By Victor L. Roggli, MD
Every patient with CF has spent considerable amounts of time around hospitals and
doctor’s offices. Oftentimes the tests and procedures and medications and blood drawing seem endless. Many patients become desensitized to the pain and discomfort because they have done it so frequently, like a diabetic taking daily injections of insulin. As a small child, the physician’s office and the hospital can be intimidating to say the least, and sometimes downright terrorizing. These large people in white coats who poke and prod and stick needles in your arms and put a cold stethoscope to your chest leave an indelible mark on one’s memory. I am in somewhat of a unique position, having been on both sides of that fence, first as a patient, and later as a physician. Perhaps that perspective may provide some useful insights to patients with CF as well as their caregivers.
I am in somewhat of a unique position, having been on both sides of that fence, first as a patient, and later as a physician. Perhaps that perspective may provide some useful insights to patients with CF as well as their caregivers.
My earliest memories of being around doctors are not dissimilar to those described
above. I remember the distinct smell of alcohol that was used to clean everything, including the thermometer poked under my tongue. All the doctors and nurses wore white, and everything was clean and sterile. That sterile environment seemed to convey a feeling of cold indifference, although the healthcare professionals who took care of me were kind and considerate. That cold indifferent feeling combined with my helplessness at being sick made me literally dread going to the doctor. The fact that I inevitably received a painful shot of penicillin in my rear end on nearly every visit did little to allay my concerns and fears. Not even the promise of an ice cream cone afterward helped very much, and indeed, such promises indicated to me that my parents also realized that seeing the doctor was a dreadful ordeal!
As I grew older, I gradually became indifferent to the routine needlesticks and cold
stethoscopes. And then when I became a teenager, I was tough and could take whatever the
doctors decided to dish out. Going off to college introduced a level of independence that I had never experienced before. Furthermore, I had to decide what I was going to do with my life! Toward the end of my junior year, I met with my advisor who asked what I wanted to do. I told him I was interested in medical research, to which he said, “Then you need to go to medical school”. To which I said, “Oh!” So I headed off to take the MCAT exams and fill out forms for medical school admission.
It didn’t take long in medical school to realize that doctors aren’t always right. Like
anyone else, they are imperfect and make mistakes. Doctors are basically information gatherers, and most entered the field of medicine because of the intellectual challenge and the desire to help other people. As I spent time in my pediatric rotations, I remember how odd it felt being a physician with cystic fibrosis while seeing patients with cystic fibrosis. I learned that one of the most important components of being a doctor was the establishment of the doctor-patient relationship. This bond is critical for the doctor to learn what he or she needs to know to give the patient the best treatment possible. As more and more CF patients reach adulthood and transition from a pediatrician to adult pulmonologist care, re-establishing this bond of trust becomes all-important.
This bond is critical for the doctor to learn what he or she needs to know to give the patient the best treatment possible. As more and more CF patients reach adulthood and transition from a pediatrician to adult pulmonologist care, re-establishing this bond of trust becomes all-important.
So, you may ask, now that I am a doctor with knowledge of anatomy and physiology and
pulmonary function and pharmacology and pathology, why do I need to see a physician myself? I am of course reminded of the old adage that the physician who treats himself has a fool for both a doctor and a patient. There are these small issues of conflict of interest and denial that get in the way. Many aspects of CF treatment are not fun at all, so there is a part of me that would like to avoid them or deny warning signs or dismiss the things that deep down I know really help me in the long run. I, of course, know my body and my disease probably better than anyone else in the world. But when it comes to major decisions, I need the unbiased and objective opinion of a medical professional. And that, of course, means total honesty with your doctor so that he or she can provide you with the best care possible for you.
Being a physician certainly has its rewards, but also carries great responsibilities. I feel
fortunate to have been on both sides of the fence, and in many ways, being a doctor has helped me to be a better patient. I have a great relationship with the doctors who take care of me, and I have great faith in their judgment and their abilities. In turn, they respect me as a colleague and recognize that there is no threat of a malpractice lawsuit from me. After all, we all are on the same team and have the same goal, which is the very best health and healthcare that the patient with CF can experience.
About the Author: Victor Roggli is a professor of pathology at Duke University Medical Center in Durham, NC. He was diagnosed with CF in 1963 at Vanderbilt in Nashville, TN. He has had genetic testing twice and is a deltaF508 homozygote. He grew up on a farm in Tennessee and is the third of four siblings. He enjoys Duke basketball and is a karaoke enthusiast, having recorded more than 300 songs. He is married to Linda, the love of his life, and has a daughter, two step-sons and two grandchildren. He is 68 years old, still working full time with no plans to retire.