Thursday, April 12, 2007

The incomparable Dr. B

Is it strange to talk about the OB who followed you through the pregnancy that ended in stillbirth as the "wonderful" Dr. B? It might be, but the truth is that with Dr. B I lucked out. The OB I had five years ago up and left the state on me (how inconsiderate of him, really), so when I called the practice to say "I am one of your high risk patients, and my progesterone is falling again, and my doctor left the state," it was simple luck of the draw that landed me in Dr. B's pile.

My old doctor, Dr. G, was good-- he was attentive and knowledgeable, but also understanding and respectful of my desire for as little intervention as was strictly necessary, and he protected me from overeager chief and not so chief residents when necessary. This is not to say that all doctors in that practice are stellar. There is Dr. E who looks like Doogie Howser and whose lousy bedside manner and apparent inability to treat patients as distinct individuals made me want to kick him out of my labor room five years ago. There is also Dr. R who neglected to mention to a friend of mine that she is likely to zone out during her induction because she will be on relatively high doses of MgSO4 and who later refused to apologize for that. I only tell these stories to underscore how lucky I was to draw the long straw in the random assignment lottery.

So Dr. B. What can I say about Dr. B that will make you love him as much as I do? He has a very calm voice and is very very thoughtful. He is up on the latest research which is very important to a science nerd like myself. Not to mention beneficial. For example, I didn't have to drink the gross stuff they give you for the glucose test because he appreciated the fact that it makes me gag and that I don't ever consume that much sugar in one sitting. Instead I got to eat a sni*kers bar-- still gross, but much less so-- because he saw the research that indicated the results you get are as informative as in the torture everyone else undergoes. What else? Oh, yeah-- when considering what to do, he takes you as a human being into account. That, perhaps, is the key to why I love my OB-- he respects his patients and he treats us as individuals. I have encountered so many doctors who don't really listen, who assume they by definition understand what's going on with you better than you do. After all, they are the ones with the medical degree. It's refreshing to realize your doctor actually heard what you said the first time.

And did I mention that Dr. B is also unbelievably handsome? Which trait he carries in a soft and understated sort of way, as if he is slightly embarrassed by it. But only slightly.

So far I didn't mention the word compassion. That's because everything above I could've told you before A died. And after...

I ran into Dr. B on my way to triage and he told me he thought everything was fine (so did I, actually--haha), but that if it wasn't they would page him. That was a bit after 9pm. By the time I thought to ask if anyone paged him, it was past 11. He was in our room around 7 am the next morning. We talked and he said he will be back in a couple of hours to check on me. He was back in 30 minutes. To say he thought we should do the amnio now to make sure pathology would have good cells to work with for karyotyping and for determining whether infection is present. He did the amnio himself. I don't know what he was supposed to be doing that day, who he got to cover for him, or how long it took him to catch up. I just know I was glad that he was there and that he was trying to get us some answers.

So why am I writing about all of this today? Because I saw the incomparable Dr. B for a consult this morning. That, and I only started this blog yesterday, so I could use a longish entry right about now. Or something like that.

We talked since my hospital discharge, of course. We talked on the phone when the autopsy report came back, and at my six week follow up, where he handed us the copy of the report and talked to us about what he would recommend for "next time" in light of it. And he said to please call if we had any other questions after we read the full report. It took me a while to actually read it, but after I did, I had questions. So I called and talked to his nurse. She called me back that day to say he didn't want to rush through my questions and that he preferred to have me come in and talk. Would that be ok? Did I mention that I love my doctor?

So today was the day. He slated an hour for the consult. We actually talked for about an hour and a half. I brought PubMed printouts and we poured over those and came to a decision about my PCOS drugs in a future pregnancy (ask me if you want to know-- I am now up on the very latest research-- everything from insulin control to ovulation induction to reducing miscarriage rates to placental penetration, and everything that was published up to last week), but he is also going to look more into that before we decide what to do past the first trimester (ha! try getting there first!). We talked about the autopsy report a lot, about what we know (two true knots, acute asphyxia) and what we can only hypothesize about (evidence of strep B infection-- what does that mean?). And we talked about the statistics. Increased odds of bad shit happening in the future, being scared of those odds, working to minimize them. We talked as scientists and as a doctor and a patient at the same time. No pity, just compassion and respect.

He showed me pictures of knots and normal cord structures that can look like knots and explained for the upteenth time why these are so hard to see and distinguish on the ultrasound (previous explanations didn't include visual aids). But the decision on whether I would want to know if he saw a knot next time was mine. That respect thing again, apparently. Go figure.

Dr. B is clearly one of the good ones. But as I sat here writing all of this up, it occurred to me to ask whether he really is as exceptional as I think he is or whether I just had entirely too many bad doctor experiences before? Because we all sure as hell deserve a good doctor. The incredibly handsome part is optional, of course.


niobe said...

Well, it certainly sounds like you got a great doctor. Though it also sounds like you were a very well-informed patient -- which makes it much easier on both sides of the doctor-patient relationship.

I'd love to hear others' thoughts and experience, but for me, if I'd had a normal pregnancy and delivered two healthy babies, I doubt I'd even remember the doctor by now.

Aite said...

Two of my three REs approached me both as a patient and a fellow scientist. (This sometimes made for a strange experience with a learned conversation carried out during some procedure like hysteroscopy.) The latest one didn't even seem to be in an awful hurry, either. Not so much luck with OBs, as you well know.

S. said...

I was lucky with my last MFM--wonderful, skilled, and good looking as a bonus.

I am so very sorry for the loss of your child. I can't begin to imagine your pain and am just very sorry.