Open Letter, Reflection

An Open Letter to an Awful, Just Terrible, Doctor

Dear Awful, Absolutely Terrible Doctor,

Bravo and congratulations! You, madam, have the healing prowess of a druid, or perhaps some sort of automaton. You have healed me of all which ails me. Goodbye chronic pain, hello bright, shiny new day without chronic pain.

Except, wait, no. That’s not right at all. No, sorry, what I meant to say was Bravo and congratulations. For the first time in thirteen years of suffering from chronic pain, you have made me feel like a drug seeking addict.

 I guess that says something about my experience with the health care system thus far. I’ve been very lucky with all the doctors and nurses I’ve dealt with. That is, until I had to deal with you.

My regular Doctor, whom I adore, does not work on Thursdays. Coincidentally, my only weekday off during this holiday season is Thursdays. That is a predicament. Do I let my medication lapse and try to survive working 8 hour retail shifts behind a cash desk without my medication until the season is over and I can see my regular doctor on a different day? Do I try to replace my medication with something equally potent like distilled children’s tears or Draino? Or, do I do what was clearly the wrong thing in this scenario, and make an appointment to see whoever might be able to fit me in, explain the situation, and hope for the best?

I went with the ill-advised #3 because, quite frankly, I hate the taste of Draino.

I get my blood pressure taken, and a few minutes later you walk into the room and, without introducing yourself, ask what I need.

‘Medication refills,’ says I, emphasizing the refills.

You want to know what medications, so I tell you. Morphine and Cymbalta.

I can see your beady, judgmental eyes working around the idea. I am young, a mere 26 years of age. Why would I need morphine. You ask, and I quickly explain:

‘For chronic pain. I’ve had five spinal surgeries to correct severe scoliosis. I have a massive curve and degenerative arthritis in my vertebrae.’

You are clearly not convinced, and why would you be? I look nothing like a chronic pain sufferer in that I am smiling and polite. I decide not to mention that my very elaborate history, including the many treatments that I have attempted, are clearly listed in my file, which is sitting right in front of you. Perhaps you are unable to read. In which case, kudos! You’ve done very well for yourself. Perhaps you simply don’t want to read, in which case I must caution you, as lazy doctors tend to end up with dead patients, or so prime time television has taught me.

Don’t get me wrong, Worst-Doctor-Ever. I understand that it is your job to carefully monitor the doling out of opiates to patients. You can go around prescribing the extremely high 5mg doses of morphine willy nilly (ed: 5mg is a considerably low dosage, especially when taken for breakthrough pain.)  I understand because I have been part of the system for many years, and have heard many stories from my mom about patients who have come to her clinic, seeking out drugs. I appreciate your tenacity. What I do not appreciate, is your attitude. I made it quite clear my morphine was through breakthrough pain. I am not crushing it and shooting it into my veins every morning while my husband hires out prostitutes from some seedy back alley. I have a job, one that is taxing on my spine. Hence the morphine for breakthrough pain.

Still, our interaction up until that point was manageable. I knew I would make an effort to avoid seeing you again. My other doctor is much better than you.

Then you had to ask the stupid question. You had to treat me like an idiot. That is your crime, Horrendous Doctor. Your failure to get to know a patient or read a situation led to you assuming I was, I presume, mentally challenged in some capacity.

You asked me how much I am usually prescribed. Truth be told, I don’t know. My usual Doctor prescribes how much she thinks will be good, usually a couple months worth. I am not sure how much the pharmacy chooses to dole out at a time, but I assume it is not a lot… Again, drug seeking behavior.

I tell you as much and you, you ask a question that is the medical equivalent to slamming someone’s head repeatedly into a fridge door.

“Well, how do you know you’re out then?”

Bitch, please.

Like the boardwalk entertainer has the capacity to determine how much emotional intelligence is in your skull simply by looking at you (see: none), I have been gifted with the amazing ability to look at a clear plastic bottle and determine whether or not it contains anything. Much in the same way I have the ability to reason that the number ‘0’ indicates a lack of something being present. In this case, the number of refills on my empty bottle is 0. Ergo, I have no refills, nor do I possess any morphine.

You, in all your brilliance, questioned my ability to keep track of my medication. Woe to you, Horrible, Just Absolutely Awful Doctor.

Now we sit in silence as you click around on the computer. I assume you were playing Mahjong, or perhaps Solitaire, because you certainly weren’t reading my file or taking the time to understand my unique situation as a patient. And you certainly weren’t taking the time to master the art of bedside manner, which you clearly missed in medical school. You weren’t making a note of all the doctors I have seen, or the various clinics I have attended, or looking at my various x-rays and reports from specialists. I know this because if you were, you might not have seen fit to question my basic intelligence and instead, discussed with me treatment options. Hell, you might have even done the right thing and talked to me about why you were uncomfortable prescribing me a small measure of morphine for breakthrough pain. Because, please, I am an adult and fully prepared to have a discussion about this. If you are not convinced that I am receiving the right treatment then engage me on it, tell me why you think it is wrong and what changes you would recommend to my regular doctor.

Do not assume for a moment that your stealth shield has gone up and I can’t see you mentally question everything about my medical history. You are two feet from me. I can see you. Just like I can see the pills (or lack thereof) in the bottle.

But let’s get to the crux of the issue here. I can put up with rude treatment. I can even deal with the fact that you acted like a soulless bitch. What I cannot stand is the idea that you treat other chronic pain sufferers who don’t have as strong a grasp on their emotions or their situation, with the same damn disrespect. Your lack of care, I assume, must coincide with your lack of knowledge on how to deal with chronic pain and how prevalent it is in our society. You education in chronic pain is lacking, as is your education in communicating with your patients.

Go to and read some of the stories from people just like me. People who have to find a way to convince themselves to get out of bed that day, because the pain is so bad and it certainly won’t be getting any better. People who struggle with government institutions, trying to get financial support to assist them in everything from getting food to paying bills. People who, every day of their unhappy lives, have to deal with doctors like you who treat them like criminals. I have cried myself to sleep due to my pain being uncontrolled more times than I like to admit. I have had days where all the breakthrough medication in the world doesn’t help me feel human. I have experienced the looming cloud of depression and somehow, I managed to fight it off. Because I had good, considerate doctors who were patient with me, who took the time to learn about me and my condition and how it made me feel and what the impact was on my life. You are not, and never will be one of those doctors, and I pity any other patient that has to cross horns with you in order to receive a smidgen of respect or understanding when it comes to healing them.

You are probably a competent doctor at the core. But you are a terrible person, and unfortunately for myself and those like me, your attitude is exactly what causes us to talk about ‘giving up’. We deserve better from our health care providers. We deserve your time, and your patience. We deserve your understanding and yes, even your questioning of our medications. Chronic pain is a forever illness. I have had it for half my life. When I turn 27 next year it will be for over half my life. And when I die at the ripe old age of 102, presumably from a skydiving accident, people will note that I suffered from it for most of my life.

For most of my life I will deal with chronic pain. I can only hope to whoever might be listening that today was the one and only day I had to deal with you.

Most Sincerely,

Kathleen Sawisky

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