When the patient is a Googler and the doctor is a pompous ass

Contempt for those who would research their own medical conditions says more about doc

I am Dr. Scott Haig's kind of patient and he is, in one sense, my kind of doctor ... but he's also a standout pompous ass in a profession that has more than its fair share.

Haig authored this diatribe in Time about his distaste for patients who have the audacity to research their own medical conditions online. The screed and its headline - "When the Patient is a Googler" - drip with contempt for these medical do-it-yourselfers and their inability to trust their doctors over whatever latest quackery they've stumbled upon via the Internet.

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My point is not that he doesn't have one, but that in making it in such a ham-handed, even mean-spirited manner he ends up saying more about himself and his own shortcomings than he does the difficult patients.

Exhibit A illustrating Haig's point is Susan, a 40-something mother with a bum knee who's found his office for an initial visit. Haig asks us to share the pain of having to treat this "brainsucker."

After gratuitously establishing that Susan's 3-year-old is a "little monster" and Susan a terrible mom, he gets to the meat of the matter: She's a doctor's nightmare because she used the Internet to find out too much about him - including personal information - and she demonstrates a complete unwillingness to defer to his expertise. Haig writes:

Susan got me thinking about patients. Nurses are my favorites - they know our language and they're used to putting their trust in doctors. And they laugh at my jokes. But engineers, as a class, are possibly the best patients. They're logical and they're accustomed to the concept of consultation - they're interested in how the doctor thinks about their problem. They know how to use experts. If your orthopedist thinks about arthritis, for instance, in terms of friction between roughened joint surfaces, you should try to think about it, generally, in the same way. There is little use coming to him or her for help if you insist your arthritis is due to an imbalance between yin and yang, an interruption of some imaginary force field or a dietary deficiency of molybdenum. There's so much information (as well as misinformation) in medicine - and, yes, a lot of it can be Googled - that one major responsibility of an expert is to know what to ignore.

Susan had neither the trust of a nurse nor the teachability of an engineer. She would ignore no theory of any culture or any quack, regarding her very common brand of knee pain. On and on she went as I retreated further within. I marveled, sitting there silenced by her diatribe. Hers was such a fully orbed and vigorous self-concern that it possessed virtue in its own right. Her complete and utter selfishness was nearly a thing of beauty.

Susan sounds like a piece of work, all right, but I wasn't under the impression that doctors were trained to treat only the easy ones.

As to his point about self-diagnosis: Some of you may recall that four years ago I had a heart attack that turned out to be the least of my worries at the time. In treating the heart attack, doctors couldn't help but notice the golf-ball-sized tumor that was either attached to or inside of my heart wall. They couldn't tell conclusively, even through a biopsy, where exactly the tumor was or whether it was benign or malignant. Removal was recommended, which would mean open-heart surgery.

I was referred to one of Boston's most famous hospitals where a highly regarded cardiac diagnostician concurred - "If it was in me, I'd have it out today," he said - after which he sent me across campus to see a surgeon who I would learn was head of the hospital's heart transplant unit. (My primary care physician of 25 years, also a cardiologist, concurred with their opinions.)

Now there are two ways to react to the realization that you are going to be operated on by the head of a famous hospital's heart transplant team: 1) I'm so incredibly fortunate to live so close to such extraordinary care, and; 2) this is no trifling matter because surgeons of this stature don't trifle.

At no point did I think, "Hey, maybe I should do a little Googling just to make sure these guys didn't miss something."

Yet several people asked me whether or not I was doing my own research, with one colleague going so far as to express his disbelief that I was not.

Call me crazy, but I'm with Susan's Dr. Haig on this one. It's not that I believe the four doctors who were advising me to be infallible; it's that I was in no position - and certainly no frame of mind - to take up cardiac medicine with a few hours of online searching. And, to be frank, I was too busy being scared and getting a will together.

However, had I decided to be less trusting and more like Susan - even if I was a pain in the butt - I'd like to think my doctors would have shown me a degree of understanding and sympathy befitting their profession and my predicament.

I wouldn't expect them to whine about me being a lousy patient.

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