Sunday, March 8, 2009

Part IV. Personal Cancer Story

The second and last visit to Dr. Gosewehr was exasperating at best. It reminded me of the birth of my sixth child, when the placenta had peeled off halfway, and I was hemorrhaging to death, aware that if I got upset, (which I was) the contractions would begin in earnest, and my child whom I had protectively waited for, for over 9 months now, would die of lack of oxygen. It helps to be observant in nature, and go inward to find your core of strength. Weeks before the birth of this sixth child, my husband at the time had divulged a personal faux pas so burdensome, that I knew I would have to raise the children myself. I wasn't wholly excited to continue to live at that point. I was somehow tired at the idea of raising six by myself. The pinnacle of avoidance.

Comparatively, here I was with endocervical cancer, trying to make decisions about what treatment I should allow, and which doctor I was going to trust, and any more stress was not what I needed. The young female medical assistant came into the examining room and with the record open, asked me if any changes had taken place within the last couple of weeks. Any changes in your family's physical or mental history? In two weeks, I asked??? I could tell what was coming. Uncomfortable, she asked, "Any changes in your physical or mental condition?" "Beyond the normal depression or distilling of a critical illness? I asked. No. But I would like a copy of the entire medical record of mine to this point, when I leave," I said.

Immediately, the young woman straightened, and said, "I don't know if the doctor will allow that. I'll have to ask him". "It is my record, I said. I have a right to see it and have a copy." After their social worker who referred cancer patients to groups told me that "Effexor works well for the depression of cancer patients" on an initial information-seeking phone call, and Dr. Gosewehr's language and behavior on my initial visit, I ascertained that this Portland, Oregon St. Vincent's Medical Center Pelvic Oncology office was making some serious money with the Pharmaceutical Industry in prescribing beyond their scope of practice. As a social worker with my own individual practice at the time, I was already infuriated at the drugging of Americans as guinea pigs and victims through the financial bond of Big Pharma and Medical Doctors.

When Gosewehr came in to do an exam, we discussed my records request in a diversionary manner. I told him I could tell by his questions and his assistant's behavior, that he had written me down as some kind of mental patient; it sounded like bipolar. A 50 yr. old should know by that age if that was the case. Well, you presented in my office several deviations...-(it's a catch phrase or marketing cliche' bought by many naive people) above some 'normal' mark. "I have never had anyone present like you did." I am not like anyone you've ever had in your office. Was he trying to clone people, or did he not understand I had worked around death as a volunteer Hospice worker for a year, and used humor as a coping mechanism? How fast do people usually talk, when they aren't told how many minutes they have to make life and death decisions? I knew most people are too trusting of medical personnel, and may accept anything like sheep. I always stood out at the top of my classes, got bored at the norm, and am my own person.

"You said you were narrowly trained. Why are you trying to step out of pelvic oncology into my profession?", I asked. Even your social worker tried to sell me on Effexor. She has no right to do so." "She works in a medical office," he said or some such excuse. I reminded him again that without a psychiatrist's license or being a mental health nurse practitioner, a social worker is not allowed to prescribe or 'push, or suggest' any drug. What is more, she has never even met me. Then Gosewehr asked me if I was offended. "Would you be offended?" I asked, if in 10-20 minutes some pelvic oncologist tried to diagnose you with some mental illness? "Well, I've always been different, too," he said. Ay vey.

In his 'sales' job, he told me he was trained to do the most radical hysterectomy. He would strip the pelvic cavity of lymph nodes, and there would probably be rectal and bladder nerve damage. There is a tiny nerve here on your leg, he said. We miss it, but inevitably sometimes it is cut, and you will probably wake up from surgery with a numbness in this part of your leg. He made an appt. for pre-surgery work. I knew this guy would not be my doctor. No 'immediate' cancer debulking for me, it looked like. More searching necessary, in a small pool.

He never gave me a copy of my records to that point. He most assuredly was afraid of a law suit. When I came into his office to pick them up at a later date, needing them for a second oncologist visit, again I was not given any records. Later his excuse was that they were on the computer, as he didn't know which hospital I would have the surgery in. He finally sent a copy of the 'Dr. Crimm, thank you for referring this patient letter,' with a brief synopsis. Last year, again, I requested the full medical records from his office when I saw another doctor. After 4-5 requests, and no response, the path is clear.

An interesting development later was meeting a doctor who contracted with the care center where my elderly father had just been admitted. In the transition from one abusive, neglectful, dysfunctional 'care' center to this one, I went two nights without much sleep, as my dad was in my home and woke up repeatedly to go to the bathroom, etc. This doctor Dunitz whom I had never met, asked me how I was in passing courtesy. Oh, I'm a little tired after the last two nights. "Manics need their sleep", he said. "Excuse me?", I said. He realized what had slipped from his lips, and literally bee-lined down the hall, and continued to avoid me and my questions of how he dared to label me, a perfect stranger. "I saw a television show last night, he tried lying. But no eye contact, and running from room to room, let me know that 'Someone' had worked with the pelvic oncologist, heard the rumors as a breach of confidentiality and misdiagnosis, and diagnosing outside his 'narrow practice'. A couple of clowns. Portland's medical scene seemed exceedingly small and dysfunctional at this point.

"Moreover, maintaining patient confidentiality is a legal duty as well as an ethical duty. A physician's legal obligations are defined by the US Constitution, by federal and state laws and regulations, and by the courts. Even without applying ethical standards, courts generally allow a cause of action for a breach of confidentiality against a treating physician who divulges confidential medical information without proper authorization from the patient."

"The legal basis for imposing liability for a breach of confidentiality is more extensive than ethical guidelines, which dictate the morally right thing to do. Although current law in this area has been referred to as "a crazy quilt of state and federal law," protecting patients' confidentiality is the law of the land. Included in the patchwork are federal and state constitutional privacy rights, federal and state legislation and regulation governing both medical records and licensing, and specific federal and state legislation designed to protect sensitive information (e.g., HIV test results, genetic screening information, mental health records, and drug and alcohol abuse rehabilitation information)."

Without obtaining my full medical records, both written and electronic (online) I am now set up to be picked up after any accident, and with the false information, I can be 'helped' by being put on some psychiatric drug. The Good Samaritan Legacy Healthcare Hospital on 23rd and Lovejoy in Portland, Oregon demonstrated how many rights a patient truly has any more, when they admitted my father with a serious bowel impaction in his 80's per my ambulance request, didn't allow me as his Power of Attorney and established medical representative to make medical decisions and give patient preference and information, and gave him injections of Haldol, an antipsychotic, without my knowledge or consent. They also 'failed' to supply me with his blood and urine tests for over a week, which showed he had a urinary tract infection. Despite a female doctor, whose name I will certainly look up for accuracy, who told me that she herself wouldn't mind if her son or husband was treated the same, I beg to differ.....with all of it.
To be continued.....

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