The Hell of the Angry Patient

Greetings from Knoxville, TN.  I’ve returned to a former “home” — lived in Farragut, a suburb, for many years, but left in the early 1990s.  I’d forgotten how beautiful it is, and how lovely the people are.  Feel like I’m home again….

But I digress. 

I wanted to share a theme that has run through a half dozen conversations in the past week or so. As I think about it, I realize that patients who understand the concept, and doctors who acknowledge and address it, will all find better outcomes.

It’s the concept of the angry patient; patients who have suffered at the hands of the healthcare system in some way, or perhaps love someone who has suffered.  They have been misdiagnosed, or have gone undiagnosed, or perhaps have experienced a medical error.  A loved one may have needlessly died. 

The angry patient becomes distrustful and generalizes his/her anger toward all healthcare providers; not just the one who perpetrated the crime against his/her health. 

The angry patient puts up tall, strong barriers because of that distrust.

The angry patient, when presented with new symptoms, or when returning to see his doctor, or when seeking another opinion or follow up care, cops an attitude and instantly puts everyone on the defensive.  S/he expects substandard decision-making and care.  And too often, that’s exactly what s/he gets.

How do I know this?  How can I so completely describe the scenario?  Because one result of my own misdiagnosis was my descent into the hell of the angry patient.

It’s easy to see how it happens.  We are raised to trust and respect healthcare providers.  And when that trust is broken in any way, we feel violated.  Since healthcare can’t be avoided — we will always have some type of medical or health challenge — that forces us to return to the abuser(s) for our care, despite the fact that we don’t trust them.

A woman who has been violated, raped or in some way abused by her partner is counseled to walk away and never return to that person because that partner will likely abuse her again.  But the violated patient must return to someone who represents a SYSTEM that has violated him or her.  S/he has no choice but to return to the system that violated him/her.

As a result, s/he uses anger as a shield, as a way to protect him/herself from getting hurt again.

Are you an angry patient, too?  If so, let me share with you some of the wisdom that’s been shared with me, and the thoughts I force through my mind each time I must return to a doctor…. 

We’ll start with the fact that NO doctor ever intends to cause a bigger problem than we arrive at her office with.  Doctors all want to fix us, make us well, get us back on our feet.  They aren’t always capable of it;  but that’s most definitely their goal.

From there we need to understand that we patients need to be fully engaged in the process — from being completely honest to complying with the doctor’s orders, we can’t expect any healthcare provider to overcome a problem that we, the patients, aren’t 100% open to, and invested in fixing, too.

Doctors don’t want to hear complaints about other doctors.  That doesn’t mean you can’t or shouldn’t share those complaints;  in fact, I think it’s important that providers get feedback about their colleagues, especially if a referral has been made.  I’ve even blogged about that before.  But there are ways of delivering feedback about your experiences with others that don’t put all parties on the defensive…  “Doctor, I’d like to share an experience I had and ask for your advice on how to deal with it….” is a whole lot better than, “Let me tell you what a quack Dr. So-and-So is!”  You get the picture.

The more you partner with a provider, and the more little successes you find together, the better will be your ability to separate from that anger.  It’s an opportunity — or maybe a requirement — that you both work through the differences and move on.  This is true whether you are returning to the scene of the previous error/crime — or — whether you are starting all over again.

Don’t hang on to your anger for no other reason than to hang on.  If the system or the provider continue to violate you, then by all means, hang on to your anger!  It may be protecting you to some extent.

But more often whatever happened to you or your loved one is past, and it’s time to move on to acceptance.  Elizabeth Kubler Ross described the five stages of grief as they relate to death and dying.  Anger is the second, and possibly the one that wounds the process of getting beyond the violation.  Don’t grieve the violation forever.  You need to let go eventually in order to move on.

Learn to forgive.  I was the angriest at the two pathology lab directors and the first oncologist I saw who were involved in my odyssey.  I’ve had conversations with the two lab directors and based on those conversations, I was able to forgive them.  I’ve never had a conversation with the oncologist — he was far too arrogant and far too self-righteous to make that happen.  However, I’ve forgiven him many times over.  After all, if he hadn’t been such an arrogant b*st*rd about the whole thing, I would never have changed careers to this advocacy work.  And nothing in my life has ever been so rewarding as this work. 

Don’t forget:  everything happens for a reason.

Tomorrow I’ll write about the doctor’s side of this trust equation, and how they and other providers can actually acknowledge and help heal the angry patient’s trust wounds.

For now it’s time to step outside to enjoy a bit of Knoxville again. 

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