still no diagnosis

[The Female Eunuch]

Hi all,

today I got a chance to ask my GP whether Cloacal Exstrophy is the correct diagnosis for the condition I was born with. He said he didn't know, and that he had never heard of Cloacal Exstrophy, or any other label that describes what I was born with. He suggested I could ask my urologist. I'm not seeing my urologist again until next year (which is annoying as I am waiting for an operation from him), and I generally don't find him a useful source of information. I'll ask him, but it looks like I may continue not to have any diagnosis. My body will continue to be a mystery.

cheers,
Caroline

[fraulein_Maria]

[QUOTE=The Female Eunuch;18650]Hi all,

today I got a chance to ask my GP whether Cloacal Exstrophy is the correct diagnosis for the condition I was born with. He said he didn't know, and that he had never heard of Cloacal Exstrophy, or any other label that describes what I was born with.

>>> Well, at least he was honest. Truthfully, i would not expect a GP to know. My condition is far more common; and far more common in the part of the world and nation in which i live, yet my GP had not heard of it either. She has literally been cracking the books and googling just so that we can have an intelligent conversation about it. I hear from a bunch of others right here on this site, the same story told.
Its not there fault that what we have is rare. You can't cover everything in med school, and a heart specialist will know even less about us than a GP.<<

He suggested I could ask my urologist.

>>> good advice, if passing the buck. i would suggest finding a GP that gives a shit about you as a person... such a doctor actually might care enough to educate himself, instead of just collect his fee. <<<

I'm not seeing my urologist again until next year (which is annoying as I am waiting for an operation from him), and I generally don't find him a useful source of information. I'll ask him, but it looks like I may continue not to have any diagnosis. My body will continue to be a mystery.

>>> you do not have a Dx, but you've consented to surgery? Here, they will not operate without one, unless its officially an exploratory... though with MRI's, C-T's, PET's and the next gen. 4-D ultrasound, this is becoming far less necessary. Something is rotton in Denmark... but i don't think its you.

[Kailana]

its the belief that not knowing is better then knowing. Many doctors still think it is better to withhold any information that they think could be detrimental to you, your family, or could cause you to have issues such as violence, rage, assault against one of their staff members. That is why getting a dx is difficult, or getting complete records. They could cause lots of issues that hospitals do not want to have to deal with so instead they tell you nothing, and release nothing, which all by itself cuases tons of problems, and trauma that again no-one is will to acknowledge that they "the hospital and doctors" actually cause.

[JOS]

I keep coming up against this phrase

"a patients right NOT to know"

people keep saying this and I still cannot get my head around it?

it just seems like people are so worried about the consequences to them they forget that there ARE consequences to not telling too.

I agree with the sentiment of surrounding yourself with professionals who can be honest enough to admit they don't know the answer yet but are dedicated enough to help you find out! :smash: (easy to say!!!)

big hug
Jos

[Kailana]

I keep coming up against this phrase

"a patients right NOT to know"

people keep saying this and I still cannot get my head around it?

it just seems like people are so worried about the consequences to them they forget that there ARE consequences to not telling too.

big hug
Jos

thank you for mentioning Jos. I agree with the consequences to people like us who know what we need better understanding of what has happened. The answers are desperately needed by many of us. Personally I would hope no doctor ever force answers onto any of us, but would patiently wait for the time when we become needy? desire to know what has been done. When we need to know, answers should be there, surgical reports released, all medical information provided, because by the time we are ready to hear what happened, is the time when we really need to understand what we are and not getting answers is to me, one huge problem that i think is still making my life extremely difficult to accept. Sort of like, I feel that without those answers I am instead getting treated with even more bigotry and discrimination rather then getting or feeling that I am beng accepted for who I am. Does that make any sense at all?

[fraulein_Maria]

[QUOTE=JOS;18659]I keep coming up against this phrase

"a patients right NOT to know"

>>> who says shit like that? its certainly NOT in the patients bill of rights, there is no such "right" that i have been aware of... it sounds more like a doctors excuse for negligence and mal-practice... since there IS a patients bill of rights, that says the very opposite. <<<

people keep saying this

>>> what people? smart-ass like me would be tempted to say that they have the right not to know... that i have hacked there computer, and will be helping myself to what's inside, and screw them if they don't like it. Haven't our bodies been hacked? <<<

and I still cannot get my head around it?

>>> umm, because it sounds ORWELLIAN? like "war is peace" "fucking for virginity" etc? <<<

[Peter]

Hi Maria,

I agree that "a patient's right not to know." is like "fucking for virginity". Perhaps, if a person expresses a desire not to know all the details of a terminal illness, that is something that they can express to their doctor. However, when a few years ago, a person won an ethics essay contest in Canada for promoting not telling AIS women of their condition, that was truely Orwellian. Intersex people get fucked to preserve the virginity of others. That is even worse than "fucking for virginity". Not telling a person whether or not they have Cloacal Exstrophy, as in Caroline's case, is mean-spirited. Maybe, one particular doctor does not know the answer, but a lifetime of secrecy and shame is wrong. But then again, when I asked the March of Dimes national archives for my own personal infant medical records for treatments my parents said that the March of Dimes funded, I was not able to get anything out of them.

Peter

[peaceandparty]

i really wish i was more of a science head so that i could understand the whole ins and outs of everything
but the reality is i dont understand a lit because i always hated science in school!

it was hard for me when i got told i was xxy
because then i knew i would have to at least get into understanding genetics a bit more....i absolutely hated the idea of genetics in school
so...as i read as much as i can on BLO and other places...i thank all of you for speaking out and spreading the information even if i dont get it all the time

its certainly better explained for me than nedical textbooks!

thanks a lot everyone

and tajke care
peace be with you all always
all for one and one for all
we are all one but we are not the same

[fraulein_Maria]

[QUOTE=Peter;18671]Hi Maria,

Intersex people get fucked to preserve the virginity of others.

>>> oh the virgin eyes, ears and minds of "norm-borns". pass there women some valium because the ladies can't handle the pain and mess of child-birth, pass there men some hard liquer and cigars because they would not be caught dead anywhere near a delivery room....

Wait a second... that's the '50's and of course we have grown out of that right??? except those are the values of the doctors still treating us and deciding policy for us today. <<<

That is even worse than "fucking for virginity". Not telling a person whether or not they have Cloacal Exstrophy, as in Caroline's case, is mean-spirited.

>>> i agree. i almost wish it were happening in NYC just so she could sue the shit out of them and have the devil himself for a lawyer. <<<

But then again, when I asked the March of Dimes national archives for my own personal infant medical records for treatments my parents said that the March of Dimes funded, I was not able to get anything out of them.

>>> i've suggested what i'm about to say to someone else here privately, but i think the advice is both useful and generic enough to be helpful to some here.....

You Peter, and some others, have doubtlessly been photographed and made TEXTBOOK examples of.....

perhaps its time to find the textbooks and journal articles that refer to us as sources of answers.

So many here MUST have been written up as case studies. Our personal medical records may not be findable... but the trail may not be cold. The records that exist on us as LAB RATS still exist SOMEWHERE.

In that sense, the rarer your condition... the easier it will be to "find yourself".

Though i still don't have my birth records... Dr. Herzog did me a wonderful service by asking me if i minded if he included my story in an article he was writing for a neurological newsletter.....

It got me thinking about how far from our genitals and gonads our stories go... i would have thought myself more likely to be written up in "dermatology today...'beardless CAH gal; a myth?"

But no, he was interested in the fact that emergency cortisol therapy for a severre allergic reaction had the serendipitous effect of calming the nerves of moi. (more like tamed the savage beast, but he was kind ;)

[namaste]

its the belief that not knowing is better then knowing. Many doctors still think it is better to withhold any information that they think could be detrimental to you, your family, or could cause you to have issues such as violence, rage, assault against one of their staff members. That is why getting a dx is difficult, or getting complete records. They could cause lots of issues that hospitals do not want to have to deal with so instead they tell you nothing, and release nothing, which all by itself cuases tons of problems, and trauma that again no-one is will to acknowledge that they "the hospital and doctors" actually cause.

Having worked in a hospital for four years as an administrator in charge of medical records in the Department of Radiology, I'm wondering how you're going about asking for your medical records. Are you sending written requests by certified mail? Are you getting a lawyer involved? Are you actually talking with the secretaries, clerks, or administrators? Are you going to the medical records department? Or are you asking your nurse and/or doctor for the records?

Oddly enough, asking your doctor for your medical records is possibly the least effective way of getting them. First of all, most doctors are incredibly busy, and it's not uncommon for them to see upwards of 40 to 60 patients a day, so it gets *very* easy for things to get lost in the shuffle. Second, in larger hospitals, there is a specific department that's set up to handle copying medical records for people. If one doesn't go to the medical records dept, it's like asking someone from facilities to work an x-ray machine. You're simply asking the wrong person to do the job. Third, you would simply not believe the immense amount of paper work that goes on in a hospital. If you want something to be prioritized and to get done, there needs to be a tracking number. Certified mail is a good way to generate a tracking number and require that somebody respond to you.

I really had no idea so much paper work and bureaucracy went on at a hospital until I got a job at one. And the complaints you're writing about... I think they're common complaints to any number of people with various conditions. And to be perfectly frank, intersex conditions usually aren't immediately life threatening. If you go visit an endocrinologist at a large hospital, and the person behind you is a diabetic with a sugar count of 500, guess who's records are being put on hold and being ignored until the life threatening condition is resolved?

FYI, in the Department of Radiology that I used to work at, we would receive a lawsuit about once a week, and would receive probably 20 subpoenas a week. We were a 600 bed hospital, and did 150,000 cases a year, and this was considered fairly typical. We were a medium sized community hospital. With that kind of work load, an issue generally didn't get our attention unless somebody was about to die or there was a lawyer involved. And if there was something complicated or technical about a particular issue, well, it would often sit on a desk in limbo, waiting for the issue to expire and go away or for the right person to get to it. I've seen turn-around times for exams easily go into the multiple months when it's not a meat-and-potato problem that people know how to solve right away.

And for what it's worth, in my four years as an administrator at a community hospital, I never heard the phrase 'a patients right not to know' a single time. I'm really not sure what you're talking about. Who, specifically, has been saying that?

Anyhow, I read through this thread, and my gut reaction is 'somebody isn't working the bureaucracy correctly'.

[The Female Eunuch]

Maria wrote:>>> good advice, if passing the buck. i would suggest finding a GP that gives a shit about you as a person... such a doctor actually might care enough to educate himself, instead of just collect his fee. <<<

I think my GP does care about me. He's usually much more willing to explain things than any other GP I've been to, he doesn't seem to make the mistake of prescribing medicines that are contraindicated for other problems I have, like other doctors have done. Far from wanting to change GPs, I'm worried that I may have to get a new GP soon, because he's nearing retirement age. Part of the reason I'm not optimistic about getting the information out of my urologist is that I get the impression that he's not interested in communicating with his patients.


>>> you do not have a Dx, but you've consented to surgery? Here, they will not operate without one, unless its officially an exploratory...

Well, I've had surgery 31 times before, and as far as I know, they didn't need a label for my medical condition for any of them - just an understanding of the particular problem they were operating on, and maybe a label for it. And I've had this particular operation 4 times before. This surgery is to replace an artificial urinary sphincter, which has broken. The artificial sphincter is to take the place of the muscle that holds urine in the bladder, because my bladder doesn't have any such muscle due to congenital malformations. The anatomical abnormalities of my bladder are reasonably well documented and understood, even if the cause isn't known.


Something is rotton in Denmark... but i don't think its you.

well, it wouldn't be me if it's in Denmark, would it? I'm in New Zealand, which isn't even named after the largest island in Denmark - it's named after another place with the same name.

cheers,
Caroline

[namaste]

Part of the reason I'm not optimistic about getting the information out of my urologist is that I get the impression that he's not interested in communicating with his patients.

For what it's worth, that attitude is really common with Doctors. Most of them would like to be left alone and not bothered, but it doesn't work out that way. They're bombarded around the clock with difficult questions and scenarios, and are expected to know everything. Often, they want nothing more than to hide in an office and to be left alone to catch up on work. And dealing with abnormal conditions that don't have any clear resolutions?

Having worked in a hospital, I'll describe the thinking and mentality of the majority of doctors out there. I'm not saying its right, but it's how they look at things:

On the one hand, your urologist could have a meat-and-potato case, like a case of genital warts. Simple diagnosis, simple solution. Apply some cream or schedule a time to remove the warts with a scalpel; collect some money; go on to next patient or call it day. On the other hand, your urologist could have a really rare case, with a patient that has a medical history a mile long and with dozens of surgeries. Getting involved means increasing liability in the case that something goes wrong; there's no clear solution on how to handle certain situations; and there's very little reference material to consult on how to do things. So, it becomes a choice for them: easy quick fix case with clear reimbursement, or complicated case with liability issues.

To make a long story short, their anxiety goes up when dealing with cases that aren't 'meat and potato' cases, as they call them. I hate to say it, but they're a distinct chance that your urologist might be nervous or anxious about working with you. So, you might want to consider doing what you can to put him at ease. I know it may sound silly or trite, but I'd recommend bringing a thank-you card and some chocolates, or other sweets to your next visit. Maybe a fruit basket for the Doctor's staff? You have no idea how far those little things go. Whenever we would receive a fruit basket or chocolates from patients, the entire office would be abuzz for days about how nice and how thoughtful that patient was, and their paperwork would go to the top of the pile to be expedited. The patients that got the most buzz were the ones that brought in chocolates and fruit baskets that would sit around the office for a week.

I'm not saying that's how things should be, or that it's right that people react to little bribes that way... any patient should be able to get quality healthcare without resorting to those kinds of things. But healthcare workers are people also, and they respond to the little things, like thank you letters and sweets. Particularly the staff. If you write a glowing letter of thanks, it will get posted in the hallway or the staff lounge for people to read. Which is something to consider. The meat-and-potatos case of warts doesn't make nearly as good of a thank you letter trophy as the thank-you letter from someone who is intersexed. So, for what it's worth, a thank you letter from you carries a lot more weight than a thank-you card from a meat-and-potatoes patient. Again, not saying that it should work way; but the people who offer healthcare workers rewards in the form of sweets and thank you letters get better attention than those who don't.

And for the record, Surgeons tend to be worse than Doctors, because Surgeons tend to see people as slabs of meat to cut into. Sad, but true. I've met so many Surgeons that have completely wrecked social lives because of their profession, and how it's made them view people. Becoming a Surgeon comes with a very high price in terms of happiness and being able to relate to others. So, there could be a chance that your Urologist simply has a wrecked social life and doesn't communicate with *anybody* very well. But chocolates and thank-you letters won't hurt.

Anyhow, just $0.02 on how to get the doctor and staff to communicate with you.

[prince....ss?]

My problem with doctors is they are always right and we the patient is dumb as shit. So if we say "NO" they get their panties in a wad and from that point on they are useless. You then wait another 6 months to find another doctor to say NO to and start the process all over again. No amount of chocolates will fix that. My card would say "thanks for nothing".

I am sick of being treated like I'm a normal woman with doctors. Doctors are no different from any one else in the service industry. You pay money they provide a service. Unfortunately the doctors don't see it that way they just take your money. It's all about the money.

[namaste]

My problem with doctors is they are always right and we the patient is dumb as shit. So if we say "NO" they get their panties in a wad and from that point on they are useless. You then wait another 6 months to find another doctor to say NO to and start the process all over again. No amount of chocolates will fix that. My card would say "thanks for nothing".

I am sick of being treated like I'm a normal woman with doctors. Doctors are no different from any one else in the service industry. You pay money they provide a service. Unfortunately the doctors don't see it that way they just take your money. It's all about the money.

You make a good point. After enough condescension and elitism, it's like 'fuck you, already'. I was just trying to make a point about honey and vinegar and how to grease the wheels of the healthcare bureaucracy.

Chocolate might be able to help you get off on the right foot with a new doctor though. If you were running a business or providing a service, and taking on a new client, would you want the person that complained about every previous doctor, or the one who offers chocolate? I guess I'm looking at it as a self-fulfilling prophecy. If you go into a hospital or visit a doctor looking to be treated badly or looking for a fight, you project that energy and people will respond in kind. Likewise, if you project the energy that this time is going to be different, and that you're going to have a positive experience, people will pick up on that.

Also, in the US, Doctors have a monopoly on healthcare services, and create an artificial scarcity of doctors, through admission caps by the American Medical Association. So, unlike most other people in the service industry, medical doctors are members of an organization that's something of a monopoly/cartel. So, there are some supply and demand issues that make doctors unlike other people in the service industry. Not to mention all the established law.

[prince....ss?]

I do understand your point and you are very correct.

My point is that in my case I have no medical insurance and I live in the USA so I pay my doctor for their service the same I pay my auto mechanic. So it is very costly for me to see a doctor in the first place then to get the fast food approach to medicine with steakhouse prices is not acceptable. If they are not interested in doing their job then just tell me and I will find someone that is willing to work. I know there are some good doctors but most are in it for the pay check and it get's expensive trying to find the good ones.

In the USA the doctors are doing you a favor just giving you an appointment.

I know I have a bit of an attitude towards doctors. Just keep in mind that Doctors have been playing GOD with my body since the day I was born. I will no longer allow someone to dictate to me what my health needs are and if I'm paying for a service I should get what I pay for.

I see it as going to a restaurant and you order steak. When you get served you get fish. when you ask where is your steak the waiter explains that the chef decided you get fish.

I should not half to beg or negotiate a steak if that is what I'm paying for.

Please don't take this as anything more then explaining my fustratations.

I'm trying to get some genetic testing done. But they want me to see some reproductive endo first. WHY? I cant even make a simple appointment without waging war. If I cant even decide what doctor I want to see and why then why would they listen to me when I tell them what I want to be tested for.

If I ran my business like this I would not be in business long.

[The Female Eunuch]

Hi namaste,

thanks for your comments. some of it may turn out to be useful, but some of what you said sounds like stuff that would only happen in America. Surgeons in New Zealand are paid salaries, not fees for service, and they do not get sued. But having said that, I guess there is still a way for doctors to be found liable through the complaints process.

I would say that my urologist is simply not very good at communicating. I've had difficulty getting information from him from the start, and I never had that sort of difficulty with the with the urologist I had before him. I sometimes wonder if he thinks like a plumner, seeing his work as a technical exercise, and that he's rather uncomfortable about the fact that it's actually people's bodies he's working with.

cheers,
Caroline

[fraulein_Maria]

[QUOTE=The Female Eunuch;18696]Hi namaste,

thanks for your comments. some of it may turn out to be useful, but some of what you said sounds like stuff that would only happen in America.

>>> can i ask a really stupid Q. ? What's stopping either doctor from telling the office lackeys....

"would you be kind enough to COPY EVERY PAGE of ms carolines chart please? ... that will be $50 dollars"

I mean, i've done PRECISELY that. the only copies i can't get are my birth records... its infuriating, but necessary these days only for closure. <<<

[The Female Eunuch]

>>> can i ask a really stupid Q. ? What's stopping either doctor from telling the office lackeys....

"would you be kind enough to COPY EVERY PAGE of ms carolines chart please? ... that will be $50 dollars"

I borrowed my GP's notes about me to read a few years ago, and I'm sure I could do it again, but they seem to skip over most of what happened in hospital. It's a really thick bundle, but most of that is things like urine test forms and copies of referral letters to specialists, and very little back from specialists about things that were done in hospital.

For example, I had a urostomy stoma for 15 years, it was reconstructed twice, and there's lots peripheral stuff to do with it in the notes, but no mention of the surgery to construct it or the investigations that led to that surgery.

cheers,
caroline

[The Female Eunuch]

I've just found out from the Office of the Privacy Commissioner what I have to do to get a copy of my hospital notes, and it's going to be quite an involved process. I have to start by writing to privacy officers at the hospitals that treated me as a baby, in case the records are still there. And if they're not, I will have to write to other hospitals that have treated me more recently. Presumably every hospital I deal with will have to get some sort of proof of identity from me before they can tell me whether they have any records or not.

It's going to take months.

[fraulein_Maria]

[QUOTE=The Female Eunuch;18703]

It's going to take months.

>>> considering your history, that's not surprising.... But i see your situation as a hopeful one... :)

some of us may NEVER be able to get our records. It was easier to get my dead sister's records than mine (somehow, a dead intersexed child is less of a threat than a live adult one)...

the family story had always been that my oldest sister RACHEL had died 4 days after she was born of multiple deformities (un specified)... and that Godde had taken her home because I (not any of my other brother's or sister) needed a guardian angel.....

sound suspicious to anyone? <<<

[namaste]

>>> can i ask a really stupid Q. ? What's stopping either doctor from telling the office lackeys....

"would you be kind enough to COPY EVERY PAGE of ms carolines chart please? ... that will be $50 dollars"

I mean, i've done PRECISELY that. the only copies i can't get are my birth records... its infuriating, but necessary these days only for closure. <<<

Not a stupid question at all. Two things: First, nothing is stopping them, in principle. Second, it's not exactly their job. Copying of records is considered a legal / administrative / secretarial duty, not a clinical duty. In a private practice settings, there isn't as much division of labor, and doctors will get involved with directing secretarial staff to do stuff like copying records. But in larger organizations (i.e. clinics and hospitals), the division of labor is such that doctors and clinical staff (nurses, lab techs, etc) simply don't consider it their job to even communicate such requests to others. In a larger hospital, if you ask a doctor for copy of your medical records, it simply goes in one ear and out the other. They might nod and be like 'yeah, we'll get that to you', but they're taking no personal responsibility when they say that, and assume that you're going to follow up with a secretary or one of the administrative staff. They simply don't think that they should waste minutes of the day even thinking about issues of copying medical records, when there are broken bones to mend, illnesses to identify, and exams to perform. Simply not even on their radar. They don't consider it their job to even think about copying records.

Also, don't even bother to ask to talk to a 'supervisor' to get medical records. Mostly pointless. In the healthcare bureaucracy, Supervisors' responsibilities are for scheduling the days appointments, making sure that the day's exams get completed, and making sure that each day's exams get reported correctly.

If you need a copies of your records, you need to specifically ask for a Clerk, Secretary, Manager, Administrator, or Director (in that order of responsibility, usually). Private practices likely won't have Clerks, but hospitals will, and their entire job is specifically to manage clinical records, which by definition includes getting copies to patients. Secretaries are more versatile, but don't specifically work with Clinical records; but they'll generally be able to help, but may have to get approval, whereas the Clerks already have authority to copy records for patients. . Managers make the department run, and take care of anything and everything that other people don't know how to do; but they're generally swamped with work, so you'll have to butter up to them, because they're also taking care of getting broken equipment fixed, managing budgets, hiring and firing people, and so forth. Same goes for Directors, but a step up in authority and responsibility. An Administrator is most likely to be be familiar with how to work the local bureaucracy, as well as legal laws surrounding copying of medical records. Your best bet, however, for getting records without having to make a fuss and go up the chain of command, is to ask for the Medical Records Department or the File Room, and ask to speak to a Clerk, who should have the authority and responsibility for copying medical records and getting them to patients. Lacking a Medical Records Dept, a File Room, or any Clerks, that's when I'd start asking around for Secretaries, Managers, and Administrators.

Also, if a particular individual is giving you problems, I'd recommend using a proxy agent and lateral transfer to get a copy of medical records. Two ways to do this: First figure out a nearby big city that's convenient to commute to, and look up doctors in the area who's sympathetic to the community. Contact their office, ask to speak to an administrator or manager; explain the situation, ask if you can become a patient of the doctor, and if they would be wiling to transfer your records from your current doctor to their practice, and then give you a copy of the records. You can do this all by phone, and basically shop around for doctors who will be willing to give you your records. When they request copies of the records from your current doctor, it will be pretty straightforward, and they shouldn't have any problems because they're already part of the healthcare system. Alternatively, you can do the same thing, but use a lawyer who can act as a proxy for you instead. Either way, using a proxy agent and a lateral transfer will remove you from being directly involved in the process, which can sometimes make the difference between getting the records or not.

Lastly, I should mention that most states have an 8 year requirement for keeping medical records for adult patients, and a 21 year requirement for keeping records for pediatric patients. Keeping medical records is a huge pain the ass, because they are very bulky, they're easy to get mixed up, and they attract mice and bugs who like to actually live in the paper and folders. This, in turn, causes a sanitation problem for most clinics and hospitals, if rodents and bugs are living in the file room, so they try to get any medical records older than two or three years offsite. There are medical record archival companies that run massive warehousing operations filled with boxes of old medical records. Getting the records to those companies is usually described as 'sending the file to deep archive'. In the Department of Radiology that I used to work at, we would have weekly archival shipments, where we'd send off 10 crates of records, and ask for 10 other crates. The turn around time for a record that's in archives can be on the order of a couple months. And if you don't constantly ask for the record, the archivists will silently hope that you'll simply go away. That's why I recommend sending requests for medical records by certified federal mail. They'll be required to sign the certified mail, and acknowledge that they received the request. Then, you can follow up on a biweekly or monthly basis, and make sure that they actually contact the medical records archiving company to actually get the records. In fact, if you send *every* bit of correspondence by certified mail, you'll create the legal paperwork trail that a lawyer needs to really represent your case, if you decide to go down that route.

The problem, however, is that if the record is older than 21 years, it's very likely that they'll have purged it or have destroyed it. It costs money to store medical records, and the archivists look for any opportunity to 'accidentally' loose records. Thus, it's very common for medical records older than 21 years to be stored in the most abysmal places possible: ie. basements. Water damage is very common for old medical records, and the archivists can say 'oops, water damage; gotta through out these ancient records that only one person out of 10,000 is going to ask for'. The hospital winds up reducing the cost of storing old archives, and gets rid of the liability, so everybody looks the other way. Not saying it's right that people do this, but that's what happens. So, if you're having problems getting the medical records from around the time you were born, and you're older than 21 years old, my guess is that they're in deep archive, or simply don't exist anymore (i.e. purged from the system, or destroyed by paper shredder, water damage, or mice/rodents/etc).

And yes, do expect that the entire process could take months, especially if the records have gone to deep archive, as they likely have if they're older than 2 or 3 years.

Also, you're correct that I have a US centric perspective. It's where I live and work, so if you live elsewhere, your milage may vary. Anyhow, just my experience having worked as a Archival Administrator at a hospital.

[namaste]

Oh, and while I'm at it... just to point out the kind of bureaucracy that goes on at hospitals and clinics, and to explain another reason why they might not get your records to you right away: there exists such a thing known as a 'teaching file' or 'interesting case file' at most clinics and hospitals. Its a bit of a misnomer, because the 'file' is usually a folder and can sometimes be an entire bookshelf or even an entire room. But, basically, the doctors will separate interesting cases that they want to use for teaching and/or publications from the rest of the file room. It's a *really* big problem for hospitals and clinics. The clerks or secretaries will go to pull a record, but it simply won't be where it's suppose to be, because a doctor pulled it and put it in the resident's office, the clinical reference library, their private office, or at their home.

Once, there was a surgeon who left the hospital I was working at, and on his last day, he came to the file room I worked in, and asked for three clerks. They went out to the parking lot with him, and in the trunk of his car he had maybe 2,000 or 3,000 patient cases that had been missing from the file room.

At any rate... guess who's records are most likely to wind up in an interesting case file or a teaching file or in a doctor's office or at their home? Not the meat-and-potatoe cases, that's for sure....

[The Female Eunuch]

Also, you're correct that I have a US centric perspective. It's where I live and work, so if you live elsewhere, your milage may vary.

yep. I live in New Zealand.

you can see where someone lives by looking in the top right corner of their post, where is specifies 'location' (though if they haven't specified the country, you sometimes have to guess).

cheers,
Caroline

[The Female Eunuch]

It's going to take months.

>>> considering your history, that's not surprising.... But i see your situation as a hopeful one...

some of us may NEVER be able to get our records.

yes, New Zealand has a reputation for being one of the better countries to seek information in.

[namaste]

yep. I live in New Zealand.

you can see where someone lives by looking in the top right corner of their post, where is specifies 'location' (though if they haven't specified the country, you sometimes have to guess).

cheers,
Caroline

I hear New Zealand is nice. Would love to visit someday.

And sorry for the pedantic posts. Seemed like a topic that might interest people on this forum, and I happen to have work experience in this area.... so I thought I'd share some details. I have a tendency to write posts in a way that's directed to anybody else in the future who might stumble across this thread, rather than in response to a specific person. Just a habit I've gotten into over the years to (hopefully) improve the readability of my posts.

[The Female Eunuch]

I have a tendency to write posts in a way that's directed to anybody else in the future who might stumble across this thread, rather than in response to a specific person. Just a habit I've gotten into over the years to (hopefully) improve the readability of my posts.

that's fair enough. Your last post may be relevant to me, too. The hospital I was treated at in the first few years of my life is attached to a medical school (which was the only medical school in the country when I was born), so it's quite possiblethat files would have been taken out for study or teaching.

cheers,
caroline

[fraulein_Maria]

[QUOTE=namaste;18713]

And sorry for the pedantic posts. Seemed like a topic that might interest people on this forum, and I happen to have work experience in this area.... so I thought I'd share some details. I have a tendency to write posts in a way that's directed to anybody else in the future who might stumble across this thread, rather than in response to a specific person. Just a habit I've gotten into over the years to (hopefully) improve the readability of my posts.

>>> please don't apologize. your posts are excellent. you may wish to create more paragraphs in the future though... i find that it makes back-lighted text easier on the eyes.

i will make note of one thing though...

Many of us cannot get our records for the very reason we suspect...

malice.

While it may be unwise to assume malice from the start, what else can explain being able to get my sister's records... who died 4 years before i was born, and not my own? The same hospital that sent me a form letter stating it did not HAVE to keep my records longer than 7 years, obviously did.

It was a NYC hospital. i know those records were put on microphish (sp?) seeing as they are now nearly 50 years old... but in a litigous place like NY... they save EVERYTHING. they may quite possibly be on CD now.

though not all of us were born in city hospitals, most of us were surely operated on in them... and many (if not most) refered to university hospitals for the specilized surgeries we "needed"...

a clitoral reduction (unlike a complete clitorectomy... ca-ching!) is not everyday surgery even in CAH mecca and quite involved.

[namaste]

Malice? Really?

I'm not saying that malice doesn't happen or it doesn't exist. I guess I just subscribe to the opinion 'Never attribute to malice that which can be adequately explained by stupidity.' I think that's called Hanlon's Razor or something. I think that quote is related to Murphy's Law or Robert Heinlein or something.

On my first week of my job at the hospital I've been talking about, my former boss told me something that I've never forgotten: the healthcare industry is 90% filled with very caring people who are dumb as a brick.

As far as your sister goes, from what you've described, it sounds like a very open-and-closed case. Those kinds of files stay very stationary in the healthcare system, they don't move around and get lost. So the Clerks can easily keep track of them, because nobody is checking them out, they're not changing, and they can be moved to a morbidity file for processing and closure. Your files, however, were very active and complicated, so people were constantly checking them out, updating them, and studying them. My guess is that your personal files wound up in a doctor's office, and didn't get checked back in somewhere along the way. Obviously, that's a problem in of itself, although I'd describe it as more of 'falling between the cracks' rather than malice.

I dunno. Having worked with medical records in a hospital environment, I'm more inclined to describe the system as a massive clusterfuck of idiocy, stupidity, and bureaucracy.

ps. Trying to add more paragraphs. :)

[fraulein_Maria]

[QUOTE=namaste;18716]

'Never attribute to malice that which can be adequately explained by stupidity.'

>>> generally speaking, i agree. <<<

I think that's called Hanlon's Razor or something.

>>> LOL. the quote is by a physicist named Feynmann. your thinking of "OCCAM's Razor" which postulates that "all things being equal, the simplest answer tends to be the correct one". <<<

I think that quote is related to Murphy's Law

>>> lol. :) it might, but unlike the former, murphy is imaginary... just the musings of a pessimist. <<<

or Robert Heinlein or something.

>>> the name is unfamiliar to me. <<<

On my first week of my job at the hospital I've been talking about, my former boss told me something that I've never forgotten: the healthcare industry is 90% filled with very caring people who are dumb as a brick.

>>> what's even more shocking is how many of them graduated from med school! vietnam era draft dodgers the lot of them! <<<

As far as your sister goes, from what you've described, it sounds like a very open-and-closed case.

>>> well, yeah. its why i'm really pissed. <<<

I dunno. Having worked with medical records in a hospital environment, I'm more inclined to describe the system as a massive clusterfuck of idiocy, stupidity, and bureaucracy.

>>> generally, i have to agree with your assessment. i'd call chopping off clits for cosmetic purposes the beginning of a clusterfuck, and denying it ever happened by refusing to release records, as if i can't tell what's gone, is just major "situation normal; all fucked up"=SNAFU but damn it, why does it seem to happen to us IS'er almost exclusively? <<<

ps. Trying to add more paragraphs. :)

>>> yes, thank you. :) its working. :) <<<

[Dianne]

..... but damn it, why does it seem to happen to us IS'er almost exclusively?

Wasn't it Dr. John Money's hypothesis that any knowledge of what had been done could irreparably damage a child's psyche and lead to gender issues, therefore the whole thing had to remain absolutely secret?

We wont even mention the possibility of having their asses sued .... that is far too crass to even consider LOL!

[JOS]

Wasn't it Dr. John Money's hypothesis that any knowledge of what had been done could irreparably damage a child's psyche and lead to gender issues, therefore the whole thing had to remain absolutely secret?

We wont even mention the possibility of having their asses sued .... that is far too crass to even consider LOL!

Which is where I think the comments of "a patients right not to know" gets slipped in

I have had this said to me three times by three separate doctors! Admittedly twice it was in respect to my prepubescent niece who may or may not also carry the same mutation as me.

But basically my sister and I have the view of fore warned is fore armed... ie if we know in advance that my niece also won't be able to have children, why let her wait till she's a teenager and in the middle of important school exams before she's made aware of the fact her life won't be the one she's had in mind!....

not to mention things like checking all the right hormone testing is done etc before they decide to "whip it all out before she even knows" stuff that many experience.

But the other one was relating "a patients right not to know" DIRECTLY to me... speculating that this was the motivation of the gynecologist who lied to me, despite the fact I was just 16 when he treated me... ie legally of age in the UK.... even if he DID (or didn't) tell my mum who then didn't tell me (separate issue for me!) - HE should have told ME!!!

sorry rant over ;-)

[fraulein_Maria]

[QUOTE=Dianne;18718]Wasn't it Dr. John Money's hypothesis that any knowledge of what had been done could irreparably damage a child's psyche

>>> yes. Sad that his doctoral thesis said just the opposite. Sad that it was never published in a journal, so the only way anyone knows is because they have taken the time to spend the cash to find out. Criminal that he would write that thesis, get his doctorate on it... and then spend his life denying it.

EGO! truely criminal ego run amuck. and just as criminal that no one bothered to test his "hypothesis" and instead carved there prejudices into our bodies! <<<

[fraulein_Maria]

[QUOTE=JOS;18719]Which is where I think the comments of "a patients right not to know" gets slipped in

>>> interesting how a mere untested hypothesis gets blown out of all proportion into a false right of a doctor not to be sued for negligence.

[Kailana]

when it comes to getting any kind of medical records, those that still exist.

first let me say thank you to namaste, good advice in alot of your posts. Now then if anyone is still having hard time getting any kind of records at all, you might want to try talking to your doctor and having them request medical records from the hospitals you were treated at.

personal experience, the hospital I was born in, said they didn't have any records on me at all by phone. So I stopped by in person while visiting relatives, and filled out a request for release and copies of medical records they may have on me, a few weeks later I was told they had none, too many years have passed and they aren't required to keep them that long. So I asked my local GP and he requested copies of records. Guess what, within two weeks I had some records, while almost worthless, at least There was some information 4 pages that were released. Only thing I would call unusual about them though is the Macrocystic red blood cells, the PKU that was ordered with no results, and the dates of my name ie 26 days after I was born that also matches my so called birth certificate which is also dated and signed 26 days after I was born, and registered with the state exactly 1 month after I was actually born.

Now all states here in the US due have their own rules and guidelines they use but most are similar and generally follow the same HIPA guidelines. Anyone here in the US should be able to get copies of their medical records, while they may not be complete, or complete as I would like, there should be records or some records available and upon written request copies can be obtained, usually with a fee. Now many clerks may not take all that much time looking, particularly nowadays when they will just look in there computers and say, "No I am sorry, I can't find any records that you have ever been treated here". But many of us are older, and what they won't actually say is that, alot of us, have records off in storage, often on microfilm, and it takes a great deal more effort hunting those down then it does looking up newer computerised records. And that is often the most likely reason why no records are found in most situations.

As some of us do know, getting any kinds of detailed records about actually surgeries is alot more complicated, but often enough there are references within what records are available that will provide some answers or in some cases like my own, provide more questions that need answers. Getting the answers is the hard part and that really is only likely to happen if you actually can trust your doctor. And trust is a very hard thing to earn or feel from doctors when so many of them have treated us like we don't exist.

oh and namaste, i have talked to administrators, I have also had a Radiology supervisor present during an ultrasound examination present at my request, because I do know exactly what the technicians will do to keep information from past surgeries secret. Just to let you know, that didn't help either, as even more information, imaging was withheld then what was being withheld before. It is like, no matter how hard you try or I try, to get straight honest answers there are always people within the medical field, intentionally withholding imaging results and medical information from past surgeries.

Fact is i have now learned a new phrase in terminology by radiologists that just pisses me off:

"appears to be within acceptable norms for male anatomy".

sorry i kinda had to throw that in there, as anyone actually knowing whats normal, and seeing what my phallus looks like structurally, would easily see isn't so bloody normal as radiologists claim it to be.

I am also wondering if the medical profession on a whole is really only concerned about what we appear as, Is appearance the only thing that counts in there opinion when it comes to whether or not we are men or women? boys or girls? and if so is that all we are, regardless of our genetics, hormone issues, whether we are men or women, does it truely come down to phenotype? Does phenotype mean so much to them and the world that someone else has a right to keep causing people like us pain, trauma, emotional distress. Sorry again. but well I think I am finding that Appearance actually means nothing to me, or means so much, that I find appearance as being anti-human.

Sorry if i am rambling, but doesn't how we feel count for anything. Are our opinons worthless, does not our experiences at the hands of doctors gone mad with sociological experimentation not prove just how wrong the medical field has become that we continue to be ignored and treated as though we are nothing more then lab rats.

[Dianne]

Is appearance the only thing that counts in there opinion when it comes to whether or not we are men or women?

In the 'norm world' that's pretty much it. The only thing that trumps appearance is what they put on your birth certificate when it is filed with the government.

When I was a teen in Ontario in the 1960's the birth certificate was THE legal document. Pretty much everyone KNEW I had a problem and that the "M" on the birth certificate was questionable but because it was there, no doctor would dare help me for fear of malpractice, even after I came of legal age.

In my case I KNOW that there were at least THREE birth certificates and two (or more) were sealed by court order - I know, I tried to get copies of them!

The first one was the one my birth mother signed the week I was born (which I have never seen) but she remembers.

There must have been another one filed during the 5 months I was in the care of the charity (who ran the home for unwed mothers and the hospital where I was born) because the details submitted to the court for my adoption were slightly different. I have not seen this one but I did see some of the adoption papers that were filed - they were supposed to be sealed but were given to my adopted folks through a clerical error.

The next birth certificate was post-adoption and that was the only one that was public. By then everything had been re-written so many times god only knows what connection there was to the original.

Then, of course, I had it changed again in the 1970's when I rejected the "M" and made the legal transition back where I started.

Somewhere in a court vault there is a VERY thick file on me LOL! Someone looking through the file at all the various birth certificates would be puzzled as hell ;-)

[Kailana]

kinda makes sense though, i mean, I know I have tried as well to get a copy of my original birth certificate and had the same resutls. State Health Department only has my birth certificate signed on the 5th of Nov, 1970, and registered with the state on the 10th of Nov 1970. What bothers me the most is I know I had another with Dorothy Maree Alaniz my original birthname when doctors thought i was a girl, or more correctly most likely a girl. It is annoying when other people tell you that if there was another birth certificate, and a name and gender change was done, then those records are sealed. That is basically the same thing you are experiencing Dianne. I was wondering if the birth certificate you do have is like mine where it does show other registration numbers on the top of it that do not match what they say is the only birth certificate they have on file as my original birth certificate. It is actually kind of hard to take or accept as thats all there is to me as I do have enough knowledge from family that doesn't match up with what the State Health Department says about my birth certificate.

Oh and another thing, do any of you happen to also have your forms kinda a birth certificate but not really, i don't recall what it is actually called, but the one that has your footprints and state seal with ribbons on it. I have another issue with mine as my three sisters all have pink ribbons embedded/glued down with the state seal, and my brother ribbons are both blue. My ribbons on that form has 1 blue ribbon and 1 pink ribbon and I do not know how common that is for a male assigned infant. I'll repeat my brothers ribbons are both blue, and I suspect that is normal for Washington State, and my sisters ribbons are pink, and I have 1 blue and 1 pink ribbon glued into the Washington State Seal. If anyone out there happens to understand what that means, or has similar ribbons I would love to hear about them, and your siblings. Cause I really do believe that having the two different colored ribbons is odd.

thanks all for reading once again and so sorry Dianne, or anyone else, i honestly think Sealed records of anytype are just wrong. If and when a person wants answers is when answers should be given with all openness and honesty.

[namaste]

Couple points. First, you're absolutely correct that lots of medical records haven't been digitized. That's often likely to be the first and most likely reason for people not being able to find them. If it's not in the computer, clerks simply assume they don't exist. As hospitals go digital, and new clerks are hired on and trained with the digital systems, they simply don't even know how to access the old paper records or work a system without their computers. This causes a major problem during system downtimes (i.e. hospital wide power failures, code upgrades of hospital information systems, etc).

Second, having a Supervisor present during an exam won't help. The term 'supervisor' in a healthcare setting has a fairly specific meaning, and it simply means the most senior person present at that level of clinical certification. It's a critical distinction. Exam techs generally require a 2yr associates degree. So, if you ask for a supervisor to be present during a radiology exam, you're simply getting the tech with a 2yr associates degree who's been at that particular clinic or hospital longer than the other techs. It doesn't help you much. Asking for a 'supervisor' is [b]not[/i] going to find you somebody who knows more about medical law, clinical diagnosises, human anatomy, etc. A 'supervisor' will get you somebody who knows more about how that particular piece of equipment works, and how the results of that exam equipment get used by others in the healthcare setting. If you want somebody who understands the policies and procedures for that clinic or hospital, you need to ask for an administrator. The directors adn administrators are going to be the ones familiar with the policies and procedures and how to work the system. From a lay perspective, one would think that an Administrator is also a type of Supervisor. From a clinical beurocracy perspective, they're distinct titles, with different responsibilities and levels of expected knowledge.

As far as the 'appears to be within acceptable norms for male anatomy' comment goes, that sort of language is the defacto-language of Radiologists. And for what it's worth, medical doctors tend to use word macros and templates for common reports; especially 'normal' results. They could have just as easily said "the aortic ventricle appears to be within acceptable norms for cardiac anatomy". The word processing template they use would be something like 'the [anatomy1] appears to be within acceptable norms for [anatomy-system] anatomy'. Then, the doctors only have to press the TAB button, and flick through the fields, without actually spending the time to type up the entire report. That allows them to read more cases per day (it's common for Radiologists to get in trouble if they don't read at least 80 cases a day).

So, I guess the point is that Radiologists don't spend that much time thinking about how the report reads to the patient. They're just reporting the facts as they see them, and are spending very little time thinking about how the reports will be interpreted by the patients. Personally, I wouldn't get too worked up about it; but then I've worked in a Radiology department, and I've seen worse examples of report snafus and typos. From my experience, your Radiology report is a classic example of how using a word processing template can result in a report that may be clinically precise, but horrendously callous and insensitive. If you're not accustomed to using that medical lingo on a daily basis or understand how those reports are generated, it may like a downright offensive report (particularly when it involves urology and/or gynacology). It's very typical wording however.

As far as appearances and feelings go... well, appearances can be measured with a yard-stick, so to speak. *shrug*

[Kailana]

As far as the 'appears to be within acceptable norms for male anatomy' comment goes, that sort of language is the defacto-language of Radiologists. And for what it's worth, medical doctors tend to use word macros and templates for common reports; especially 'normal' results. etc*

understandable to a point, problem for me accepting those words as accurate is having been told and explained and shown just how not normal I am formed. habing radiologists now who don't want to take the time to report what is there, as was pointed out to me originally, and explained to me to be penile cosmetic surgury/reconstruction, with additional scar tissue underneath, scar tissue and a small tear right side of the labial/scrotal folds pointed out as well and even questioned if I had any feeling or issues with the area in question, which i generally don't as I pretty much feel nothing there at all. It might make sense If just one of my current doctors would actually explain to me, how what I have is considered within normal acceptable range for male, when not a single anatomical sketch/drawing/picture/ in any medical books look anything like what I have.
Does that make any sense?

It is not that I always mistrust Radiologist or doctors, it is more that since leaving the military I have only seen doctors, a urologist, hematologist, and endocrinologist who only read the radiology reports and pretty much refuse to bother to look at the images the hospitals provide and without looking at the actual images, they won't understand what I have issues with and that pretty much comes down to acknowledgement and acceptance for all the things I have experienced by them. I basically feel that without complete radiology exams, and complete open honest reporting, that how I get treated by doctors is just going to continue and that so far has pretty much proven to me that doctors the people who are suppose to be helping me actually aren't even trying to do so.

[namaste]

Yeah, it does make sense. Totally. I'm thinking about how the healthcare bureaucracy works, and you're absolutely correct that other doctors (such as endocrinologists and urologists) don't usually look at the images, and will simply go for the radiologist report. Which just causes further falling between the cracks.

Hrm... At the hospital I worked at, when faced with a situation like this, we would notify the Chairman of Radiology about the case, who would either take care of it personally or delegate it, with instructions, to a Sr. Radiologist. Also, we'd make sure that the patient got a copy of their radiograph images, so they could show them to the surgeons.

The more I think about it, the more I think that a written letter, to the Chairman and/or Administrator of the Department of Radiology, might help sort things out things a bit. I'm trying to think on the best way to communicate to the doctors involved, and what should be communicated. It depends on your goals, I suppose. I think the end goal, for future health care, is to get a written document put into your medical records, with instructions on people to contact, facts to be aware of, and protocols to follow when working with your case files. A letter to the Chairman and/or Administrator of the Department of Radiology, followed up by a sit-down consultation, then followed by an MRI exam, might help with all that.

Also, I'm thinking that you can trigger responses in the healthcare industry with the right complaints, symptoms, and diagnostic codes. There's two types of diagnosis codes: initial evaluation codes, and result codes. The initial evaluation codes are things along the lines 'Cough', and are very generic. In response to those codes, a procedure code will be generated, such as 'Rule out Pnemonia'. And the Radiologist will respond either positive or negative on the presence of Pnemonia. Now then, if there's a cancerous growth in the liver, the Radiologist is likely not going to report it for a couple of reasons. First and foremost, they're simply not looking for it. Second, the images may very well not be taken in such a way that they *can* see the growth. If it's a lung image, the liver is partially presented, but not very well. Now, if the growth is humongous and you can't fail to see it, then Radiologists will note down a diagnosis of 'Liver Cancer' and add a new procedure code 'Rule out Malignant Liver Cancer' and send the patient out for another exam specifically focusing on the Liver. But the point is, specialist doctors like Radiologists tend to use a request/response protocol, and you have to be specific about what you ask them.

So, I'm thinking that there might be an ICD9 code out there that could trigger them to take a closer look at your anatomy and report the results in a more detailed fashion. My initial thought was something along the lines of, 'Rule out Prostate Cancer' might be a quick way to get a report detailing the region. But it would just feed into the whole problem, because the Radiologists would simply say 'yes' or 'no' on the prostate cancer question, and would most likely remain silent on the rest of the anatomy.

In particular, I'm thinking that there are codes for 'Confirm X' as well as 'Rule out X' and some others. Let me take a look around a bit; dig through some ICD9 manuals, and see what I can come up with. My thinking is that there may be ICD9 codes out there for something to the effect of 'Map and describe anatomy' or 'Confirm intersexual condition' or 'Rule out intersexual condition'. The general idea being is that the doctors are acting like computers a bit... they're only responding to *exactly* the questions asked of them; so, one has to be real specific in what one asks. And by having the right question and the right ICD9 code, they'll respond with the information you want.

Lastly, if one could find a good ICD9 code, something along the lines of: '1234.11 Confirm/rule out intersexual condition', your problem would be mostly solved. You could write a letter to the Chairman of Radiology, ask for them to use that code, and everything would be reported correctly later on.

ps. I made up that ICD9 code. I have no idea what it actually stands for, if anything.

[namaste]

Mmm... quick online lookup. I'm guessing you're probably already familiar with ICD9 752? And now that I think about it, the 'Rule out' and 'Confirm' codes aren't ICD9 codes. They're procedure codes. (It's been a while since I had to do any coding, and I'm a little rusty.) Anyhow, I'll continue looking around, and see what I can come up with.

[Kailana]

Mmm... quick online lookup. I'm guessing you're probably already familiar with ICD9 752? And now that I think about it, the 'Rule out' and 'Confirm' codes aren't ICD9 codes. .

seriously, no knowledge what so ever. Yes i've browsed ICD9 diagnostic and procedure codes, but without any understanding, the codes don't mean much or say much, or explain much in any way that I understand could help me.


thank ya for looking things up, though you really don't have to, cause really at some point one of my many doctors is gonna get it and a bright light is gonna click upstairs and they will then understand where I am coming from, untill then though, I am just gonna continue being annoyed with doctors. They really are not as smart as you'd think they are. Kinda of like they are some of the more stubborn people in the world, they get the notion of something and are unmovable or prone to reject concepts they do not grasp. I would call that stubbornness, and the real problem is that I am just as stubborn or even more stubborn then they are, and our two ego/id's clash badly.