Scary vs. coherent

It seems like my current primary care physician has it in for me.  Last year she told me flat out to lose ten pounds – a delicate statement to make around any woman.  And it’s true I was about 7 pounds over my standard weight.  But still, not an entirely reasonable thing to say to a reasonably healthy young woman.  She’s always been a bit brusque, so I take her words with a grain of salt (and hopefully prompted me to do the same with all doctors).

Still, when I noticed that a mole on my back seemed to be larger and then turned skin-color in the middle, I brought it to her attention.  Changing moles are freaky – your mind does all kinds of cancer-flips and worries at what other changes might be happening on your unobserved flesh.  I was not worried really, but still wanted a professional opinion.  Hers was that it was a cyst, not a mole, and nothing to worry about, but I was welcome to see a dermatologist.  Um, okay, I think I will.

It’s hard to say whether her nonchalance or her absolute denial of my opinions and knowledge of my own body that was more frightful.  True, she’s the doctor.  Maybe something is called a cyst that I think should be called a mole.  Maybe there’s some sort of oozy something under the skin (I’ve always thought of cysts as juicy) where there used to be a mole.  It’s hard to really evaluate the status of your skin in places you can’t see – maybe she can see or understand something I can’t.  Of course, if she’s right, then are there other things I should be checking up on that I am missing out of misconception?

So I went to see the dermatologist today worried.  I am a wimp when it comes to pain, and high in my mind was also the possiblity of having something dug out of my flesh to be examined and tested.  Not fun.  And what if I had cancer and was going to die?  The imaginative mind is prone to melodrama.  Fortunately, teh dermatologist I saw understood this.

His first comment:  ‘It’s not a cyst.”  Lovely.  Validation.  He went on to say that it was perfectly benign (of course, no one can be completely sure, but he seemed pretty sure.)  More importantly, he was perfectly willing to do whatever I wanted.  I could live a happy full life with my mole, or he could take it off if it was going to psychologically dist rub me to have it there.  So not only were my questions seen as reasonable, but he was willing to take into account my emotional well-being as well as my physical condition.  It was wonderful.

Of course, I was still pretty nervous to just rely on this guy’s word for my saftey.  After all, doctors are falliable, and I want to take steps to preserve my health.  I also don’t want a chuck of flesh carved out of me.  So I asked questions – how woudl this happen?  Should I be avoiding certain activities in the future?  And he was more than happy to explain.  Moles can change if they become inflamed.  Usually the first thing to vary with inflammation is pigment.  Probably your bra strap rubbed and inflamed the mole and that’s what caused the change.  Simple.  Direct.  Reasonable.

That’s all we want, really.  That’s what we pay our doctors for.  Not science or study, or even miracle cures.  We want communication.  We want the right words to tell us that we are safe, or we are unsafe, or that we need to change to preserve our health.  Of course, the right words are the hardest to find.  But we need delicacy and appreciation more than the simple maintenance of our bodies.

I don’t know how to attribute this, but I was reading a book that mentioned a speaker who was discussing the words we use to describe cancer.  How we say someone is ‘battling’ or ‘fighting’ cancer.  How we’ve changed what is often a manageable disease into a war.  How it can convince some patients to give up, in the face of some warlike onslaught, when in reality they should have survived.  How if we had the right words, the right way to talk about disease and health, more of us would be healthy and happy.  perhaps this can be most clearly seen in the doctor-patient relationship, but it should be present for all of us:  the need to talk clearly and without negative connotation about health.

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