Cover Image - Physicians Are All Too Human

Physicians Are All Too Human

By Sean M Inderbitzen LCSW, DSW


Questionable Bedside Manner

I can’t tell you how many stories as a psychotherapist I have heard of patients with autism going to a medical clinic and being appalled at the care they receive.

Usually it sounds something like this recent story I heard from a mother:

So I went to the doctor the other day with my child, and made it very clear to the receptionist that my kid does not like to be rushed.

So we sat in the waiting room for thirty minutes, and our appointment time arrives and there was no doctor. Another 15 minutes pass and then finally they call my child’s name.

We walk back following a young woman in blue scrubs who asks my daughter to put her back against the wall. And before she can even turn around this young woman aggressively directs her towards the wall before she gets her bearings. Very flustered my poor little girl follows the womans, “Over here”. I can see her cheeks turning red, which is never a good sign if you know my little girl. But this young ray of sunshine was too busy as she took her height.

 ‘3’6″‘ she retorts. She motions for us to follow her, and we come into a cold white sterile room, and she points for us to sit. Gently, as if nothing had just happened she says to my daughter, “Can I have your arm, we need to take your blood pressure?” Unsure of what to do my daughter extends her arm cautiously, and the woman in the blue scrubs grabs it gently and places the blood cuff on her arm. The machine makes this weird screeching noise which certainly isn’t helping my poor daughter, and she laughs, “Well, this thing hasn’t worked well for years, they really need to fix it.” My daughter wide eyed, just looks and states softly, “No shit”.

The young woman speechless, looks at her as she darts her eyes away, then at me, and goes, “Well all done. The doctor will be in shortly.”

5 minutes pass and the physician walks in. Unaware of all the information I passed along to the receptionist and the abrasive approach of the young woman in the blue scrubs, he looks at my daughter and goes, “So we need to take your temp, look in your throat and ears, and then we will call it good”. He proceeds to do each of these things as my daughter continues to show increasing agitation. Completing his list of tasks, he looks at her as her eyes dart away, and asks, “Anything else?” My daughter stares blankly at the white wall, I’m speechless, unable to muster words. He gets up and leaves. As he exits the room, the door makes a large, “thud!” Tears come rolling down my daughters face silently as we walk out stunned. I’ve never been more appalled by a clinic’s treatment of my daughter, who I said does not like to be rushed.

Step Back For a Minute, Think Things Through

Now while it is easy to point the finger at physicians and lay blame, I’m not sure how helpful that rightly justified anger will be at getting us what we want, which is better treatment. So what if we took a different angle to this all too familiar story, more specifically the physicians remark, “Anything else?” with a bit more openness?

As a psychotherapist, I’m all too familiar with this sense of “stuckness” that people like myself with autism, their family members, and their care teams all can experience. Whether it is schools, employment teams, or medical care teams, “stuckness” is an all too familiar ingredient to the approach, which I would argue is largely part of the medical

So what if instead of interpreting “Anything else?” as a statement, we see it for what it is grammatically. A question.

Not Gods, Only People

I would argue the generative assumption in this case is to see the physician as a human being with fears, concerns, and insecurities just like everyone else.

And while it would be wonderful to assume they are as smart as people tell them they are or the degrees and plaques on the walls might indicate, they are human.

And I would contend they are subject to what is known as ambiguity. That is to feel two-ways about a thing. In this physician’s case, ambiguity about what he misses: maybe something substantive, or maybe nothing at all.

So what if that parent had spoken up? Or that woman in the blue scrubs passed along that daughter’s off putting remark to the whole room (which lets admit was kind of hilarious). I think this interaction could have and would have gone a much different direction.

Therefore, my recommendation that I will begin to lay out over the next few months is that physicians are humans too, and need not to be treated like gods or objects of grievance, but people. People with uncertainties, horrific moments, bad days, and wonderful abilities to aid us in our journey towards healing if we grant them the same compassion we hope we might receive from them.

This is in light of what I hope will be a new project that builds physician confidence based on research I’ve conducted with Mayo Clinic Health System on primary care providers, and hopefully will be introduced to a community near you. So that if you have autism, you will have a more confident doctor, which will lead to greater access for you to get the care you need in your community of choice.

To 2024.

Doctors are all too Human.


 

Sean is a Behavioral Health Therapist, and lives with an Autism Spectrum Disorder. He has a caseload with 33% of his patients that live with ASD and varying comorbid psychiatric conditions. Prior to being a mental health clinician, he was a Vocational Rehabilitation Specialist for Wisconsin Division of Vocational Rehabilitation for 3 years. He was also appointed by Governor Walker to the Statewide Independent Living Council of Wisconsin. He is an incoming member to the Motivational Interviewing Network of Trainers, and provides training on motivational interviewing, ASD and employment, and ASD and comorbid psychiatric conditions. For more info, find him at Seaninderbitzen.com or on LinkedIn, and look for his new book Autism in Polyvagal Terms: New Possibilities and Interventions.