naamah_darling: The right-side canines of a wolf's skull; the upper canine is made of gold. (Default)
[personal profile] naamah_darling
Here you go. Ground rules for dealing with me in a medical context. Feel free to grab, edit and add to them to apply to you, and give them to your healthcare professional. If you are pretty sure your doctor is cool, or you are just a really sarcastic cutup, you can use the first one. The second might go over better, though.

Notations and Helpful Hints:

Considering how friendly we are about to get, I think we ought to start off on the right foot. To that end, I feel obligated to inform you that I've had negative experiences with other doctors. Regrettably, I have discovered the need to spell out the following in explicit terms:

I get extremely nervous before and during exams. I make every effort to be cooperative and pleasant, but I am often in a state of intense anxiety – whether or not it shows. I will appreciate your patience with me more than I can say.

Because I get nervous, I usually bring written material with me. I'm not a pushy hag, I just hate getting home and realizing I forgot to ask which end to put the pills in. Trust me. Bringing in typed-up sheets is better than hauling in my secretary, a giant redheaded viking. His memory is as bad as mine, but he likes to set things on fire.

Unless I specifically ask to be told, I do not want to know my weight. I will never ask. Never tell me.

There's nothing wrong with the word "pain." It's a perfectly good word. Use it! "A little pain," "a lot of pain," "bite down on this leather strap," "MUWAHAHAHAHAHA!" . . . this is all good and helpful. All I need is some warning. "You will feel some discomfort," and "a mild cramp" are suspicious, though, so you might want to be more specific; if you tell me "little pinch" and I get "fiery red-hot wasp sting of death," I will not be held responsible for the consequences.

If something hurts like hell and I ask you to stop, please stop unless doing so would put me in immediate danger. I'm honestly not lying when I gripe about pain -- my pain threshold is quite high. Consider an "Ouch!" from me to be equivalent to a stream of profanity from someone else. If I start swearing, just ignore it, unless I say "stop." We can always use another safeword if you like. I like "turnip."

Please do not surprise me by sticking anything into any orifice without giving warning and obtaining subsequent consent. And you know, you'd think it would not need to be said, but this goes double for anything going into my ass. Even my husband, whom I love very much, has to obey this rule. I am sure you see that I can't make an exception for you without setting a dangerous precedent.

I look into everything very thoroughly and I ask lots of annoying questions. Usually I'm tractable once I understand why something is necessary, but if the day comes that I say no to a particular test, exam, procedure, or medication, it means no, full stop. I live with three cats. Badgering and cajoling do not work on me.

I realize I'm fat. I don't like it much, but it's not going to kill me. I eat a healthy diet of fish, chicken, fruits, and vegetables, and I exercise for an hour six times a week. I'm not a lazy glutton, I'm just following in a long tradition of short, squat, swarthy people with bad tempers. I promise I am fit and healthy.

As you can probably guess, I don't tolerate being treated badly because of my weight, sexual orientation, sexual history, disinclination to have children, my religion or lack thereof, my income, my completed level of education, the presence of tattoos or piercings, what crazy thing I've decided to do with my pubic hair that week, etc. . . .

And I really hope that you don't treat any of your patients that way, not even the fat, bisexual, slutty, childfree, atheist, poor folks with high school diplomas, enough genital piercings to play like a xylophone, full-back tattoos of naked pirate bellydancer mermaids, and a hot-pink landing strip of pubes waxed into a series of points.

I am childfree. I therefore expect that medical care will never be withheld on the sole basis of preserving my fertility or preventing harm to children I will never have. Because if you stop to think about it, that would be pretty stupid and condescending, wouldn't it?

I expect that no form of care will ever be withheld as an attempt to force me to consent to a particular procedure, adopt particular lifestyle changes, etc. It didn't work for my parents when I was a kid, it didn't work for my teachers when I was a teen, and it definitely won't work on me now that I'm old and set in my ways.

I also expect that if needed care conflicts with your personal morality, you will refer me to a physician who will provide said care. I don't think that's likely to be necessary, but I want to cover my bases in case you acquire a sudden objection to touching a fat, foulmouthed heathen.

I would like a copy of this to be placed in my file for future reference.



And the snark-free version:

Notations and Helpful Hints:

I truly regret the need, but due to negative experiences with my last doctors, I have discovered the need to spell out the following in explicit terms:

I get extremely nervous before and during exams. I make every effort to be cooperative and pleasant, but I am often in a state of intense anxiety – whether or not it shows. I will appreciate your patience with me more than I can say.

Because I get nervous, I usually bring written material with me so that I won't forget anything important.

Unless I specifically ask to be told, I do not want to know my weight.

If something is going to hurt, please warn me. Surprises can make me jump or lash out. And I swear. A lot.

If I ask the physician to stop what they are doing because something is hurting me unexpectedly, or it is beyond my ability to bear it, or for any other reason, I expect the physican to comply unless to do so would be to place my well-being at immediate risk. I'm probably not kidding when I say I am about to throw up.

Please do not surprise me by sticking anything into any orifice without giving warning and obtaining subsequent consent. It should be perfectly obvious, but this goes double for anything going into my rectum. Not even my husband ignores this rule.

If I say no to a particular test, exam, or procedure, it means no, full stop. I will make every attempt to make an informed decision, and I may need extra time to do so, but the final decision does lie with me. I expect the physician to respect my wishes and work within the limits of my personal boundaries. This is teamwork, not a dictatorship.

I do not wish to be pressured to lose weight; I am perfectly healthy as I am. I eat a nutritionist-approved diet of fish, chicken, fruits, and vegetables, and exercise for an hour plus, six times a week. My weight is higher than average, but I keep myself fit. I just come from a long line of hefty folks.

I won't accept derogatory remarks or poor treatment because of my weight, sexual orientation, sexual history, my childfree status, religion, income, level of education, the presence of tattoos or piercings, what crazy thing I've decided to do with my pubic hair that week, etc. And I also hope that you treat your other patients with the same respect.

I am childfree. I therefore expect that medical care will never be withheld on the sole basis of preserving my fertility or preventing harm to children I will never have. Doing so would be nonsensical.

I expect that no form of care will ever be withheld as an attempt to force me to consent to a particular procedure, adopt particular lifestyle changes, etc.

I also expect that in the unlikely event that needed care conflicts with the provider's personal morality, I will be quickly referred to a physician who will provide said care.

I would like a copy of this to be placed in my file for future reference.



There.

This is all very basic stuff, you see. And if they object to any of it, give them the finger on your way out the door. They do not deserve the spit to swear with.
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Date: 2007-10-23 05:57 am (UTC)
From: [identity profile] kittyblue.livejournal.com
Though I have not had any (significant) problems with my medical care as yet, once I'm off Mom's insurance next year, I'm into an HMO system through work OR I'm budgeting a third of my paycheck to get the PPO option ($10 versus a basquillion... hm.) -- I am so definitely saving this for future reference, just in case.

[Though the ex-shrink I have smiled and nodded while I went into gory detail as to how I would kill fellow commuters that tailgated me. I really don't think he heard a word I said in the two years I went to him.]

And 'grats on finding a Good Doctor(tm). :)

Date: 2007-10-23 01:54 pm (UTC)
From: [identity profile] twistedrecesses.livejournal.com
I "tested" my psych, during one of my first few meetings with her. Felt her out about BDSM and related sexual practices, sexuality, what have you. Had she been judgmental in any way, I would never have gone back. The moral of the story being, push you doctors a little, to make sure they're a good fit.

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From: [identity profile] the-xtina.livejournal.com - Date: 2007-10-23 03:20 pm (UTC) - Expand

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From: [identity profile] naamah-darling.livejournal.com - Date: 2007-10-23 04:50 pm (UTC) - Expand

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From: [identity profile] twistedrecesses.livejournal.com - Date: 2007-10-23 08:21 pm (UTC) - Expand

Date: 2007-10-23 06:37 am (UTC)
From: [identity profile] heartbreakangel.livejournal.com
I suspect my current primary care would double over snickering if he read the snark-filled version of this letter. I'm going to miss this man when I move to Canada. Gah.

Date: 2007-10-23 07:10 am (UTC)
From: [identity profile] afalauabrain.livejournal.com
Hilarious! I love it :)

Have you had past issues with Doctors to make you write this letter? If so, I am amazed! You poor thing!

Date: 2007-10-23 07:21 am (UTC)
From: [identity profile] naamah-darling.livejournal.com
Go back several entries for the full tale of woe, and one or two back from that for everyone ELSE's tales of woe.

Suffice it to say, I've had more than enough fuckery to last me the rest of my days, and if I've seen the last crazy gynecologist in my life, well, I could not be happier.

Date: 2007-10-23 07:56 am (UTC)
From: [identity profile] pandoradeloeste.livejournal.com
Permission to use this in class? (I'm taking a class on problems in American health care, and this is a good example of a basic - and funny - patient's bill of rights.)

Date: 2007-10-23 11:58 am (UTC)
From: [identity profile] lark-ascending.livejournal.com
Totally off topic - that's a fantastic userpic.

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From: [identity profile] muppetk.livejournal.com - Date: 2007-10-23 02:19 pm (UTC) - Expand

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From: [identity profile] naamah-darling.livejournal.com - Date: 2007-10-23 04:52 pm (UTC) - Expand

Date: 2007-10-23 08:12 am (UTC)
ext_12535: I made this (Default)
From: [identity profile] wetdryvac.livejournal.com
*thinks about it*

Right. In both seriousness and farce, I do believe I need to do up a wetdryvac variant of this. It's that or the next doc who suggests gender based decisions without actual scientific backing gets set on fire.

*grins*

So many doctors would be rendered so much more effective through the application of small personal fires and Bactine.

Date: 2007-10-23 04:53 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
My dad had this thing he used to do with a squeeze bottle of lighter fluid and a match. He could shoot jets of flame with pinpoint accuracy up to about 20 feet. He mostly used it on wasp's nests and bagworm colonies, but I keep thinking there's a more practical real-world application for this mini-flamethrower.

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From: [identity profile] rikibeth.livejournal.com - Date: 2007-10-23 06:20 pm (UTC) - Expand

Date: 2007-10-23 08:22 am (UTC)
From: [identity profile] copperwise.livejournal.com
You are beautiful and brilliant and considering how many people had previously said "oh you should check out her LJ" I am utterly despondent at how long it actually took me to do it. Imagine what I missed out on. You're on my hero list.

Date: 2007-10-23 04:56 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
YAY!

And thank you! I enjoy reading you a great deal.

Date: 2007-10-23 08:42 am (UTC)
From: [identity profile] tautriadelta.livejournal.com
Once my printer comes back online, I'm also going to ask for permission to print this, and share it at work. I serve food to nurses/pharmacists/respiratory care all in training, and most of them would appreciate this!

Date: 2007-10-23 09:05 am (UTC)
ext_74: Baron Samadai in cat form (Sanity on backorder)
From: [identity profile] siliconshaman.livejournal.com
Permission to pass along that icon to a friend of mine...she's having serious issues with being told she's "fine" by various oblivious and uncaring medical people and is in dire need of a laugh!

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Date: 2007-10-23 09:06 am (UTC)
ext_74: Baron Samadai in cat form (Blowing shit up for great justice)
From: [identity profile] siliconshaman.livejournal.com
You know.. I think I need to write myself one of those.

Date: 2007-10-23 10:21 am (UTC)
From: (Anonymous)
The gynecologist who commented a few posts back: The second version above would be likely to make me think, "Wow. Poor thing, she's had some bad in-your-face medical care, hasn't she. We won't be like that!--Either that or she's the nutty one and no one can please her; I guess I'll find out which." (That is true, I would think that last part too. Sometimes difficult patients ring your "nutty" warning bells.) The first list? Would have me losing it laughing and saying, "Dude, I LOVE you." Humor really does help defuse the physician's "are you gunshy or are you impossible to please?" worries and puts me on your side from the git-go. (The "hot pink landing strip of pubes" would have me screaming and pounding you on the back in glee.) I say go with version one. (But I don't claim every gynecologist has the same sense of humor I do.)

Date: 2007-10-23 05:00 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
I don't think I'd WANT to see a doctor who didn't have a sense of humor I could relate to. It's the reason I adore my GP and will never go anywhere else, even though he never returns my calls and is always running absurdly behind (because he takes so much time with each patient, so I can't fault him for that).

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From: (Anonymous) - Date: 2007-10-23 05:10 pm (UTC) - Expand

Date: 2007-10-23 10:32 am (UTC)
From: [identity profile] flewellyn.livejournal.com
The snarky one is a thing of beauty.

Date: 2007-10-23 11:00 am (UTC)
From: [identity profile] cimry.livejournal.com
I love you!!

That is absolutely magnificant! and a sad commentary on the state of our health system that it's needed.

Date: 2007-10-23 05:01 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
It shouldn't be needed in 90% of cases, really, but it's that TEN PERCENT that really screws things up.

Date: 2007-10-23 11:09 am (UTC)
From: [identity profile] silver-mage.livejournal.com
Would you particularly mind if I print this and bring a non-married version to my doctor? Because really, the entire "in-pill-out" part of my checkup for thyroid is getting OLD when I have questions to address.

Date: 2007-10-23 05:01 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
Please! Take, amend, use! And good luck!

Date: 2007-10-23 11:24 am (UTC)
From: [identity profile] hermitgeecko.livejournal.com
Thanks for sharing. This looks really useful and helpful.

Date: 2007-10-23 11:54 am (UTC)
From: [identity profile] xviragox.livejournal.com
Ah, brilliant as always. BTW, I was very glad to read that you had such a good experience with the new doctor.

Date: 2007-10-23 12:05 pm (UTC)
From: [identity profile] dorei.livejournal.com
Have you searched for a KAP doctor? They tend to be a little more accepting in general of their patients, and at least won't raise eyebrows at tattoos, piercings, and interesting pubic hair colors.

Date: 2007-10-23 05:04 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
I check the database from time to time looking for a doc in my area. There aren't any so far, except for one LCSW who looks very promising, should I part ways with my current therapist at some point.

Date: 2007-10-23 12:12 pm (UTC)
From: [identity profile] emperorbuz.livejournal.com
That's good stuff.

Date: 2007-10-23 12:15 pm (UTC)
akacat: A cute cat holding a computer mice by the cord. (cat & mouse)
From: [personal profile] akacat
I adore the snark version. 'Turnip' made me snort.

Date: 2007-10-23 12:24 pm (UTC)
From: [identity profile] greenjeanz.livejournal.com
I have the opposite problem with weight..I would rather they tell me once I step off the scale, which they never do, and I have to ask.

Date: 2007-10-23 05:05 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
In the days when I actually did want to know, I'd just turn and watch while they moved the little sliders, or I'd have to ask. They get a LOT of people who don't want to know coming in. Most people apparently would rather not be told.

Date: 2007-10-23 12:31 pm (UTC)
From: [identity profile] arielstarshadow.livejournal.com
I have to say, the snark version made me giggle with glee.

Date: 2007-10-23 12:52 pm (UTC)
From: [identity profile] a-treitell.livejournal.com
I love my docs.. I think my MD and my CNM would both crack up laughing reading that..

(though they're pretty easy going, we've had the poly talk with both of them, and my CNM knows about my pretty pretty piercings lol)

I'm really glad that you found a doc that seems to be responding the way docs should!

Date: 2007-10-23 01:21 pm (UTC)
From: [identity profile] alainbriongloid.livejournal.com
you are my hero... seriously. Permission to point folks to this entry?

*hugs*

(no subject)

From: [identity profile] alainbriongloid.livejournal.com - Date: 2007-10-23 06:15 pm (UTC) - Expand

Date: 2007-10-23 01:48 pm (UTC)
From: [identity profile] bailey21975.livejournal.com
I'm so happy for you finding a doc that's working out for you! And I love the list. :)

Date: 2007-10-23 02:04 pm (UTC)
From: [identity profile] ysabel.livejournal.com
I like the first version better.

And I think it says something about my current doctor that I think she would too. I very much like my current doctor.

Date: 2007-10-23 02:06 pm (UTC)
From: [identity profile] tlatoani.livejournal.com
Which version did you give her, out of curiosity?

Date: 2007-10-24 06:27 am (UTC)
From: [identity profile] naamah-darling.livejournal.com
I gave her the second version; the first wouldn't fit on one page.

Date: 2007-10-23 02:32 pm (UTC)
From: [identity profile] rimestock.livejournal.com
Once again, you amaze us all.

*applauds*

And now I just have to decide if I need to print out some of that stuff and take it in, etc.

I also have to decide what I'm going to do about the now-incorrectly-named "birth control," seeing as how I am going to destroy my uterus next time it attacks me, and kind of doubt it's going to be playing host to any resident I'd actually like any time soon, if ever.

Date: 2007-10-23 05:07 pm (UTC)
From: [identity profile] naamah-darling.livejournal.com
I do not miss the days of having to wrestle with the many bad answers to that problem. My uterus is on a very short leash now anyway, and if it gives me too much more shit, I will gladly have the thing cauterized into utter submission.
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