Friday, 25 November 2016

Dear Doctor's Receptionist...

I get it, I really do.  You've got a hard job.  

It can't be easy to spend your working day fielding phone calls from sick people who, not feeling well, are probably grouchy, sometimes overly persistent and more than likely always certain that their  illness is urgent enough to merit the doctor's immediate attention - certainly it is much more urgent than the other five phone calls that are waiting in a queue for you to be able to answer.

It can't be easy to field these phone calls, to judge who needs to be at the top of the doctor's callback list and who might be ok to be at the bottom.  It certainly can't be easy to suggest to some patients that, perhaps, their condition isn't actually urgent for today and might be able to wait a day (or even two) when the doctor or nurse will ring them back.  

It can't be easy to deal with the reaction of the patient at the other end of those phone calls.

I understand too that you would like to help but that you also know the doctor (or nurse) cannot possibly speak to, or see, every single person who needs their attention in the next five minutes...or even today.  I can understand that it is your job to make sure the most urgent situations are indeed dealt with urgently and the rest to be decided by the doctor or nurse.  I understand that you probably want to protect the doctor from overworking because if he or she goes off sick, then no one will be seen and everyone will have to wait...or end up at the hospital where those already overstretched staff will try to meet their needs in four hours or less.  Even they will not succeed and will also face frustrated patients.

So you see?  I get it.  

But sometimes, I wonder if you get it because, you see, my role is hard too.  

It's not easy to be the parent and carer of a profoundly disabled child who is hearing impaired, visually impaired, autistic, asthmatic, globally developmentally delayed, incontinent, violent and effectively non-verbal.  Oh sure, he can say certain single words like drink, dinner, car and school.  On some occasions he can ask for what he wants like "purple-pink" for the iPad, "Blue" for that particular episode on TV or "Red" for one particular toy.  

But he is not capable of telling me if something hurts, or indeed where it hurts.  He cannot tell me if he feels hot or cold, he cannot tell me if he is tired or sad.  He does not understand that boys who have four broken bones in their foot really shouldn't be "stompety stomp stomping" along with Baby Jake (that was last spring) and he is not capable of sitting down to rest when he feels unwell or has been hurt.  

He cannot understand what it means when his entire body is covered in a red angry rash that turns to hives or that this should not be scratched.  He cannot tell me when he has such a bad ear infection that the screaming, violent meltdowns that have been repeating all week are very likely to be because he is in significant amounts of pain   He cannot ask me for help when he needs it.

So when I ring you saying that I need to speak to or even see a doctor or nurse, you can be assured that I really do need that advice and expertise.  You can also be assured that I am not trying to waste the doctor's time and that I will have already done everything I know how to do, depending on the illness and my son's symptoms, from administering Calpol to Neurofen, from skin creams to ointments, from inhalers to even starting my son on steroids because I have an emergency prescription at home for him at all times - with the doctor's approval.  By the time I ring you, I have already exhausted my options, you are not a first resort.

And when I tell you that my son's special needs school has already rung and asked me to pick him up early because he is not himself, he is not eating and he is not playing, this indicates that something is wrong and it is significant enough to merit the doctor's advice - because my son doesn't sit still.  Not ever.  He is either awake and moving, running, twitching and stimming or he is asleep.  Sitting still is sometimes the only visible sign of significant illness that we will receive and it is our job to understand and interpret what that means.  

When I also tell you that both the first aider and the school nurse have already examined my son and have judged that he needs to see the doctor, then he really does.  Sometimes only the expertise of the doctor can fit all of the pieces together, and sometimes even they don't understand until symptoms become more visible and therefore serious.

I understand that you need a certain level of information to pass to the doctor, but please understand that you are not the doctor and the level of need in this house goes vastly above your skill set.  When you give me the third degree and when you try to tell me that the symptoms I'm describing may not be urgent and perhaps I could try the chemist first, you are really not being helpful, and you might even be putting an already very vulnerable child at risk.  

I know I call a lot and seek advice quite frequently.  I won't apologise for that but I will tell you that I wish I didn't need to.  You may well be a very nice and helpful person underneath all of the questions and brusqueness but I'd really prefer not to have to speak to you quite as often as I do.  

So please, let me ask you to remember just one thing:  if I call and ask to speak to the doctor, it's because I really need to.  In return, I promise I won't be a time-waster, I won't call unless I have already tried all of the usual over-the-counter remedies.  But I will push you if I need to, I will be determined and persistent and I will probably annoy you with my refusal to give up.  

You see, this is what I need to do in order to be the voice my precious son needs me to be.  I am the only voice that my son has and it is my job to be his advocate.  So please, when I ring, try to be a little bit more understanding, a little bit more aware and a little bit more helpful.  Trust me, my life and circumstances are hard enough as it is, pulling up the drawbridge, throwing down the portcullis and calling from across the moat that the doctor isn't available just doesn't help.  

Please, take a deep breath, look at my son's two-foot thick medical file and think before you tell me that my call may not be urgent, and the doctor may be too busy to speak to me.  It won't make me go away, it will only make me fight a little bit harder.

THAT Patient

Sadly, not always a joke...