Dr. Incompetent, Mysterious Abscesses, and a Lack of Logic

The amount of incompetency I’ve encountered in the past two weeks is truly beyond words.

Most of you know that I just wrapped up a week long visit to the Mayo Clinic, that was both enlightening and incredibly frustrating and left me in quite a bit of turmoil. I called both the rheumatologist I saw, Dr. W, and Dr. A (A for asshole as you lovely followers have so dubbed him!), the gastroenterologist, on Monday to get the results of my labs repeated the week before. 

I called Monday morning. Waited two days. No call back from either of them. So I called again on Wednesday. No call back. No response on Thursday.

I mentioned that an abscess was supposedly found in my abdomen while at the Mayo Clinic, however I had no answers whatsoever as to how large/small the abscess is, where exactly it is (is it subcutaneous or is it near/around a vital structure?), or what needed to be done other than the obvious repeat CT scan. Because of Dr. Asshole’s inappropriate behaviour, I sought out a local GI doctor.

If it wasn’t obvious by my musings about Tallahassee health care, it’s poor. Extremely poor. I have heard this from students and professors alike, and reviews for local specialists all seem to be consistently horrible and in abundance. I had a bad feeling about this local GI group— my intuition said not to go, but what choice did I have?

Within 30 minutes of arriving I knew I was in for it. First, the pre-eisting conditions form listed Lupus, Fibromyalgia, and Arthritis. No Rheumatoid Arthritis. That is both unusual and alarming— if a physician lumps Osteoarthritis and Rheumatoid Arthritis into the same category, it’s generally a red flag if not the signal to go elsewhere for health care. Such was the case with this local group. I crossed out Arthritis and wrote Rheumatoid Autoimmune Disease/Rheumatoid Arthritis and turned in the form and was then placed in an exam room.

Dr. Incompetent walked in and I knew just by our introduction that this was not someone I could communicate with. I could not even finish saying “nice to meet you” before I was cut off— being immediately interrupted is never a good sign.

I explained my complicated chain of events and explained that the last doctor refused to communicate with me about the abscess, which is why I was there— looking for a repeat CT scan and some concrete answers. Dr. Incompetent’s response? Well I must have not been listening to Dr. Asshole up at the Mayo Clinic or I would know whether or not this abscess was a real issue. Really? He also insisted that if this Mayo Clinic physician found an abscess, I would be in the hospital already having had urgent surgery to remove it and would be on strong antibiotics.

He continuously asked me questions as he looked over my chart, but allowed me not a moment to answer them and answered his own questions for me. When he looked at my medication list, he stopped when he saw Percocet. He scoffed and asked me why I was on narcotic medication. I explained that the RA, FMS, and pelvic pain cause me acute chronic pain and I explained how I properly (and safely, I might add) use the medication. His response?

Rheumatoid Arthritis doesn’t cause chronic pain! You need to get off those drugs!

Dr. Incompetent then went on to tell me that I don’t have an abscess and the left upper quadrant (LUQ) pain is just from bruised ribs as a result of the RA. Since when does Rheumatoid Arthritis cause bruises rather than inflammation? I corrected him three times, and each time he insisted RA causes bruising rather than inflammation. In response to my complaint about the persistent nausea/vomiting since November, he asked if the Zofran was working. When I said “to a point,” he told me to keep taking it and that should fix the problem. He also said “It’s not a problem if you’re not running fevers or vomiting” after I had just discussed my constant fevers and vomiting… I knew I was done there.

I stopped playing nice and insisted he look at the CT scan I had done in December (the one that Dr. A looked at and discovered an abscess on). Despite being a surgical center, he had not a single computer that had the ability to read scans/x-rays.

I finally demanded he order another CT scan, got the paperwork from his nurse, and left without paying. I will not be back to Dr. Incompetent or his group. It was a long Thursday.

Friday morning, I called Mayo Clinic rheumatology again and this time put my “bitch face” on and made it clear to their assistants that I had pressing concerns that could not wait another week to be addressed. In the week’s time, I had spent three days without the use of my left hand, which for some reason had completely been crippled. In a weeks time, I have literally felt myself worsen by the day— something I have never experienced before. In a week’s time, I considered going to the hospital just about daily, also something I am very hesitant to ever do (the ER is not always the safest or kindest place for the chronically ill to be, especially with this new Fibromyalgia diagnosis). I finally received a phone call from Dr. W last night. With bad news.

• I’ve become “severely” anemic
• Vitamin D level is “extraordinarily low” despite OTC supplements daily, so prescription strength supplements have been ordered
• Inflammation rates are back up since stopping the Enbrel— no surprise
• Cortisol level is slightly elevated— 27.8— repeating the test to see if it’s a fluke and likely influenced by outside factors, including birth control, but Cushing’s has been tossed around here and there.
• Still seronegative

Why bad news? Well apparently Dr. W no longer believes in seronegative autoimmune diseases. The plan we had come up with to start me on Remicade has been terminated. No treatment whatsoever. When I discussed how crippled I have become and how bad my hands have deteriorated in just one week’s time, he had no response for me. When I confronted him with discussion of the bald spot and distinguished malar rash, the over-clotting problem I’ve had with my blood, he had no response for me, when previously he had felt strongly about a confirmed Lupus diagnosis (which has been up in the air for about a year now). His suggestion? Go back on the Enbrel for the time being. When I said to him that the whole reason I stopped the Enbrel was because it wrecked havoc on my intestines, he had no response for me.

What kind of a rheumatologist, especially one of his caliber, does not believe in seronegativity, or the 30+% of patients that are seronegative? Immediately my confidence in finding a new rheumatologist was once again shattered. I emailed Dr. S, my rheumy back home, and explained what happened.

Until the abscess is taken care of I cannot start a new treatment anyway, so it will likely be March before I can even consider getting onto another biologic. But Dr. S agreed with me that going without treatment is ludicrous and Orencia (infusion) is the next step. I go for a CT scan on Wednesday and am praying that the abscess will not require immediate surgery. Luckily, my spine surgeon(s) and the team of doctors who worked with me during my September surgical recovery have been amazing and will be reviewing this CT scan and arranging anything that needs to be done. Taking time off for another surgery would mean losing all of my scholarships and my admission to my current university (permanently, meaning I no longer have a college education if I have to leave— you cannot medically withdraw from university twice), but my spine surgeon Dr. J assured me he would make sure that I would be able to both attend school and be in good financial standing. What kind of a physician goes out on a limb for a patient like that? Granted him and I have a long history, but it’s a true testament to the man he is.

The amount of stupidity, incompetency, irresponsibility, and disrespect I’ve encountered within the past two weeks has completely blown my mind. Why it is so difficult to find a physician that can communicate properly and treat patients with the same respect they want in return is beyond me, but it makes going out there and finding yet another physician that much more difficult and exhausting. Disheartening is the word. I know many patients who have simply given up because they have experienced such rejection and humiliation with physicians in the past; the prospect of putting their most vulnerable self out there again is terrifying.

I have quite a following of pre-med/medical students on this blog that I hope gain something from reading about horrid doctor-patient experiences, and I can only hope that they gain a little perspective on what it’s like to be a patient under the microscope of a judgmental/disrespectful/incompetent physician. I can only hope that some of them take these words and hold onto them as they go through residency and wherever it is their career takes them.