When the specialist laughed at her

The first specialist we consulted may have shrugged off follow-up visits, but his manner had been so unsympathetic and the information he gave so scanty that we were not sure we’d done enough for the situation. On the other hand, the whole experience had also left all of us–and especially my mother–reluctant to go to another doctor. My mother felt insulted, and probably was shaky inside because she was experiencing more cognition problems than were obvious to us. Now she did not feel she could talk to a doctor…

It took my mother a while to agree to consult another doctor. Her walking problems were alarming by now, and her memory loss quite obvious within the family. We finally narrowed down to a hospital that specialized in neurology, and where every doctor was a superspecialist. Surely my mother would get suitable attention there.

We took an appointment at the specialist hospital, asking for a senior neurologist.

This senior specialist was a portly man, retired from the army and still totting the title with his name. He looked through the various records cursorily, then examined my mother. My mother had a history of cervical problems, which are often a cause of vertigo, but she had undergone tractions and the problem had seemed under control. This doctor suspected that the walking problems were because of some nerve pinch in the neck. He subjected her to X-rays, made her go through a series of vitamin B12 injections for her muscles. He did not bother to look at the MRI, which I carried around dutifully on every trip, just in case.

On our third trip there, I mentioned to him that she was suffering from memory loss, and seemed confused and worried very often. My mother was there, and though she often protested that her memory was just fine, it was obvious even to her that something was wrong, and she had agreed with me that we can ask the doctor about this problem.

I think she hoped that some magic pill would be found; as an intelligent woman, she hated that helplessness of memories slipping away.

I still remember the doctor’s reaction. He leaned back on his huge chair and steepled his fingers.

He laughed.

Maaji din bhar khaali hain na,” he said in Hindi. Meaning, your mother has nothing to do all day, so she is like this.

Sometimes, words just fail one. I said nothing. I hoped my mother had not heard the sentence or registered it, but her face looked frozen. I did not dare say anything for fear of aggravating the situation and having that creepy, insensitive doctor add insult to injury by justifying his statement.

We emerged a few minutes later from the consulting room, my husband supporting my mother, and I clutching the latest prescription. We made my mother sit in the lounge. I asked her if she was comfortable, and said I’d buy the medicines from the hospital pharmacy, while my husband fetched the car from the parking. She said she was fine. I patted her shoulder, and went off to the pharmacy.

When I returned ten minutes later, I found my mother surrounded by solicitous men all consoling her about something. As soon as I reached her, they started scolding me for leaving my mother alone for so long. My mother was trembling and she gripped my hand as if I’d been gone for hours instead of ten minutes by the clock.

One of the men explained that my mother had wanted to go to the bathroom, and that she had asked for help because she could not walk. As there were no ladies around, the men took her to the Gent’s bathroom after adequately ensuring decorum, and that they then escorted her out. The whole process must have taken ten minutes, which meant that she would have asked for help as soon as I left her. She told the men that she did not know where her daughter was, and that she had been sitting alone for a long time.

I explained again and again that I’d just left her ten minutes ago to go to the pharmacy, but the men continued to scold me.

By this time, fortunately, my husband had managed to extract the car from the parking, and I escorted my mother to the car. At one level, I was quite upset with her for not having told me that she wanted to go to the bathroom, because I had asked her whether she wanted something and was comfortable, and moments after I leave she behaved as if I had deserted her. But on the other hand, I also knew that she was very upset about the doctor’s remark–a remark we never dared discuss or mention at any time. Not then, not later. Never.

Needless to say, my mother refused to take any of the prescribed medicines, and totally refused to go to that doctor again.

I wonder sometimes why the doctor acted so contemptuous and nasty.

This doctor looked like he was in his late sixties. Was his remark a sexist remark, or an ageist remark, or just crass insensitivity? I also think of his insistence that the problem was due to cervical problems even though the X-rays he got taken showed no change from X-rays taken twenty years earlier. His shrugging off that MRI envelope was another thing that puzzled me.

When doctors do not diagnose properly or treat patients properly, patients usually switch doctors, but the doctors do not know why patients switched out. A few doctors have told me that they usually assume that patients stop coming because of “non-compliance,” that is, the patients neglect their health and don’t take the prescribed medicines and don’t therefore want to face the doctor.

Possibly most doctors do not know when they have made a mistake, so they do the same the next time over. Definitely, I don’t think this doctor had any idea of the impact of his remark on the patient and family in our case.

There are good, compassionate doctors, as well as incompetent, inconsiderate doctors. Too many encounters with the incompetent ones can be a real setback, because laypersons do not know that the doctor is incompetent. Which is what makes it important for us to understand enough about health and such stuff, so that we at least have some idea whether we are getting competent advice or the opinionated spiel of someone who is quite out-of-touch with medical advances and current diagnostic guidelines.

Of course, with this doctor, his incompetence and unwillingness to see the patient as a person was rather obvious 😦

I’d like to comment a bit on these years wasted consulting these two insensitive doctors.

The most common cause of the dementia symptoms is Alzheimer’s Disease; in Alzheimer’s, the initial symptoms are memory loss of various types, and changed behavior, and people do not register these as a problem and do not go to a doctor in the early stage of the disease.

But when dementia happens due to other causes, or is secondary dementia (dementia as a result of another medical condition), patients are often in touch with doctors for their other medical conditions.  For example, if someone has a stroke and behaves oddly after that, doctors are already being consulted for the patient. It is visible to these doctors that this change is very likely a consequence of the stroke, and the doctors can therefore give a diagnosis of dementia in the early stage of the problem. Similarly, for Parkinson’s patients, the family can be alerted about the likelihood of the patient developing dementia.

Because of my mother’s balance problems, we were quite early in our attempts to reach neurologists; they could have warned us more about ataxia, and also detected the dementia early.  But they did not.

More tomorrow…

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About Swapna Kishore
I'm a writer, blogger, and resource person for dementia/ caregiving in India, and deeply concerned about dementia care in India. On this blog I share my own caregiving journey, my experiences as a resource person for dementia care, and musings on life, aging, dementia in India, and such sundries. More about me and the work I do for dementia care in this set of pages: https://swapnawrites.wordpress.com/about-contact/

2 Responses to When the specialist laughed at her

  1. doctorblue says:

    You expressed the dilemma of many patients well. I can only conclude that mainstream medical doctors adopt the ways and attitudes they learn in medical schools, which are largely funded by pharmaceutical and other companies that have a vested interest in the curricula.

    I highly encourage you to seek out an “integrative” or “functional medical” doctor. These doctors run tests that conventional specialists don’t understand.

    In my own quest for treatment, I speak with many patients who have experienced the callous mannerisms of some doctors to the detriment of their health. Among their stories is a man who was erroneously diagnosed with Parkinson’s disease. When treatments failed to provide any relief of symptoms, he saw an integrative doctor who discovered he was suffering from heavy metal poisoning. His life’s work exposed him to toxic materials that seeped into his skin through his hands and were possibly inhaled into his lungs. He was able to regain function and memory after undergoing chelation therapy. He and his wife told the original doctor what they’d found. The doctor who diagnosed Parkinson’s didn’t seem to care at all.

    Health care in the U.S. and possibly elsewhere is all about making money unfortunately like so many other businesses. The patient is an afterthought. I should know. I became disabled at age 50 at the hands of my doctors. Do you think any care? I don’t.

    • swapnawrites says:

      Thank you for sharing your experiences. While there are both good doctors and bad doctors, it is true that many of us have unfortunate experiences with doctors and we don’t know how a doctor will turn out to be when we go to meet him/ her. Will we be lucky or not?

      I have heard of how drug companies and insurance companies dictate a lot of the medical systems in the US, but have no direct experience of it. We live in India where we have multiple medical systems, and I did consult some other doctors practising other medical systems for my mother.

      Maybe we just hit a wrong bunch of doctors when we tried alternate medical systems, or perhaps her condition had no solution in other systems either.

      Of course, whether or not a medical condition has a solution, treating a patient insensitively is inexcusable. At least they should care about what is happening…

      I read your profile information and about your disability and lack of diagnosis. My heart goes out to you that you are essentially paying the price for a medical system that is anyway failing you by being unable to diagnose and causing things to deteriorate to such an extent. It all seems so warped.

      Take care,

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