|Riyas Komu, from exhibit "Safe to Fight" (Azad Art Gallery, Tehran, 2010)|
If I turn a cold eye on my fear, I see that I am less afraid of never playing soccer than I am of the rehabilitation that it would take to go from a torn ACL to playing again. It isn't the tear that scares me, but being off my feet, not being able to run - sinking into depression and giving up. Not having the emotional strength and discipline to take on something like that.
I called my HMO the morning after my injury and pushed to see someone that day - I was clear: "I am afraid I tore my ACL." I was determined confront my fear - or rather, I should say, my knee insisted.
I said the magic word to describe my pain ("acute") and soon gained entry to orthopedics (I had asked for Sports Medicine, but was re-routed). I am not a difficult patient, but I have something to say about what's going on with my body. Unfortunately, this doesn't always make one's journey as a patient smoother.
A detour through past medical trauma
In 1984, I was hospitalized for eight days. A couple days before I found myself in an ambulance, I had gone to the student health clinic at Rutgers College because I was afraid I had a kidney infection.
A good friend of mine became deathly ill from this when we were first-year students. I knew the symptoms, and mine were identical to hers.
An affable young male doctor saw me. He didn't seem to take my concerns seriously. I had constant, deep pain in my lower back - off to one side exactly where the kidney is located. I had a low-grade fever, symptoms of a UTI, I was starting to feel like I had a flu or something. I could feel that this back pain wasn't muscular - it was deep, and constant.
He asked if I lifted heavy things - maybe I sprained my back. I worked in a kitchen and lifted heavy things all the time - but didn't recall hurting myself. "And how would that explain the fever, anyway?" I asked.
He told me to take extra-strength Tylenol. I said I wanted to be sure I didn't have a kidney infection. Would he please run a test? Could I please pee in a cup so we could just be sure - I was really concerned because kidney infections are really serious, and if you get to the point were you need to be hospitalized, the recovery is slow. As a working student, I couldn't afford to be out of commission for a month. I peed in a cup and went home. I took the Tylenol and felt better, but the symptoms kept returning as the pills wore off.
The next day I called the clinic to ask about the test results - they said: "The test came back negative." I bought nice food for myself because I hadn't eaten a decent meal in days. I took more Tylenol - I ate cheese and crackers, some fruit, and went to bed.
That night I was violently ill. There was a reason I had no appetite: my body couldn't handle food. I soaked the sheets with sweat. My fever kept climbing, dipping, and climbing again. By the morning I couldn't keep down water. It was the last week of the semester, and I couldn't imagine not going to my feminist political theory seminar. Being young and delirious, I went to class.
I sat on the floor in the hallway with the other students and waited for the professor. My classmates (an intense collection of college activists) insisted I go directly to the nearest university health clinic (attached to the women's college, different from the one I used). I must have been a sight - gray and sweaty. Having trouble staying vertical, and having little will of my own by this point, I went. It was about three blocks away, and I remember walking there being really hard.
I more or less collapsed when I walked in the door. My fever was 104. I remember telling the staff taht I'd been to the other clinic about fearing I had a kidney infection, and that this clinic said I was fine. The doctor on duty at the women's college clinic was soon yelling into the telephone, swearing. She shouted "You did what?!" and said "What fucking assholes," or something like that when she hung up. She then ranted to her colleagues.
I later learned that the doctor I'd seen (a resident) had decided that I w as trying to manipulate him into giving me a pregnancy test, on the assumption that I was too ashamed to ask for one. So, when I called about my test results, I had gotten the result of a pregnancy test I had not asked for. This is bad enough. But when I went to that first clinic, I had told the resident who treated me that I had my period.
The picture I should have presented to that doctor was that of an articulate young woman, who was quite frank about what was going on with her body, and who was worried that she had a kidney infection. The doctor, I guess, saw me as a dumb slut trying to manipulate him. I don't think that's too harsh a way of reading his actions.
As I was being rushed off to the hospital in an ambulance, as the school worked on locating my family, I was far too sick to care.
I only learned the full story about what happened from a nurse, just before I graduated, when for some reason I had to go back that clinic. She saw my name and pulled me into an office to give me the full breakdown on what had happened. (Until then, I thought it had been a lab error, or something like that.)
The residency program at Rutgers was overhauled as a direct result of this incident: residents were not allowed to see especially women patients without supervision. If that nurse hadn't told me what happened, I'd never have known why what happened to me happened, or that the university had cared enough to prevent it from happening again.
The whole experience left me with one rule: Never let a resident talk to you without a doctor in the room. Never trust a doctor to really understand what you are saying about your body - they have their own feelings about the body you are in, and you can't control that. You have to help them see where those feelings interfere with their ability to see and hear you, just as they are there to do the same for you.
The only branch of medicine where I've found this to be less true - where careful listening to the patient is pretty much a base-line from which the doctor works, is, as it happens, Sports Medicine.
Sadly, that wasn't where I found myself the morning after I heard that tearing sound from my right knee. I was at Orthopedics. In a room with a resident.