Trust is precious and, yet, in our daily lives, we give it out freely. Sometimes to our great detriment. And yet, what choice do we have?
I forget the context, but someone once pointed out to me the everyday trust we place in the people we pass on the street. This lesson sunk in deep after my car was broken into with the intent to steal it. For weeks, I shook inside every time I passed someone I didn’t know on the street. I still struggled with this two and a half months later, when I got sick with what became Long COVID….What a way to get hit on the head to forget about the pain in a stubbed toe.
In her memoir Golem Girl, Riva Lehrer exemplifies the fragile two-way street of trust in medical care through the heartbreaking story of her mother. Carole Lehrer slipped and fell on a snowy winter day injuring her back to the point that she needed surgery. After the surgery, the medical team did not trust her when she complained about continued severe pain. When it was too late to prevent permanent damage, they went back in and found that the surgeon had left either a sponge or gauze next to her spine. Carole Lehrer’s subsequent medical malpractice lawsuit against her surgeon fell apart when the medical community closed ranks to protect one of its own…despite the frequency with which he made mistakes like the one with Carole.
Lehrer’s story reminded me that I have been placing an immense amount of trust in numerous medical professionals who are complete strangers throughout my Long COVID journey and that my mostly positive outcomes are not guaranteed.
The most risky of these was the trust I placed in my endometriosis surgeon.1 I agreed to the surgery after having only had 15 minutes with the surgeon. I placed my trust in her for three reasons. First, the person who had referred me gave a glowing review of the medical practice, although they were not familiar with the surgeon I got assigned. Second, in the 15 minutes the surgeon spent with me in our consultation session, she exuded a blend of efficiency, competence, and compassion. Third, nothing about her raised any red flags in my gut. The outcome of the surgery rewarded my trust.
Lehrer’s story also reminded me of a time when my trust was betrayed by a medical practitioner, though without the severity of effects of her mother’s experience. In my teens, my canine teeth were impacted and I required orthodontia care. My mother took me to two orthodontists for assessment and let me lead the decision on which one to go to for treatment. I liked the quiet and plain office of the first orthodontist, but he said the only way to fit my canines was to remove two molars. The second orthodontist had a flashy office with personal tv screens mounted to the ceiling above each of the exam chairs placed in a round. He said by using a palate expander we could probably create enough space for the canines without removing any other teeth.
I liked the idea of keeping all my teeth so I chose the second orthodontist because of his treatment plan when by every other criteria I would have far preferred the first one. After months of pain as I nightly turned the key to spread my palate wider, we gained a few millimeters of space, but not enough to fit both canines and so I lost my first molars on each side anyway. I was devastated by this betrayal. I had put up with his flashy, loud office and flashy, loud staff to keep my teeth. If I had known I would lose them anyway, I would have chosen the calm and quiet first orthodontist. Not to mention that I would, presumably, have avoided the pain of the palate expander and the groove it cut into my tongue, which is still there.2
When you need medical care, you sometimes don’t have time to make a choice. For example, I don’t remember meeting my surgeon before my emergency appendectomy. When you do have time to make a choice, you may only be given 15 minutes on which to base the decision. But like the case with my endometriosis, I only got a choice on the surgeon, not the 6-8 other people in the room. In any case, we place an immense amount of trust in the people who treat our bodies.
Unfortunately, as Carole Lehrer’s story illustrates, there are incompetent people in the medical field just like any other field. There are also people who are competent who may just have a bad day. Carole’s story reminded me that we take huge risks when accepting medical care (hence the waivers and acknowledgements required before colonoscopies and other surgeries). It leaves me wondering if there is a way to mitigate the risk and to ensure timely medical care without becoming prey to the incompetent.
- Although, my endoscopy/colonoscopy was perhaps even more risky as I met the surgeon about 60 seconds before going under. ↩︎
- Granted there is a possibility that the first orthodontist may have found after extracting my molars that there still wasn’t enough room in my jaw to straighten all my teeth and so he may have also put me on a palate expander. ↩︎
Feature image credit: trust by ramacae from Noun Project (CC BY 3.0)
Carolyn Ristau 