Thursday, January 10, 2013

Who's Bob?

     People are very suggestible.   They hear something, and repeat it, and it gets repeated over and over until the whole town is abuzz with the thing, which keeps getting presented as an original idea every time it's said.
     Today a new patient told me she'd heard something bad about me from a pharmacist at Walgreens, --a guy named "Bob."
     First, I wondered, why is this patient coming to see me to "establish herself as a new patient" when she knows I'm closing my clinic in three weeks?
     "I found out you were closing, but I had heard such good things about you from other people that I knew I didn't have much time to get in and have you check me out," she said.
     "But...I'm closing.  You'll need to find another doctor."
     "Couldn't you please do whatever you think I need before you close?"
     "I'll do what I can."
     "Oh, thank you."
     Even more perplexing was that she had heard negative things about me in the prior months, especially from this pharmacist, a professional.
     Why go to a doctor about whom you've heard negative things?  Was she like those groupies who circle around murderers and other public villains?  The journalist, for example, who fell in love with (and got engaged to) Ted Bundy?  Was there something about my negative public persona that was attracting a queer mix of patients?
     There were three new patients today, all trying to get in under the wire, before I closed.
     I felt as though I should be signing autographs, based on the urgency they expressed about seeing me, and only me.
     All three had serious health problems, however, and wanted my help.  So they weren't likely to be chasing bad.
     "What did 'Bob' say about me?" I asked.
     "He said you were really bad."
     "Is that so?  In what way?"
     Had I had gotten hung up as a character in a detective novel?
     "He said you put your hand on someone's neck, like this"--and she placed the index and third fingers of her right hand over her right carotid artery--"and then you charged $1,500."
     "What an easy job," I answered.  "Can people do that?"
     "He said some other things, too."
     "I didn't know practicing medicine could be so simple."
     "He's been telling everyone the same thing."
     "But, you know, he still fills your prescriptions."
     "I guess he doesn't have much choice."
     "He told me how the police were trying to shut you down."
     "Why did you schedule an appointment with me, after hearing all that?"
     "I don't believe him.  I think he's full of crap."
     "Maybe I'll go meet 'Bob,' and get the story for myself."
     I imagined myself showing up at Walgreen's with a wig, disguised as, say, a laundromat worker, and asking what 'Bob' thought about Dr. Colasante.  Would he recommend her clinic?  Did he think she was a fraud, or a criminal, or a greedy, overbilling, lazy, sleazy, shyster of a doctor?   Did he wish the government would shut her down?  Was his life boring, and did he need a little drama, even at the expense of others?
     Bob?  Are you out there?  Could you please come forward and register your complaints?
     In any case, I accomplished a lot today with my new patient--the one who gave me the rundown on "Bob"--after she unloaded her story.
     I spent an hour taking her history and doing a physical exam.  I ordered lab tests specific to her complaints.  I gave her a pertussis vaccine and flu shot, and scheduled her to come back next week for the pneumonia and shingles vaccines.  I got a chest x-ray because of her cough, and an abdominal ultrasound, because she seemed to be having gallbladder problems.  I set up a mammogram, colonoscopy, and an eye doctor visit.  I recommended a reputable, low-cost office for dental care, as her teeth were in disrepair.  I recommended a pelvic exam, and did a hemoccult test.   She told me about her husband, now deceased, and her parents.  She talked about her thirty years of work at the university, before she retired, and showed me some of the knitting she had been doing while sitting in the waiting room.  There were booties for a new grandchild.
     I wrote two prescriptions for "Bob" to fill for her.
     Oh, and I did put my hand on her neck, to check her thyroid gland, and I placed my stethoscope there, too, to listen for a carotid bruit.  There isn't a charge for that, and there never was.
     Are you reading this, Bob?

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