After forty-two years of marriage, my husband has mastered the art of half-listening. He catches my first few words, checks out for the meat of the message, and responds with “Hmm,” or “Really?” at the end. When I dipstick his retention, hours or days later, he will confirm my suspicions. He didn’t listen.
I like my primary care physician but I fear he may also be a master of this dubious skill. I’ve complained for years about feeling unwell. I’m chronically exhausted. Aches and pains migrate from my fingers to my feet to my knees to my back. I’ve had all the basic blood tests and been ex-rayed. No red flags. I walked out of my appointment without answers. Worse, I accepted my fate as a hypochondriac. I dreaded going to the doctor’s office.
In May, I got sick in a more tangible way. Stomach ache, bloating, and fever won me a pass to the emergency room where they diagnosed me with diverticulitis. They gave me a potent prescription and told me to eat a light diet of broth and canned fruit and then slowly introduce my favorite things: white bread, pasta, and potatoes. Two weeks after my first bout, I felt lousy again. I called my gastroenterologist who tele-healthed me for fifteen minutes, extended my prescription, and sent my insurance company a bill for $450 and charged me a $50 co-pay. He didn’t suggest a colonoscopy or a follow-up. His dismissive approach to my care caused me to wonder if he was also afflicted with the half-listening gene.
A few weeks after the original diverticulitis diagnosis, I developed a cough and shortness of breath. Cipro, the antibiotic I was taking, is great for lower GI infections but research links the antibiotic to blood clots and pneumonia. When I called my primary care physician’s office, I was told he was not available for a few weeks. The receptionist offered me another doctor. I was sick enough to know I had to be seen.
I dissected Doctor R as she walked into the examining room. She was a tall, thin woman with sandy medium-length hair. Her outfit–tan slacks and a breezy white blouse–was unfussy and comfortable but well put together. I realized I never looked closely at what my own doctor wore. It must have been a woman-to-woman thing.
I described my concerns, gagging and coughing as I spoke. Doctor R looked critically at me. “You’re having a lot of difficulty speaking.” Checking the notes on my vitals, she asked, “Is your heart rate always 120?”
She sent me to the hospital for a chest x-ray and a scan. The result showed a partial lung collapse and no aneurysm. I began a new prescription to treat my latest ailment: pneumonia. I slept through the better part of June as I recovered from my multiple illnesses.
I spent July worrying about myself. My diverticulitis diagnosis was unfinished business. Unsure of next steps, I read WebMD for advice. By the end of the month, I felt sick and bloated again. I panicked. As we traveled by car to Vermont for a wedding, my back ached. I wriggled in my seat, searching for a comfortable position. We stopped at a grocery store and grabbed a thermometer and some over-the-counter pain killer. I survived the weekend only to arrive home feeling lousy and with a sick COVID-stricken husband in tow.
I waited for the all-clear before calling the doctor since I knew no one would see me in person while Tim was sick. Once again, my own doctor was unavailable so I opted for Dr. R, the doctor I had seen in June during my bout with pneumonia. I explained I wanted guidance on how to avoid a relapse of diverticulitis. “Well, first, you need a colonoscopy,” she said. “Didn’t anyone tell you that?”
“No, they didn’t.” I felt a bit foolish. Maybe I should have asked earlier. Maybe the gastroenterologist should have told me. Maybe I was lucky to be seen by this doctor who seemed to take charge of my care.
“How are you feeling in general?” she asked.
I rattled off the litany of aches and pains, tiredness, foggy thinking, and anxiety. While I spoke, she typed notes into the computer. She reviewed prior entries at the same time.
She looked up. “You’ve had these complaints for a while.”
I wondered if she was on to something or was just throwing shade, confirming my hypochondria. I nodded.
“Well, there’s no one test that will give us the answer you are looking for,” she said, “but I am going to order some blood work that might point us in the right direction.”
I frantically signed in and out of the hospital’s online portal as the lab slowly posted the results. Normal complete blood count. Normal thyroid function. A red exclamation point indicated a higher-than-it-should-be A1C. I wasn’t surprised. I come from a long line of diabetics, should take off more than a few pounds, and should abandon gummy bears as my favorite guilty pleasure. Nothing pointed to the answer that matched my malaise.
A few hours later, another exclamation point appeared next to ‘Rheumatoid Factor.’ I clicked on the highlighted text. The number was thirty times above the normal range. Hmmm, that’s not good, I thought. I opened a new window on my computer and typed in ‘rheumatoid factor.’ The positive test results indicated raging inflammation in the body. The index finger on my left hand throbbed in agreement. I scanned an article about rheumatoid arthritis that outlined the symptoms. The diagnosis made sense. As Dr. R had hoped, the result pointed in the right direction.
A few weeks later, I visited a rheumatologist who listened to my story. After ordering additional tests, she confirmed the diagnosis: rheumatoid arthritis. I immediately began treatment with the goal to reduce the inflammation and the degeneration of my joints.
In spite of my long-standing symptoms, I am at the beginning of the illness, which is good news. I resist the urge to investigate the far-reaching impact of a disease like RA but I know it falls into the auto-immune and systemic categories. My rheumatologist assured me that I was in a good position to fend off devastating joint damage. Early treatment was the key to getting ahead of any continued deterioration.
I still like my primary care physician, and I definitely like my husband, but half-listening is not acceptable in husbands or doctors. I’ll forgive Tim. He has too many good traits to crucify him over one shortcoming. As for my doctor, I want to say, “You have one job: to listen to me when I say I feel like crap.” I resist making the connection between gender and doctors who listen because I’ve had both male and female doctors who listen but I won’t deny I’m disappointed. While a husband can check out after forty-two years of hearing the drone of his wife’s voice, doctors don’t have that option.
I see my usual physician tomorrow for my annual physical. We will discuss the events of the summer and the constellation of illnesses and complaints that eventually brought me to a rheumatologist and a diagnosis. I will listen carefully to what he has to say and I will assess his level of half-listening, knowing Dr. R waits in the wings, ready to hear me.