Balls and Walnuts
more than you ever wanted to know
Laying on of hands
I saw my new primary care doc today. Admittedly, I only needed him to write my prescriptions for me, but still: whatever happened to the history and physical exam? He didn’t ask me any historical questions, unless you count, “What can I do for you?” And he didn’t lay a pinkie on me.
You have to understand that in med school, we’re taught to do everything. There’s a reason for that. When I did PCM (preparation for clinical medicine) at the VA, I once had to ask a guy in his 50s about his drug history. Here’s this vet who is only about ten years younger than my dad, and I’m asking him about marijuana! But he said yes, he did a little coke on weekends.
We were expected to poke and prod at everything, too. And we did.
The thing is, if you do a good history and physical, you will sometimes discover interesting things. Just the other day I looked up the snoot of a guy who saw me for a skin cancer. He has nasal polyps! He was unconscious of them, but it’s still a significant finding; some polyps behave aggressively, and can even become malignant.
I wonder if my doc adopted the hands-off approach because I’m a doc, too. Maybe he figures I’ve been feeling my own liver. Anyway, I’d be more critical of him except this has become a near-universal phenomenon. This is not the first time I’ve observed this sort of behavior (although Karen’s doc back in Crescent City used to listen to her lungs, and would do the occasional Pap smear), and I’ve heard it said more than once that today’s primary care docs diagnose by blood test.
So: whatever happened to the laying on of hands?
I’m a doc. I know better than anyone how fallible we are. I’m not too superstitious . . . and yet I must say it would be reassuring to have someone listen to my heart and lungs, prod my belly, and look up my snoot, and declare me Not Dead Yet.
Even a doc likes to hear he’s Not Dead Yet.
D.
I think I can say definitively that you are Not Dead Yet.
Or, at least, you weren’t Dead Yet at 10:46 PM on Dec 16th.
Still there, right? Not gone yet? Can you feel your own liver?
I am relieved when doctors just want to talk. I guess I should be worried because they’re not doing it to save my dignity after all.
That’s what really gets me. They know we’re docs and they still blow us off. It still galls me the way my wife’s pain doc barely did an H&P on her before deciding to inject her. He had dollar signs in his eyes. Ka-ching!