I’ve been for treatment in almost every conceivable kind of facility it’s possible to be treated in and just a few where it was impossible to get treated. In this wide variety of experiences, I’ve always been alarmed by how much lipservice is payed – especially in fiction – to the narrative of the experience of the medical professional. The patient on the other hand usual has their experience relegated to morbid tabloid rag columns about proceedures gone wrong or to trying to claim $5000 for the sort of grievance people with chronic illness go through on a daily basis.
If then, there is some kind of insurmountable conflict that crops up every time I find myself in a hopital or somewhere like it, does it suggest something fundamentally wrong with the Doctor-Patient relationship?
The first thing to note is that responsibility for the standard of care starts and ends with the doctor that is providing it. Money makes for a very small amount of difference. Often the so called world-class institutions we can pay for if we really fork out use their inflated sense of just how good they are to push the paternalistic angle to dangerous levels. This is to say that when my family, with the very best of intentions, chose a very particular mental hospital to commit me to during one of my manic periods in my 20s, they were powerless to know that this hospital, just a few blocks away from some of from some of the leading hospitals anywhere in America, functioned more like a school for naughty children.
It wasn’t hard to act up under that pretense, to make a mockery of the way your treated, even if it’s a coping mechanism. Someone who finds themselves in one of these insitutions, something that patients are repeatedly being told to consider doing voluntarily, can be expected to be schooled, not cared for. Intelligent solutions give way to parternalistic condemnation of you and your behaviour and your coping strategies and individual care all to often gives way to the conveyor belt approach to treatment. I was put through the wringer and the chopping blades and I was all the worse off for it. The drugs and invasive treatments I was plied with were not the same thing as treating a serious illness or even treating my symptoms individually. What were any of us in there going to do? We had already been categorised as children.
It was impossible to respect this lack of respect. To reciprocate in the Doctor-Patient relationship was made as difficult as getting along with a condesending parent, an arrogant colleague and a detached bureaucrat silmultaneously. Restricting the bloodflow to the all important dialogue that’s going to individualise your experience of getting better. It’s no coincidence that a whole raft of these issues dissapeared once I invested time in psychotherapy, a form of treatment that realies entirely on said dialogue.
If you’re not privledged enough to get yourself into this form of treatment and the people who are treating you aren’t dilligent enough to tailor they’re approach to the individual you are, all the treatment you receive is going to fall on a scale of being progressively more invasive. Take for example the old headline grabber Electro Convulsive Therapy. I’ve been seeking treatment for this illness from the time that the controversial method did indeed resemble a torture technique up until the most modern version – painless, fast, quiet but the requirement of the patient to be poked at and for their reaction to be studied. No physician has ever been able to answer why people in their profession default to this persistance with tests and examinations as if the patient really is back in school – only to point vaguely to the notion that all our minds and bodies are inherantly different anyway, should said tests not go their way.
This is a perfect set of excuses economically too. The patient’s convalesence gets longer and longer, granting more revenue from any financial incentives the hospital has from keeping a certain number of patients but the necessity of these tests and whether or not their expense can be spared is placed entirely in the hands of the hospital and the Doctors running it; they don’t know and you don’t know if it’s even something you should be doing.
All that being said, the way in which you’re treated and the way in which your mood is allowed to be elevated can solve an astonishing amount of these issues. During my own hospitalisations, I went to the very same institution. But simply by virtue of having access to interactions and activities that could elevate my mood and help me feel less depressed and pessimistic about my situation, I found myself more willing to engage – and when I did, I was doing it with staff members and fellow patients who had a more vibrant sense of my personality, and of just how very individual Bipolar disorder is. Fascinating, then, that being allowed to doss around in a common area with a couple of likeminded individuals was the alleviation I was searching for – rather than the latest piece of experimental treatment.
