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No more Mr. Nice Girl

As some of you may know, I had a checkup at my neurologist’s office early Monday morning. In a post a couple weeks back, I showed you the letter I wrote to him requesting that he be the only person I see during my visit. I suppose I shouldn’t have been surprised to receive a call from his assistant/receptionist person and not him. She started out the voicemail all wrong, calling me by the wrong name (the name she chose, and quickly corrected, is one I really dislike–though it sounds a lot like my first name, it drives me NUTS when people call me it; in seventh grade I won the most prestigious award in school and the principal announced this name instead of my own–ew!). She had a message from Dr. _____ himself for me (if they talked about it, why couldn’t he have called me himself): he wanted me to know that he takes the time to see every single patient at each visit but that it’s just not possible to guarantee that I’d have my visit with only him. The point that he visits with every single patient was reiterated twice. (Um, shouldn’t a doctor see his patient? Am I to feel honored that he bothers with a personal visit at all?)

I was not impressed with the outcome.

On Monday morning, I showed up on time for my appointment, having commuted the night before. (I slept at a friend’s house in the big city so I could be ready and rarin’ to go in the a.m.) I asked told the never-smiling-yet-never-exactly-rude receptionist (NOT the one who called me, mind you) that I requested to visit with just Dr. _____, even if it meant waiting a little longer for the appointment to start. She was, to put it mildly, unhelpful. “There’s probably no way that can happen,” she began unapologetically. “That’s just not how it works. We have to follow protocol, and there’s no way to know in advance who’s going to be free to take you back for your initial consult.”

“I understand that. I did write a letter requesting this, though, and–”
(Interrupting): “That’s just not how it works. It doesn’t matter if you write a letter or call or ask now, you just go back with whoever’s free.” Interrupting. Unsmiling. Unhelpful.

I retreated tearfully to the fluorescently-lit waiting room, adding one last deflated, “I get it, but for the record, that’s my request.” I lost.

Moments later, my Least Favorite Nurse Practitioner emerged. She’s the entire reason I ever began requesting neurologist-only visits; though my request was only granted once in a few years, I did have the good fortune of having a better NP take me back for the initial consult during my last several visits. To my relief, she called back the only other patient waiting with me. A moment later, that patient reemerged and she said, “I’m sorry–I meant to call you, ____. I haven’t had my coffee this morning.” “Neither have I, no problem,” I said, hoping that for once we had established some kind of friendly banter.

We walked into the room in which the patient sits and answers questions using the frustratingly simplistic Likert scale questionnaire. The shades on the windows, which cover an entire wall, were all drawn. The overhead fluorescent light was only feet above me, ready to start an attack. “Do you mind if we dim the lights a little?” I asked in what I heard as a pleasant voice. Nearly every doctor or professor or any other person with lights like this I have seen in the last few years has been more than accommodating when I make this request–surely someone who specializes in migraine treatment would understand, eh?

Wrong.

“Um…we could, but I wouldn’t be able to see,” she said. I am not one to assume folks are talking down to me; in fact, when I find out that someone isn’t a big fan of mine I tend to be pretty shocked. Therefore I do not think I was imagining the slight touch of patronization in her tone. (Duh! Darkness means you can’t see! Why didn’t I think of that? I guess I was foolish to believe that she could open the blinds and let the sunlight come in. I’m so dumb.)

Cue the teary eyes again. I knew this wasn’t going to go my way.

She asked me the open-ended question, “How have your migraines been?” but only listened for the first couple seconds. She had opened my file and was reading the letter I’d written to the doctor, the letter in which I requested I not be seen by the likes of her. Great. She zoned out while I talked about my condition. This was probably extraordinarily productive, and it certainly made me feel as if she cared. Ha.

We began the classic “On a scale of zero through three, how bad have your headaches been? How many days have you missed work? How many social events have you missed?” routine. Any time (seriously–ANY time) I tried to clarify my answer (“Well, that’s a 2, but only if I’ve had alcohol the night before…”), she looked at me or the computer screen blankly, finger hovering over the mouse button, waiting for me to end. Every time I was finishing my explanation she’d cut me off with, “Okay,” and then launch into the next question. GRRRRR!!!!

The visit with the neuro. was okay. The NP had updated him on my answers, my weight, and all that jazz, so he just had some questions about how well I was tolerating the Petadolex and wondered if I wanted to try Imitrex. “You’ve never been on that, right?” he asked, repeating the question she’d asked me. “Uh, yes. For three years or more.” “Oh.” Thanks for reading my file before my visit. (Granted, this error in forgetfulness would have been excusable had I not had the buildup of frustration already.) He slapped his legs lightly with the palms of his hands, indicating he was about to stand up and walk out. “Oh, I do have a long list of questions for you.” Boom. There I go taking the visit into my own hands. Go me! Except it didn’t feel good, or victorious, or especially helpful. I felt beaten down and rushed despite his understanding smile and pretty good answers.

I think it’s time for a new doctor.

Thanks for bearing with me.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Liz
    10 years ago

    I just discovered your blog, hence my commenting on something over a year old. I also have chronic migraines and have had to ditch my neurologist recently.

    I loved my doctor. She's the first doctor who I saw just after my migraines developed (8 years ago) that I didn't feel was patronizing me. She understood what I was going through and seemed to care about me as a person. Fast forward to two years ago and she adds a nurse practitioner intern to her practice. I was ok with her sitting in with me and the doctor during my visits and watching my botox injections. However, this np was then hired full-time and I began to see her during my appointments, not my doctor. I found it weird that I was paying tons of money to go to a doctor that I wasn't seeing. And to add to that, the np wasn't friendly. She was nice enough if the doctor was around, but if she was just around me she wouldn't even say hello or acknowledge that she knew me in any way, shape or form.

    The last straw, however, was when my doctor left to volunteer abroad. The practice has been left in the NPs hands for a year and she recently hired someone qualified to do botox injections. I discontinued botox over a year ago as I could not justify the cost for something that wasn't completely getting rid of my migraines, yet I've been sent numerous letters asking me if I'd like to renew my interest in the botox because this man is working on commission and would really like to see me.

    Oh, I'm sorry, you're supposed to care about the fact that the $3000 I was spending ever 4-6 months wasn't doing anything for me and not the fact that you were getting $6000 a year. Goodbye Ms. NP.

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