Tuesday 16 April 2013

Dear Doctors.

Dear Doctors,

A young patient presents at your ER/clinic/rooms, with unexplained symptoms of chest pain and fainting.

What is you first response?

I'd hope that you'd investigate.

I'd hope that you would take it seriously.

I'd hope that you'd reassure your patient that you believe them, and will do your best to help them.

But sadly, this response seems to be the exception, and not the rule.

"You're just anxious."

"You're just depressed."

"You're too young for [insert illness of choice]."

"You just need to get out more."

"You're wasting our time."

This is what far too many patients encounter.

Do you know that your response in that moment can influence that patient's relationship with the medical system for years to come?

Do you know that your response can make or break that person's sense of self?

Do you know we come to you because we are scared?

Do you know we come to you because we trust that you can help us?

Do you know that you can crush that trust with an uncaring word or flippant attitude?

Do you know that rare, doesn't mean non-existent?

Do you know the tears we cry and anger we feel when we are casually and sometimes callously dismissed because you could not find the problem after some basic bloods and a quick check of our vitals?

Do you know how we second guess ourselves and avoid seeking medical care in the years to come because maybe you are right, and it is in our heads?

Do you know we now no longer trust the medical system because you, the expert, you who we imbue with hope and power, told us we were crazy or wasting their time?

Do you know many will fail to get the treatment they need because you made them feel like a hypochondriac?

Do you know many will lose jobs, relationships, lives, because they will no longer seek care for their symptoms for fear of dismissal or ridicule?

Do you know that even when we find a doctor who can put the pieces together, we are hampered by that one exchange we had with you?

Do you know that we mistrust the compassion and understanding we receive from that doctor because our trust was dashed by your indifference and disregard?

Do you know that we will spend years trying to overcome the damage you created in that one exchange?

Do you realise the power you have?

We come to you scared.

We come to you with trust.

We come to you with hope.

We want to believe.

We want to feel better.

You may not understand our condition.

You may be frustrated by a lack of clear results.

You may be overworked and tired.

But do not forget your power.

Do not forget that you promised to first do no harm.

Do not forget you are dealing with a person, not a bed number.

Do not forget that in that moment we are vulnerable.

A kind word.

Genuine concern.

A simple admission that you don't know.

Will build trust.

Will build hope.

See us as people.

See that there are real world, long-term consequences to how you interact with those who seek your care.

You have the power to make or break a person's entire experience with the medical system.

Remember that before you speak with your next patient and use your power well.


(I've woken up to a bunch of emails asking if people can print this post out and give to their local doctors, hospitals, medical schools etc. Rather than reply to all and because I am time and energy poor at the moment, the answer is YES feel free to copy and share. All I ask is that there is a link back to the blog URL and authorship noted.)


  1. This should be a handout in every medical school & posted in every medical facility ! Awesome article!!!

    1. Cheers Anon. It sometimes seems this aspect of medicine is being lost. :)

  2. This is so true and I agree with the above comment. I would give a handout to all 12 of my drs who dismissed my illnesses but gave me 27 different diagnoses

  3. I had to be nearly at death's door and for my own mother to walk in and "smell death in the room" before a doctor sent me to hospital after the birth of my first child (a different health 'thing', although I have autonomic issues too, but it came with the same problems of being dismissed as a hypocondriac/depressed new mum/young mum/weak girly girl looking for attention/wanting a 'label' and so on).

    Until I started fitting and hallucinating. Bits of placenta had been left rotting inside me for 4 months (it was written on my notes that the placenta was "ragged & incomplete) and I was hugely anemic (HB of 7-also written on my hospital notes. In red. Laughed off as I left the ward as "must be a mistake...you wouldn't be standing!").

    Not a lot has changed all these years later, as I faint, lose my sight,my hearing goes, get a dripping cold sweat/hot flashes, have palpitations, chest pains, feel as if I am having electric shocks/needles and glass stuck in me and so on ad infinitum. Apparently it's no longer because I'm a mother, now it's solely because I'm a woman and apparently *want* the attention. If only they realised how bad it has to be and how many times they don't see it happening before we decide we *have* to bite the bullet, pull on our big girl panties and face up to the Big Bad Dr for help.

    Hoping you get to see vaguely human shaped one this time. :-(

    Keep fighting that fight, ladygirl...this article was spot on. Thank you xxx (and to my fellow zebras, keep being FABulous)! <3

  4. Fab letter, going to send it to my GP as i'm about to leave practice I have been at for 37 year because of him, he has broken my trust, faith, etc, (and i'm terrified at even the thought of going to a practice that doesn't know me) but I have to. Thanks for a fab post again Xx

  5. Awesome post! You have put into words what I have felt for the last few years. I'm going to print this out. There are many doctor's I would love to send this to, especially the first one almost four years ago that said, "you are too young to have heart problems." I don't have heart problems, but do suffer from POTS and if he'd just taken a bit of care and listened (instead of totally disregarding me and my symptoms), I might have been dx sooner rather than later. This particular dr. totally ruined my perception of the medical community and after four years, I am finally trying to get myself to realize that there are good dr.s out there. I just hope I can run into one soon. Thanks again for this post and all your posts for that matter!! Love reading your words. Will you please write a book already :)
    Be well!!

  6. I would love to post this link to my blog, if I have your permission. Truly a great post and one that so resonates with me as well as, I'm sure, so many of us out there searching for the elusive caring doctor.

  7. This is so true and should be given to every practicing physician everywhere!! Great post as always!!

  8. This article is so true in the past and even today, still. I have had Autonomic Dysautotomia for over 20 years (diagnosed 10 years ago). I am taking meds, but still have 'flare ups' that the docs still can't explain. Lost the love of my life because of this disease and possibly my job too (waiting for the bomb to drop here). Please find help for those who are in need!

  9. once again michelle you have hit the nail on the head. I was recently writing something similar to this, yet as usual my brain wasn't working correctly. with your permission I would like to print some of these off, and guerrilla post them on notice boards in hospital waiting rooms. hope that's ok with you? I have so much anger, so much lost of the twenty years of misdiagnoses. x

  10. If a doctor...any doctor had acted like that I would not have spent the years I have blaming myself and being too scared to try again. May every doctor and med student read this. Imagine how different life would be.

    Caroline xx

  11. I wish we could get the doctors to read this and understand.

  12. Bravo!!!!! If you admit to having an 'anxiety' disorder, this does happen, and did happen to me 6months ago. I am still suffering the consequences of severely high blood pressure that my 4 doctors cannot seem to "find the cause". And although I've had chest pains several times in the past couple of weeks, with BP in the stage 2 hypertension range, on 3 meds- I refuse to go back to the ER, only to be told it could be "anxiety" or "panic" and I should follow up with my psychiatrist. I told my pcp I want it in my medical chart that I KNOW this is not anxiety, I've had gad for many yrs, this just started 6 months ago- perhaps, I'll print this for my chart too.

  13. Hi, I'm new to your site and i have to say "I LOVE YOU!" not in a freaky kind of way :) I am newly diagnosed, but have been dealing with this for 2yrs. THANK YOU THANK YOU THANK YOU!!! for the validation

  14. I feel like I could've written this too!! Well said Michelle, THANK YOU!!!

  15. I am one of those people treated so poorly in the first few years of getting ill that I then avoided doctors for many years after, even as I continued to decline. I truly believe I developed PTSD from some of them. The very thought of having to see a doctor would put me in tears and coming up with every excuse possible to avoid it. In the last year I've had to face my demons (the doctors) because the decline was too much. I arrived at my first doctor appointment this year scared helpless of the doctors, shaking and weak, and neither the nurse or doctor could get a blood pressure reading or detect a peripheral pulse unless I was flat on my back. Needless to say, they sent me straight to the hospital. I got lucky then and while I have seen a LOT of specialists this year, MOST of them have been very kind even when they couldn't be helpful.

    Sadly, I have to wonder how many of these doctors would have been as kind had I seen them 10 years ago when my dysautonomia and other problems were milder. In all likelihood, many of them would have been just as dismissive, disrespectful, and maybe as cruel as most of the doctors I saw then. I think your letter is wonderful and should be required reading in medical schools.

  16. Oh I so agree with the first comment... hand out in every medical school and every medical facility! Bloody spot post and bloody brilliant words.


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