Back in the '80s, when I was living in Watertown, outside of Boston, I attended a concert by the great Beaux Arts Trio at Harvard's Sanders Theater. Midway through the first number, a commotion arose at the rear of the balcony. Someone called, "Is there a doctor?" This being primarily a Harvard audience, a goodly number of medical students, Mass General residents, and junior and senior Med School professors looked around, searching for the most senior physician attending the concert [protocol in those days compared favorably with that among the English Peerage.] The trio fell silent while we all sat and waited. After a bit, we heard the siren of an ambulance [this was well before cell phones, so someone must have called on a house line.] Eventually men hurried in with a rolling stretcher and carted some poor sod off. The trio picked up where they had left off, and we all cheered them to the echo when they finished, as much out of relief as aesthetic pleasure. Then, mid way through the second number, it happened again! This time, Isidore Cohen, Leonard Greenhouse, and Menachim Pressler threw in the towel and announced intermission. The next weekend, I flew to RDU to visit Susie on one of my twice-monthly trips. When she picked me up at the airport, she told me with great excitement that she managed to obtain tickets to a sold-out concert at Duke. The Beaux Arts Trio was coming to town! The concert went off without a hitch. Nobody died.
I thought of this tidbit of ancient history this morning as I walked because for some long time now I have been struggling with increasingly invasive pain in many parts of my body and I have been unable to get my doctor to really pay attention to me. I have access at UNC to world-class specialists of every conceivable variety, but I do not feel that I have a doctor. Let me explain. [I apologize for this shamelessly personal post on a blog that has always striven for an elevated intellectual ambiance, but the pain has destroyed my equanimity and undermined my philosophical ability to view the universe sub specie aeternitatis.]
Four or five months ago, I began to develop increasing pain in various parts of my body -- elbow, thighs , neck, arms -- nothing remotely life-threatening, let me hasten to say, but as it worsened, enough to destroy my normal cheerful equanimity, so that in the past two months, my life has been mostly about the pain. My doctor did not seem to me to be paying much attention to what I was saying when I saw him, so I complained loudly. At that time, four weeks ago, he was very apologetic, thanked me for being honest with him, and examined me. He did three things. At the suggestion of the specialist who was treating me for "tennis elbow" [a separate problem], he took me off a statin medication I had been taking for years to lower my cholesterol [statins can cause generalized muscle pain -- who knew?]. He prescribed Celebrex for the pain -- 100 mg twice daily. And he referred me to UNC's big hernia man for a possible femoral hernia.
And that was the last I heard from him. So far as I could make out, when I walked out of the examining room, he totally put me out of his mind. Was he curious whether taking me off statins helped with the pain? Apparently not. Did he want to know whether the dosage of Celebrex needed to be adjusted? It seems never to have crossed his mind. Yesterday the hernia maven told me the CT scan showed no evidence of a hernia. Does my doctor even care? Who knows?
I made an appointment to see my doctor this afternoon at 2:20. I am going to ask him straight out whether he wants to be my doctor, because as of now, I do believe that I have a doctor. What I have is access to a suite of world-class specialists who will attend with great skill to neck or my thigh or my left elbow [I feel like Koko in The Mikado!], but I do not have a doctor who is treating me, all of me, in an intelligent on-going fashion.
Am I in the grip of a nostalgic fantasy? Is medicine no longer practiced that way?