I’m feeling a little kvetchy.

 

We are commanded to guard not only our souls, but also our bodies. Beyond the usual requirements of adequate and proper rest, nourishment, exercise, and the like, this custodial position requires us to be critical consumers of health care. Sadly, many of us shirk our responsibilities, evading our obligations by elevating health care providers to positions of decision-makers. Equally sadly, those of us who elect to fight for our well-being, to question procedures employed merely for the sake of protocol, get stigmatized in the least, or demonized, more often.

 

Very recently, a torn knee ligament brought me to my kupa. Although I am fat, frumpy, b’ayin tova, over fifty year-old woman, I have engaged in regular exercise all of my life. While no longer a martial arts practitioner, in recent years, I’ve stoked my metabolism through: weigh lifting, elliptical cycling, power walking, and swimming. These days, I especially like pushing through laps and participating in water aerobics classes. Nonetheless, in midlife, as in my youth, I’ve intermittently had exercise-related or exercise-exacerbated injuries.

 

Knee problems are among my chronic tribulations. I was even photographed in a knee wrap in my early thirties! Now, twenty years later, I’m back to ace bandages. In the interim, whenever I’ve suffered a flare up, I’ve checked the condition of my exercise shoes (replacing them can be solution enough), modified my activities, and sought acupuncture or other alternative strategies. Almost always such tactics worked.

 

This year, though, in the midst of turning my house upside down in preparation for Pesach and for spring cleaning (I’m an honest balabusta), I managed to repeatedly aggravate an existing condition. Simply, tripping on puddles of water when my connective tissue was already stressed and doing so again and again led to a bad end. To wit, I wound up at Terem, an emergency medical center, where I received orders to ice, to compress, to rest, and to elevate. That drill was not unexpected. What’s more, I was not shocked that the Terem team asked me to “promise” to see my regular doc after the holidays and to consider seeing an orthopedist, as well, if my situation did not improve.

 

A few days ago, I saw my doc. That practitioner, whom my family adores, greeted me with confusingly amazing rhetoric. He suggested that I: reengage in all ambulation, take a prescription drug if my pain increased as a result of my activity, and ought to feel admonished for not embracing protocol in dealing with others of my chronic issues. He concluded his rant by writing me scripts for: pain killers, an orthopedist, getting my knee wrapped “expertly” by someone from the kupa’s nursing station, and complex blood tests for my other problems.

 

I filled the drug order at an associated pharmacy, but will likely never take a single dose of that medication. The offered compound is first an antipyretic and only secondarily an analgesic. In addition, that particular medication has been banded for more than forty years in the USA (where most of the world’s pharmaceutical testing occurs) and in large sections of Europe. In fact, liberal Sweden pulled the drug from the market, reintroduced it, and then banned it a second time. Worse, that pill can cause life-threatening blood disorders and is usually reserved, where used, for post operative or cancer-generated levels of pain.

 

As per the orthopedist, a medical practitioner, who is a family friend, came up with a referral. For some reason, our family doc was hard pressed to offer up a suggestion.

 

As per the nurse, I wish my experience of that interaction on my enemies…maybe. To say that I was patronized is to suggest that ice cream is not a warm food. Perhaps, had I not been in great pain, I would have laughedat the young miss who attempted to capture me and my blood for “noncompliance” with the protocol associated with my other issues.

 

Not sure what to do with a midlife mom who insisted she would only receive the knee wrap, for which the mom had entered the department, the nurse mouthed aloud that she would record, in her computer files, that I “didn’t have time” for all of the “little procedures” she wanted to “do to” me. In hindsight, that young lady was almost as amazing as was the hospital staff member, who asked me if I could pronounce “ne-o-na-tol-o-gist,” when one of my children, an infant only a few days old, was admitted to a pediatrics ward on the grounds of being suspected of harboring sepsis and meningitis.

 

I realize that here, in Israel, moreso than in many industrial nations, medical staffs are overworked and underappreciated. I realize that, the worldover, health care consumers would rather have medicos think for them than take on the responsibility of co-managed care. I realize most folk are not social science professors who lectured on the social anthropology of contemporary medicine and that most folk are not herbalists, who know about anatomy and physiology, and that healers would have no reason to treat me in a different way from folks with other educational backgrounds.

 

Even so, I maintain that patients are not automatons who ought to blindly integrate doctors’ words into their behaviors, emergency situations notwithstanding. I maintain that health care providers are not ethically removed from common morality; they are just specialists. I maintain that better care results will almost always continue to occur when patients ask questions and when doctors deign to answer them.

 

I still intend to get my blood workup completed after my knee heals, when I can return to regular exercise and when my lab results, accordingly, will more accurately reflect my usual lifestyle. Meanwhile, I remain an opponent of the cascade effect in medical care and a proponent of the mindful use of interventions.

 

I will receive acupuncture for my pain. I will meet with an orthopedist to learn new ways to prevent reinjury. I might, as well, need to enroll in physical therapy to build my quadriceps, hamstrings, calf muscles and tibialius muscles to further protect my knees.

 

I will, in addition, continue to advocate for patients’ rights, in general, and to encourage folk to question doctors’ contradictory words, specifically. At times, and likely unintentionally, doctors’ recommendations can be not only rash, but also dangerous.

 

 

 

 


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