This article first appeared as a regular weekly column in The Finger Lakes Times (NY): http://www.fltimes.com/opinion/denim-spirit-laying-it-all-out-there/article_2268c406-dd85-11e6-8c75-e7886ea4be1f.html
I met a woman for the first time this week while sitting naked on a table. In fact, I met two women for the first time this week, both while buck-naked.
Well, that is not entirely true.
I was wearing one of those skimpy little gowns held gracefully by spaghetti strap around the neck, and open at the back to allow a cool breeze to lick the spine. No satin sheets in this scene, just a crinkly white paper runner protecting the fake leather upholstery.
One element of moving to a new place is making new connections with health care professionals, in addition to the network of other vendors of home, car, and happiness involved in building a life and sustaining a household. It stuck me this week as I sat (mostly) naked waiting for women I had never met to poke, prod, feel, and listen to my body, that they would probably never see me fully dressed.
Like most people, I look better with clothes on.
I prepared for both these occasions with an unusual degree of primping only to sit there exposed beneath an ugly cotton frock about which no one would ever say, “Oh, look at that cute little number.” I had taken a shower, made sure my nails were trim, searched for my least worn-out underwear, and carefully robed in clean cloths that matched with some degree of pleasing aesthetic. But neither doctor would ever see me dressed.
Sitting in the cold, waiting to be inspected, this quiet little outrage went viral in my thoughts.
How we dress speaks volumes about our health. Relative poverty or wealth are revealed by clothing, so too our attention to detail and hygiene. An interesting personal aesthetic verses obsessive attachment to style and image is also indicative of potential health and illness. While it is true we cannot completely judge a book by its cover, what we wear and how we wear it can suggest potential health issues to someone with a trained eye.
Alas, my new doctors may never see me as anything other than a pale and aging flesh bag tented by a thin cotton sheet no one could ever mistake for fashion. This is not only too bad from a personal relationship point of view, but from a diagnostic vantage point as well. Just one more travesty Obamacare did not address, so no wonder they junked it and left a gapping hole for people to fall through.
Seriously, what other profession greets a new customer at such disadvantage, and with so little attention given to simple hospitality and quality of relationship?
In the old days, physicians would visit the home and see people where they lived, and while there may have been far fewer medical resources back then, there was much more information about the patient available in the domestic setting. As Healthcare increased its focus on technology, pharmaceuticals, and enhanced incomes for doctors, it lessened its capacity and effectiveness for promoting wellness – which has to do with far more than biology.
My new doctors were great within the severe confines of the current business model for medicine, and their nurses were actually terrific. Yet it struck me once again, how far medicine has moved away from being a human service on its way to becoming a profit-centered commerce. Ironically, the US Healthcare “system” is the most expensive, and worst performing of all the Developed countries (Commonwealth Fund 2014 Report), which is what happens when business is in charge of delivering human services.
Many issues to be sure!
My strong advice is to treat medical care as the technical marvel that is, and thus to stay the h*ll away from it except when that technical help is needed. One of my old school mentors fondly recalls the days when the physician was the Health Rabbi for his patients – functioning as the learned, caring and guiding shepherd in the secular realm of health. I would say my experience is that this role has been taken over by the on-line, on-TV personalities that offer wellness, diet, and lifestyle advice 24/7.
What physicians have to offer is not just increasingly profit driven, but is strongly technically focused.
What to do when concerns arise that are not easily answered with the technical training and 12-minute visit?
I’m afraid that modern medicine won’t be good at that and someone else will have to fill that gap. Wisdom, which used to be prized, has been downgraded in importance quite a bit lately. Of course the traditional “payments” for such wisdom (respect, reverence, honor) have apparently lost their purchasing power as well.
The human-to-human exchange of caring and wise guidance will continue in some form or another. But it is a rare commodity to find in medicine.
That, my physician friend, is a sobering perspective as it comes from one inside the system and who is, by broad and loving reputation, a wise and caring doctor. Thank you for weighing in.
I agree about what you have to say. I certainly prefer it when I meet the doctor or LPN in my clothes first. And those gowns–they could do better, even by having a snap to close rather than those impossible-to-tie-behind-your-head little tapes. Maybe we need to make more of a fuss about this practice!
Maybe we should, but right now it seems we have bigger fish to fry! Thanks, and I’ll be thinking of you Saturday!