It’s 2020, and I’ve accidentally changed counties. As ridiculous as it sounds, that means my doctor who has been treating me for years is legally no longer allowed to, as the office only takes the Medi-Cal low-income free health insurance associated with [County #1].

After extensive calling around, I get a phone intake (no one is really doing in-person appointments in late March 2020). The doctor asks me personal questions for over an hour, for what was supposed to be a half-hour appointment.

I’m just scared about a lapse in my vital medications, so I’m trying to just bear it, but I have to go to work.

He calls me to finish the intake on a Sunday, on his own time, and asks me personal questions about my childhood and trauma for another hour and a half.

Eventually, I start begging him to refill my medications, offering to send a plethora of documentation. He refuses the documentation, accuses me of being medication-seeking, and says that he has to evaluate me himself to decide what meds I should be on.

He is the only doctor I could get an appointment with, so I am trying desperately to hold my tongue.

Me: “Can I suggest we go over what medications I’ve been on and why, just so you have a comprehensive history?”

Doctor: “I can agree to fill some of them, but not [specific medication]. You’re too fat for it.”

I am speechless for a bit.

Me: “How?”

Doctor: “It’s my discretion and—”

Me: *Interrupting* “Do you know much I weigh?”

Doctor: “Tell me.”

Me: “No.”

Doctor: “That just confirms it; since you don’t want to tell me, you must be fat.”

Me: “I weigh 157 pounds. I’m 5’7″ and I’ve been working out so much lately that I might actually be underweight.”

I shouldn’t have said that because he switches tactics.

Doctor: “You can’t have [specific medication] if you’re underweight.”

Me: “How much am I supposed to weigh, and how do you expect me to prove this?”

Doctor: “If you don’t stop being non-compliant, I won’t fill any of your meds.”

So, I shut up, even though that’s not really what non-compliant means.

I called his office to complain, and the receptionist said that she knows him well, that he is very nice, and that he would never do that, and then she hung up on me.

It actually got worse.

He put me on a new medication, threatened to stop treating me if I didn’t start taking it, and then wouldn’t listen to my complaints. My complaint was that it made me irritable to the point that the smallest thing would actually enrage me. I then snapped at him on the phone, and he started screaming at me. I pointed out that he was the professional, not me, so he screamed more, and my housemate had to remind me to de-escalate.

I had to keep sucking up to that guy for months, with increasingly bad health due to not having all of my medications, until I finally used my old address to re-enroll in my old county. I really hope he no longer practices medicine.

When I was little — about five years old — my mom took me to the dentist. Our dentist’s office was in a converted house which became a commercial building once it got surrounded by other businesses. It was a welcoming atmosphere.

When my time came to go back, the dentist came out to the lobby, called my name, and then, noting I shared a name with a spokes-cartoon for a popular cereal, he started calling me “Tiger”. He’d end up calling me “Tiger” for the next few years.

When he inevitably found I had cavities, he used some effective distraction techniques. For example, he pinched my gums where he was about to inject with Novacaine, repeatedly saying:

Dentist: “Just a little pinch here, just a pinch.”

Then, when the actual shot went in, he’d repeat:

Dentist: “Just a pinch.”

Because of this, I thought he was just pinching a little harder. He also had me look up so that he could get the syringe to my mouth without me seeing. Or when he started drilling, he said:

Dentist: “Here comes the tractor.”

And in my head, I’d just imagine a farm tractor, not realizing my teeth were getting drilled.

Years later, my mom worked for a different dentist, so I started going there. This doctor had no compunction about letting me see the needle, drill, or other implements. I got so nervous once when I needed two molars extracted that he had to give me a sedative in my arm so I’d be calm enough for the dental procedure.

I sure missed going to that other dentist…

I’ve been a professional computer programmer since 1978. I did programs for the first IBM PCs when they came out.

Around 1986, my wife got a job as a Gal Friday for a chiropractor. He was quite proud of his office computer for managing his practice. Since he knew I was a computer professional, he asked for my help with something.

When I sat at the computer to help, I noticed that there was a numbered menu on the screen and a standard DOS prompt to enter a command. I realized immediately that his “fantastic” office management program was just a collection of hastily-written little batch files, each of which would do its thing and then clear the screen and show a new list of numbered commands to use.

I typed “DIR” to see what was on his computer first. The doctor suddenly freaked out.

Doctor: “What did you do?! It’s all messed up now! You’d better get that back to normal.”

I patiently ran the initial batch file and the screen cleared up.

Doctor: *Suddenly quiet* “Oh.”

Me: “Just let me do my job, okay?”

As an OB/GYN, I often have my nurses come to me with questions from patients that have called them. One day, I got a rather unusual one.

Nurse: “A teen girl called and said she’s one of your patients, but she refused to give her identity. She wanted birth control and wanted to know if you would be willing to prescribe some to her even if her parents opposed it. She also asked whether doctor-patient privacy included your not being able to tell her parents she was requesting birth control or why. She wanted us to email her with an answer.”

The email address was clearly made just for this question; it was something blatant like “GiveMeBirthControlPlease at [website]”.

Me: “Relay to the girl that my requirement for confidentiality means I can’t tell anyone, even her guardians, about anything she doesn’t authorize me to. However, I can’t prescribe anything without seeing her first, and without her parent’s insurance to cover the costs, anything I prescribe to her will likely be too expensive for her to use. If she tries to use her parent’s insurance, then the birth control will likely show up on a statement her parents will see.”

After some back and forth with my nurse, the girl gave her real name and told the nurse she would have her mother bring her in, but she wanted me to know her goal was getting birth control so she wouldn’t have to say that in front of her mother. I had to look into my state’s legal laws about the consent of minors and guardians to ensure I understood what I was legally allowed to do for her when she arrived.  

Sometime later, I had a mother and a sixteen-year-old daughter show up at my office because the daughter was complaining of heavy periods with severe cramping and PMS symptoms. However, both her chart and my nurse reminded me that this was the same girl from earlier. I eventually told the mother that I prefer to have these discussions privately and requested that she leave me and the teen alone. The mother didn’t seem to like that but eventually left us.

Teen: “I do believe that my cramping and PMS symptoms may be worse than others’, but the symptoms haven’t changed recently, and I mostly exaggerated them to have an excuse for my mother to bring me here. My real goal is to get birth control.”

I have to compliment her research, though; if she did have the symptoms she had claimed, hormonal birth control would have been a likely thing for me to prescribe to alleviate the symptoms.

Teen: “I’ve already had sex twice, both times using a condom provided by my boyfriend. We’ve been together for a long time. I intend to keep having sex, but I noticed that my boyfriend’s condoms were expired, and he hadn’t been storing them carefully. I’m worried they may break if I keep depending on them.”

Me: “Did you talk to your boyfriend about this?”

Teen: “I told him I was worried, and he promised to only use new condoms and to take good care of them, but he also thinks I’m being kind of paranoid. I’m worried that he’s not going to take this seriously. I thought about getting my own condoms, but I have no privacy at home, so I’m sure my parents would find them, and they’d respond really badly to that. I want to go on the pill and keep using the condoms so I have two forms of protection in case either one fails. But my mother would never agree to birth control for that, and I can’t afford to pay for it on my own, so my only option is to convince her I’m getting the pills to help regulate my cycle, instead.”

Eventually, I prescribed her an oral contraceptive. When I told her mother, she immediately said:

Mother: “There is no way I am letting my daughter be on birth control! She is not a slut!”

Her daughter, who turned out to be an excellent actor, told her mother how terrible her periods were and pleaded with her mom to let her do anything to stop the pain she was having.

Me: “This is the standard treatment for the sort of symptoms your daughter has described. Studies show that access to birth control does not increase the odds of premarital sex in teens.”

This is true; I’ve always been shocked at how negligible a factor access to birth control is in a teen’s decision to have sex.

Me: “Your daughter seems like a smart and responsible young lady, and I think you should trust your daughter to make responsible decisions rather than deprive her of medical care she needs.”

This too was true, though I think my and the mother’s definitions of “responsible decisions” when it came to sex may have been different.

I was very careful to make sure everything I told the mother was factually accurate, even if I may have intentionally omitted a few key details. Eventually, the mother relented, but only after telling her daughter:

Mother: “If I ever catch you having sex, I will disown you.”

As the daughter left, she thanked me, and the look in her eyes seemed to stress how sincere her thanks really were.

I’m sure some people would be shocked that I misled the mother like that, even if my lies were only through omission. However, the mother was not my patient; her daughter was. My job was to get the daughter the care she needed, not to worry about her mother’s failure to recognize that vilifying sex did not change the odds of teens being sexually active.

I was very careful to meet all my legal obligations, but more importantly, I believe I met my moral obligations as a doctor by ensuring that my patient would be as safe and protected as I could make her. I would do it all over again without reservations if another teen ever came to me for help.

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I’ve recently had surgery, and while I expect to be hurting for a while, I’ve been in an incredible amount of pain — think nine to ten on the pain scale. I end up in the emergency room because I can’t even eat with the level of pain I’ve got. They call in the surgeon to inspect some imaging they did of me.

Surgeon: “Oh, you’re fine. Everything went well. You’ll just hurt for a while.”

Me: “Something isn’t right. It took two rounds of morphine to get the pain down to just a tolerable level. I don’t think that’s typical.”

Surgeon: “Nah, it is. Just go home and take your [pain medication] as needed.”

I miserably go home. A friend tries to cheer me up by taking me out of the house a couple of days later. He notices that I’m not doing well at all, even loaded up on pain meds.

Friend: “[My Name], you should call your doctor.”

Me: “I went to [Hospital #1], and the surgeon said I was fine. I guess it’s just gonna suck for a bit.”

Friend: “No, you shouldn’t be in this amount of pain. Come on, I’m taking you to [Hospital #2]. I want you to get a second opinion.”

I don’t have the energy to argue. He takes me to the second ER. They do some imaging and testing, and within a couple of hours, the doctor comes into my room.

Doctor: “So, it looks like something happened with the surgery. We’re going to admit you for a bit to try and get this fixed. You should have gone into the ER sooner with the level of pain you’re at.”

I explain to him what happened at my previous visit. I make sure to include that the surgeon said it was completely fine and normal.

Doctor: *Pauses* “I see. I’m glad you came here, at least. Let’s get you started on [medications] so we can get you where you need to be.”

I am in the hospital for a few days, being pumped full of lots of medications. Because of the painkillers they have me on, I’m not sure what they say is wrong, but they clear me to go home about five days later.

As I’m being discharged, I get a call from the surgeon’s office.

Receptionist: “Hi. We want to schedule your post-op follow-up with [Surgeon] in three weeks!”

Me: “Actually, I’m good. Thanks. Bye.”

The second hospital got me in to see a doctor associated with them for my follow-ups. While I do still have side effects from the complications, they’re luckily minor. I make sure to tell everyone to avoid the surgeon now.