Doctor No

Cancer, like many diagnoses, means that you’re going to be devoting a lot of time to talking with doctors and medical professionals. Spending that long with anyone, doctors or not, means you will inevitably end up in a situation where you disagree. Whether it’s over treatment, care, or your prognosis, telling medical professionals you don’t want to do something can be difficult. Here’s some tips on how to safely navigate that particularly rocky shoal.

Telling your doctors “no” is something all people who have cancer eventually have to face. It’s a rite of passage – and not a welcome one like having your first cigarette or getting arrested and having to do community service.  Not that I know how that feels. Don’t look it up. No matter how confident and assertive we are in our daily lives, when a doctor gives us orders we all suddenly turn into fifth graders in science class. We want the doctor to be our lab partner, but just like real middle school, if you don’t stop and think you may end up with the kid who smells like sour milk and does no work.  Or worse.  Yikes.

Why is it so hard to tell your doctor no?

Why do we have an inherent desire to trust what a doctor says? It’s a form of the Halo effect. In a nutshell, because we assume that all doctors are good people and helpful, we assume that anything he or she does must be beyond reproach. The effect can be so pronounced that we take even suspect material simply on faith, without question. Unfortunately, as Instagram Models have shown us, you don’t have to be good at something to be successful. If one of your friends told you “You should drink trash pail juice for that back pain,” you’d laugh in their face and tell them they smell like hot garbage. Conversely, if a doctor said that same thing you’d defend it to the death, swearing many times over that garbage pail juice is the next kombucha. Even experienced patients like myself fall for it – that knee-jerk believability, and yes, even when we’re being fed straight kombucha. Err, garbage.

Doctors are people too

Here’s the big secret of the whole thing: doctors are people too. I know, I know, it sounds as much of a revelation as “apple pie is made of apples.” Think about what it really means, though. Doctors are considered experts in all things medical but people make mistakes. Doctors have MD degrees but people sometimes get those degrees from the Universidad de Santa Penelope in East Guam. (Total Party Doctor School.) Doctors perform surgeries that last for hours but people get exhausted. See the difference? 

Doctors can only be as good as the person inside the white coat on any given day. In addition, there is a trap of myopia that almost every doctor I’ve visited has fallen into at one time or another, especially if they have been practicing for a long time. Treatment tunnel vision. Once a doctor has been doing things a certain way for a certain period of time, that’s their default even if it may not be the best thing for you, their patient. It’s not uncommon, and we all do it whether we are doctors, construction workers, or writers. It’s human nature – the phrase “we are creatures of habit,” isn’t an exaggeration.

So, what are some of the things we can do to help our doctors understand when we aren’t comfortable or just flat out think they’re wrong? It can be daunting, and most doctors will double down and give you the hard sell. It’s like a student loan officer mixed with a pit bull.

Seeking a second opinions

The first thing you have to do is be willing to seek a second opinion. You must be prepared to walk out just like when you go to a car dealership and the gold-chain laden salesman in the velvet jumpsuit tells you he is giving you a “discount on the rust coating.” I know, it sounds scary, but in all my thirty some-odd years I’ve only had to do this once, and it was because the doc told me he knew my disease better than me.  Imagine telling a pilot you know how to fly better than they do. True story. He was a so-called “expert” as well. So I left and never came back. I heard his wife did also, apparently. I guess he was an expert in something after all.

The value of research

The second thing you should do is research, research, research. Search Google, go to the library (it’s not just for quilting expos), and talk to other patients if you can. If you are uncomfortable with a medication or you are interested in a specific treatment, find out what other people are saying and what other medical professionals have written in journals and online.  Bring it with you to your next appointment. Most doctors respond well to supporting information, which makes sense since a big part of being a doctor is reading.

If it's too good to be true, it might not be true

Third is don’t be an idiot. Yes, you heard me right. If your neighbor’s cousin’s co-worker saw on Facebook that someone cured cancer by drinking skunk juice and powdered otter hair, then you probably shouldn’t ask your doctor about it. No not probably… what’s the word I mean, oh yeah, OMG definitely don’t. 

Just like you expect your doctor to be responsible and suggest the best medically tested standard of care, he’s going to expect you not to bring him every hare-brained, half-assed cure rumor you hear. There’s a lot of them out there, too, but just use your head. If it really worked then you’d probably have heard about it from somewhere other than a website called www.TotallyRealCures.com. Think of the freezing otters.

Advocate for yourself

Finally, and it’s a short one, don’t be afraid to say no. It’s your body, and you are the one who is going to have to deal with the consequences. Your doc may be truly sorry your nipples fell off, but he can still go swimming. It’s you who will suffer. If you don’t want to do it, it’s your right to say no. You won’t be the first and you certainly won’t be the last patient to do so.

Look, it’s difficult to talk concerns with your doctor, that’s the long and short of it. It will always feel like you are telling your sixth grade health teacher that you should be allowed to go to the bathroom for the third time because, well, it’s health class. It’s just the way we are wired. If you are assertive though, and try to adhere to some of the tips above, you should be able to get through and it does get easier after a few tries. I promise.  Now I have to go do my community service at Coats for Otters. Talk soon.