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If I had a hammer. . . . or a (Occham’s) razor

You know what they say: when you have a hammer, everything becomes a nail. Well, when you have a blog, everything becomes a blog post.

In reading all this stuff from the 70s-80s-and-90s iteration of conservative Evangelicalism, I’ve had more than a few demons to exorcise. And one I’ve been intentionally avoiding talking about here. I just don’t want to think about it because the tears come too easily. I want to forget it. Ignore it. Hope it goes away. And so . . . I think, then, that I really should talk about it.

::deep breath::

It all came to a head 10 years ago just before my 30th birthday. But it started about 5 years before that. If I had had a blog back then, this is what it would have been about.

I won’t bore you with all the medical details. Who wants to hear the gory specifics about someone else’s medical condition, right? But suffice it to say, I had all the symptoms of Cushing’s Syndrome. Consistently my cortisol levels were double the normal values. That’s high, but not really that high.

I don’t know exactly how I got to that point. It may have been the birth control pills I started taking after I got married. I don’t really know. Nobody knows. But, ironically or not, as soon as I had invested my entire life into fundamentalism, it started.

Things weren’t right with my health, and my mother taught me that when things weren’t right, you need to go to the doctor for help.

When I told the (BJU-employed) doctor everything and that I had been exercising to lose the weight I had gained, she didn’t believe me. She said something like, “It’s quite obvious that that couldn’t be true.” Or something like that.

She didn’t believe me! How is that even possible? How dare she! A health-care professional who, at first blush, accuses her patient of lying!?? She, in sum, patted me on the head and sent me on my way, assuming, I’m sure, that not indulging my sinful lie would put a stop to my troubles.

[youtube]http://www.youtube.com/watch?v=pyossoHFDJg[/youtube]

This really bothered me. It still bothers me. Because I still assume that people aren’t going to believe me when I tell them what I’m doing or not doing. And I don’t live a raucous, devil-may-care life. I exercise — I have pretty consistently except for pregnancy and sickness my whole adult life. I don’t drink. I have never smoked. I take my vitamins daily. I’m a square. A total square. But when I see that white lab coat, I assume that whatever I say will be disbelieved. It’s a kind of learned helplessness for my health.

Anyway. . . . I am nothing if not stubborn. And so I set out to prove her wrong — like her opinion of me mattered somehow. I continued to power walk like mad — between 16-20 miles per week. Our lab-collie mix joined me. Back campus there. I’m sure my neighbors from that time remember seeing me in rain or shine, winter and summer.

I didn’t lose a pound. I actually gained weight. And we were so BJU-poor, that I let my shoes get too far gone. And I developed a pretty serious pain in my foot.

So back to the doctor I went. Here I had a definite, material symptom this time, right? And this doctor was supposed to be the best one, I was told. The female. The one that understood. I told her about the foot pain. And she actually told me that it couldn’t hurt that bad. That I was imagining things.

I insisted. She belittled and accused. I insisted some more. In time, I got worse; the symptoms seemed more mysterious (more Cushing’s like). I brought Grant with me. We made big enough pests of ourselves that in disgust she passed us along to a specialist although she did make it clear to him beforehand that I was a nutcase.

Thankfully, he took one look at my symptoms and blood work and did not agree with her character assessment.

But he didn’t have any answers either. Nor did his buddy up the road. Or his buddy in Indiana (we moved to Bloomington at this point). Or his buddy. Or the other endocrinologist. I got poked, prodded, infuriated, mortified, and still no answers. The pain in my foot was so intense, I’d have to crawl to the bathroom first thing in the morning. I eventually got a cane.

Because this last Indiana guy was Dr. Wait-and-See, I took the bull by the horns and got an appointment at the Mayo Clinic during my summer break in 1998. Grant had summer school and couldn’t go with me, so my mom joined me. We took the Amtrack up to Minnesota that summer. That entire experience is a blog series in and of itself. But King Hussein of Jordan was there at the same time! I didn’t bring my sedan chair though.

It was mostly a waste of time. They told me nothing new. I got poked, prodded, mortified, tested, and even photographed (!!). As before, they’d take one look at my symptoms, act all positive that they could solve everything, and continue with the testing. But when the results were neither normal nor abnormal enough, they’d shrug and pat me on the head and wish me well.

No character assassinations though. There are small blessings.

I found a NIH trial at the University of Michigan on Cushing’s Syndrome. I got in. If I remember correctly, they were testing the effects of cortisol on memory. 😉 They did the same old stuff and were headed quickly toward the same conclusion.

Until. . . . a physician’s assistant listened. Really, really listened. She asked me about the pain in my foot. I described it to her like I had described it a dozen other doctors: it felt like a nail was stabbing my heel. It’s the worse in the morning and then it gets better, and then there’s a point of no return and I can hardly walk at all.

She, God bless her, said, “I think you have a heel spur.”

A HEEL SPUR? Really?? You’re kidding?!?? . . .

One $35 X-ray later and we had our proof. There it was. For five years I had had a lousy, plain-as-day, ordinary, run-of-the-mill spur. I wasn’t imagining it at all.

[youtube]http://www.youtube.com/watch?v=9CUXLuVjO-w[/youtube]

I was still in denial, but my darling mother dragged me, hobbling and weeping, to the orthotic store the next day. I didn’t believe this would work. How could it? I still wondered if it actually was my bad character that was causing these problems.

Within 2 days, I could walk normally. And within a few weeks I was . . . well, all the Cushing’s Symptoms started to clearly diminish. I got back home to Bloomington and visited a sports doctor (tons of them in that college town). I told him what was up and he said, “You poor thing! You have really suffered.”

That was the first doctor among all those others to empathize with me. And the first to offer me actual but really inexpensive solutions.

I used to say that what I learned from all this is that doctors are really just mechanics. You need them, of course, but they aren’t much more than technicians at some point. And Occham’s Razor, of course: the simplest answer is usually the correct one.

Now I think what happened is that the birth control pills messed with my system, so I walked like a fiend to fix it (and prove my worth), got that heel spur, and the pain from that caused my stress-hormone cortisol production to rise. That was a form of “Pseudo-Cushing’s” in the end.

In the grand scheme of things, one doctor was just as incompetent as the next. Probably they were so focused on their own endocrine specialty that they couldn’t listen to the whole problem, although you’d think the famed Mayo Clinic could sort through that. It took a PA to get to the bottom of it. And it took a sports doc to understand and actually solve the problem.

Usually specialists rely on general practitioners to catch these heel-spur sorts of problems. But my general practitioner was stuck. Stuck in a lousy ideology that made it easier to accuse an Other of sin than listen. Confronting was more her job than diagnosing. Judging was more important than thinking. The metaphysical heart was easier for her to “see” than a malformed heel bone.

I still hear her voice in my head. Or perhaps, reading Jay Adams and his ilk accentuate her long-forgotten self-righteous and ill-proven diatribe delivered to me at a time of physical pain and fear while I was wearing nothing but a paper dress. Through all this, I’ve discovered that my main motivation in fundamentalism was shame and self-loathing, and that’s a deliberate systemic thing. It’s described, defended, promoted, and assumed. It’s the first knee-jerk reaction. “No doubt the trouble is with you,” right?

This is all just another layer to a recently-realized problem. A layer that lies a little closer to my gut. Another layer that needs to be sliced away a la William of Ockham.

19 thoughts on “If I had a hammer. . . . or a (Occham’s) razor

  1. Ugh! My mother passed on a “Where there is no doctor” handbook that they used on the mission field to diagnose common ailments. That has been my go-to resource for most of our family’s common complaints. It helps me keep my head and know what to look for as danger signs through typical childhood fevers and coughs.
    I remember having horrible throat pain and high fever once at the University, and they ran all sorts of tests. (Found out later after it reoccurred a few times that it was chronic tonsillitis. I was in the Dominican Republic. Doctor took one look and pronounced, “You have tonsillitis!” Got a penicillin shot in the butt and good to go!)They gave me a Percoset for the pain, and it worked so well, when the pain returned, I asked for another. But they would only give me Tylenol! Said I’d become dependent on the oher! On one more Percoset!! haha. As with most things through my time at BJ, I just rolled my eyes and kept my mouth shut. But that was painful…knowing I could have relief, but not getting it because of irrational fear on their part.

    Your viewpoints intrigue me. Can’t say I agree with you on a lot of them (haha), but I keep coming back. I really enjoy reading and considering a different side of things.

  2. In the US, Drs. have to run all sorts of tests to shield themselves from malpractice.
    Especially in an Urgent Care or ER setting, gone is the art of listening to the patient’s story and thinking about the simple things that could be the cause. Its all, tests are fine, we don’t know/it’s something minor, go home and deal with the symptoms. That’s not caring for patients, that’s processing patients.
    The best care my wife and I have received is when we go to our primary care doctor. They usually always take the time not only to fully assess the patient on a personal level, but also fully educate the patient concerning the condition and applicable home treatment of symptoms. Unfortunately, this requires an advance appointment during business hours M-F. When you are puking uncontrollably, dehydrated, or in excruciating pain on a Saturday night, you don’t want to wait until Monday morning to make an appointment for later that week. But neither do you want to undergo the typical non-care patient processing you get in an UC/ER setting. But you go anyway and pay the sky-high deductible for it just to get some relief. Just to go home, have the symptoms come back, and not know what to do except tough it out until you can’t stand it anymore at which point you go back to the ER and pay another deductible.
    It’s all really lucrative for the hospitals, as they rake in money for the repeat visits.
    Camille, I am assuming your encounter with the BJU physician was in a walk-in clinic setting. This would explain alot. Everyone needs to build a relationship with a primary care physician they trust.
    However, the gap that needs filling is the 2AM non-emergency health issue that makes your life absolutely miserable. I don’t want to be processed in the ER ($100 co-pay) just to have to make a follow-up appt with my PCP (another co-pay, $30) to finally get quality care and advice.

  3. Let me rant even more. The local company that owns the hospital we go to as well as the network of doctors we see run ads on TV about how they really take time with the patient and make sure they find out the real purpose of the visit, with very heartwarming scenes and music. But the reality is different. Their physicians are broken up into different groups, the ER is a separate entity from the UC which is a separate entity from the Women’s Center, their parking lots are outsourced to a third party, point is, there is no cohesiveness under the banner that this organization is flying. There is no communication; I had the pediatric unit call me for insurance info I had already given to the Women’s Center, and when I pointed them in their direction, they asked me for the number!!!!
    When I took my wife in to deliver our baby boy, I was paying $3.00 a pop anytime I needed to drive out for food or whatnot, even with validation, because the outsourced parking company doesn’t offer in-and-out privileges and doesn’t care that women who are giving birth might have their husbands with them who need to go out occasionally. I tried to park in a free lot near the hospital’s medical center buildings only to be told that if I was going the hospital PROPER, I couldn’t park there.

  4. The medical system is broken, that’s for sure. Way, way broken.

    And just for clarification, David, this wasn’t a walk-in clinic. This was BJU’s medical clinic. This was the doctor that was supposed to take care of BJU employees.

    Now. Let me say this — I’ve avoided this particular doctor like the plague since, and every other doctor in that practice has been a prince(ss)! I have had more than few very overwhelmingly positive experiences there.

  5. I read up on Cushing syndrome which left me scratching my head: What possible “sinful behavior” was the doctor talking about? Gluttony is the only thing that comes to mind, but the fundamentalist mindset can be very creative and convoluted when it comes to policing sin.

  6. Well, David (C) ;), she thought I was looking for attention, that I was lying about the exercise and such, and that I was making the pain and discomfort out to be more than it was. In the final visit where Grant finally joined me, she was frustrated with Grant and was saying that all my “symptoms” didn’t exist. Grant pointed one out to her very specifically — a dowager’s hump. ::bag over head:: She said, “She does NOT have a dowager’s hump. She doesn’t. She just doesn’t.” And she walked over and began to feel the top of my spine and while she continued to insist that I didn’t have it, she stopped herself and said, “Oh. Yeah. I guess she does.”

    :/

    The writers of ER couldn’t have written it more comically. :p

    So it was just thinking I was “hysterical,” I guess. Very, very 19th-century.

  7. If it weren’t sad because of the needless pain you had to endure, it would be absolutely hilarious. Your story is a good warning to everyone, but I am not sure it tells us that much about the world of Fundamentalism. After all, the non-BJU doctors missed your symptoms too. Maybe it tells us something about the current US medical system, which is simultaneously the best health care in human history and a complete boondoggle. But even then I am not sure.

    Taking a cue from Occam himself, I’m going with a simpler, older moral to this fable. Stories of “experts” so blinded by their own specialized “expertise” that they miss the obvious are timeless and universal. They also also universally unheeded.

  8. Well, I said as much, The Bard. I mean, there was incompetence up and down. But it started with the (spiritual) judgment from the beginning doctor and her even sharing it with her colleagues.

    Christ didn’t yell at the taxpayers for being crooks (we just read Zaccheus yesterday). He yelled at the moneychangers in the Temple for being crooks in the name of God.

    I think that’s the difference.

  9. “Christ didn’t yell at the taxpayers for being crooks (we just read Zaccheus yesterday). He yelled at the moneychangers in the Temple for being crooks in the name of God.

    I think that’s the difference.”

    And that is a BIG difference. Which has me all the more sickened about what is going on in Ukraine with “Pastor” Sunday. I’m livid about that. Not just taking advantage of vulnerable people, but taking advantage of vulnerable people in the name of God? Livid.

    But that is a “big” thing. . . what about all the behind-closed-doors sorts of things — like yours? So very damaging.

  10. Camille,

    You spoke about the spiritual judgment from the doctor belittling you for “sinful behavior.”

    That was a negative spiritual judgment, but what do you make out of the positive ones you’ve received in your years in fundamentalism? Aren’t they just as bad?

    In my years in conservative Evangelicalism, I was pretty much a “good boy” who often drew praise for living a life that was “pleasing to the Lord.” I was till miserable and spiritually empty inside, but my exterior elicited a lot of praise.

    I think positive spiritual judgments are just as bad as negative ones. Where do they get off claiming to know how God felt about me? What entitles them to make such baseless spiritual pronouncements?

    How would you like it if your boy told the other one, “Mommy said I could have the toy.” when in fact you never said it? Mommy only speaks for herself, but wouldn’t you be upset if your boy pretends to know what is on your mind in a very self-serving way?

  11. I almost cried when the doc that finally found the root cause of my lower back issues (after 9 years of docs, PTs, and such) said “There’s a big difference between a doctor saying ‘There’s nothing wrong’ and ‘I can’t find what’s wrong.'”

    Thank God for the ones who listen. And don’t, um, diagnose sinful behavior–good grief!

  12. Wow…

    I was all tense reading this… *wipes off brow* My goodness.

    I had a similar experience. My abusive marriage (and the whole pastor’s wife fishbowl) created some serious health problems for me. One day, it was like my body just quit working right, like my “computer” crashed or something. It was so frightening. I would have these muscle tremors all the time where muscle ticks were just going on non-stop. My skin was acting crazy too—I mean, it literally felt like bugs were crawling on my skin. My hair started falling out, there were these intensely painful spots all over my scalp and face–,like bruises but no bruise, night terrors and panic attacks… None of this stuff had EVER happened to me before…

    So, of course, I go to the doctor to find out what’s going on, right? I probably had about 4 doctors tell me that it was all imaginary. One doctor sat me down and said I needed to get evaluated by a mental health professional, because it was all in my head. I could barely hold back the tears when he said that, because I *knew* I wasn’t making it up.

    In desperation, I then went to the internet and started self-diagnosing, which made a bad thing even worse because what I was finding there was HORRIBLE (crazy parasite stuff, etc)…

    What a gift, an absolute GIFT, it was, when I decided to try again and a blessed blessed blessed PA actually listened to me…really *listened*…didn’t assume that I was making it up…gave me a FULL examination (which I hadn’t had ONCE during any other visit), didn’t assume I was imagining things…and then said every single symptom fit with a central nervous system problem. She said that my central nervous system had probably just had a serious shock and had kind of shut down, as it were (she said that can happen with a serious system shock, such as a severe virus or when a person has been in a long-term stressful situation). She gave me some suggestions for how it could be slowly and gently brought back online (about a 2 year process).

    I walked out of her office feeling like a human being again.

  13. Wow! Another P.A. success story. WOW!! I am thankful that God has placed many fine doctors in my path since this. I think I said that before. Honestly, I get teary every time I think about it. I should tell *THAT* story because it was really a miracle to me.

    David C. . . . you’re right. I’ve been thinking about what you’re saying here, and I know you’re right. I gotta unwind that one a little bit more though. Hm. . . .

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  15. Wow, that is so shockingly terrible that it would be hard to believe — if there weren’t other stories like it out there. Thanks SO much for sharing!

    Health care is changing in a big way these days, and we as patients need to do as much as we can to guide the change in a positive direction and take control of as much as we can. I use Microsoft HealthVault to store my health info and share it with my doctors. If anything, that should make it easier to switch if my physician decides to start judging and ignoring me, like yours did!

  16. Camille, I was there with you through many of your struggles trying to find an answer to your high cortisol levels! That is how we met through supporting each other on the support group for Cushings. I just celebrated National Cushing’s Day on April 8th. Last year an article on my two brain tumors for Cushing’s Disease was the only one printed in a newspaper that you could google. Now, both my children live in Greenville and I am up there alot. We have got to get together some time soon! I have met many Bob Jones students and alumni in the last few years.

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