in the library at 10:28 AM on May 31, 2009

Doctors are not scary bogeypeople!

Not according to Dogbert.
posted by neuron at 12:29 PM on May 31, 2009

we post medical askmes for many reasons....

a) we called our doctor and the assistant told us the doctor would call us back sometime in the next four hours and while we're waiting for the callback we get a little paranoid and decide to ask askme.
b) because sometimes knowing that other people have [weird thing] is comforting.
c) because sometimes anecdotal evidence is just as good as visiting your doctor, who's probably just making an educated guess anyway.
d) because some people don't have health insurance, and if it's just some bullshit thing that will go away in a couple of days, it's not worth the thousands of dollars for an er visit, or hundreds of dollars for a doctors visit.
e) because even if some people have health insurance, they may not be able to get into their hmo approved primary care practitoner for a week and a half and they want to know if [weird thing] is super serious and maybe they should go to the er just in case.
f) because going to the doctor, getting blood tests, an x-ray, a mammogram, an mri, a ct scan, etc. is enough to drive people into a decade's worth of debt. that debt will cause them stress for every single day of that decade, which will lead to worse overall health, etc. and it just might not be worth it.
g) because even if you have health insurance, and it's not such a bad plan, it's still $40 to visit your pcp, $XXX for the x-ray, another $XXX for the drugs, and that just might be too much money because you live paycheck to paycheck
h) because some people, who don't live in huge medical centers like philadelphia, just don't have access to good medical care. it may be 2 or more hours away and they don't have anyone to take them and an ambulance won't come out that far.

there are so many fucking reasons that people post askmes. that one chick who had a fucking stroke? yeah, she should have gone to the er immediatly. but people who have weird rashes or bumps or gurgles or whatever, it's not always immediately clear that a doctor's visit is necessary. in the old days, before the internet, you would ask your family or friends about [weird thing] and what they thought about and almost none of them were doctors. the internet just gives us a wider pool of non-doctors to ask.

oh, another reason that people post askmes is that sometimes doctors are wrong, or they don't give a shit, or you've seen six doctors and you're still sick and you're out of options, but maybe someone in tehran who reads askme has this same problem and they got releif by doing x, the one thing that none of your harvard and jhu docs thought of. doctors are falliable just like the rest of us, and medicine is not a 100% science.
posted by misanthropicsarah at 10:47 PM on June 1, 2009

i) Usually you get a pretty good answer, because the collective medical intelligence and experience (in the tens of thousands) of askMefi rivals that of a hospital or a medical center.

j) Sometimes people get nervous about [weird thing] and just need to talk, so they can stop freaking out.

And....

k) If AskMefi can't help people a little with something so crucial (and potentially painful) as a health issue, what the hell good is it anyway?
posted by Skygazer at 8:06 AM on June 2, 2009

Jern has some seriously beautiful work up there. Wow.

I got my print in the mail yesterday -- it's better than I had hoped.
posted by Devils Rancher at 10:57 AM on June 4, 2009