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Like many people in my demographic slot (female, near retirement age), I have become a keen, if reluctant observer of medical culture in America. Not only do I deal with my own three medicine men (one of whom is a woman), but, for the past seven years, I have tangoed with more than a dozen doctors treating my parents' various ailments.
I have filled out medical history forms for my parents in four different counties, stood beside them in examining rooms, er cubicles, and intensive care units, signed consent forms, and watched monitors record their test data. The experience has caused me to ponder any number of questions, not least of which is, how do we hold together our parts when they have been divvied up among various specialists? Or simply when, without medical assistance, they begin to shut down on their own and there is less and less of us.
For several decades, Dr. S has been my parents' general practitioner (now known as a PCP or "primary care physician"). An Ethiopian immigrant with grizzled white hair and gold-rimmed glasses, Dr. S, like most PCPs today, mainly treats colds and flu and minor infections. His wife serves as receptionist. The waiting room is always crowded, mostly with Medicare and Medicaid patients. His examining room is piled with tattered trade journals, freebies from pharmaceutical companies, and half-used cartons of supplies.
Dr. S mostly acts as a referral agent to specialists, each of whom gets only a piece of my parent to work with. Like butchering diagrams in cookbooks, only more complicated, the body is divvied up among various specialisties, all as adamant about their boundaries as Balkan nationalists. My mother's neurologists got her brain. The orthopedist got her bones and the dermatologist her skin. My father's cardiologist worked on his heart, the urologist on his prostate gland.
So focused was each specialist on his particular cut that none ever inquired about problems in other jurisdictions. Unless I insisted, few bothered to check whether the medications they prescribed might conflict with those ordered by other doctors. Physicians these days are bred to be isolationists but are working in the global economy of the body.
"Holistic" health that, just a decade or so ago, seemed to promise a shift toward treating "the whole person" has been sidelined as discoveries in genetics and electronic imaging of various sorts have captured our fascinated attention. By chopping up microscopic strings of DNA, we can now be divided into ever finer molecular portions.
Several years ago I spent the summer driving my mother to a hi-tech diagnostic center 75 miles away where diagnosticians searched for the cause of her increasing pain and physical difficulties. But none of the printouts from the often arduous tests revealed an answer.
Then a young neurologist, just revving up his first practice in subleased office space, nailed the problem in five minutes simply by watching my mother walk 20 feet, turn, and touch her nose with her index finger.
"Parkinson's Disease," he said. Both my mother and I sighed with relief. At least we knew what we were up against. I could have kissed his tasseled loafers.
But despite his skill as a diagnostician, Dr. P practices medicine the way a whiz-kid stockbroker deals in futures —fast and pumped. He enters the examining room still pocketing his cell phone. "How are you today?" he opens, scribbling away on his clipboard.
"That's what you're supposed to tell me," my mother says, half joking, half miffed by his lack of manners.
I smile. He doesn't.
"She's been taking the larger dose of Sinemet because she's felt weaker," I say. When he looks blank, I add, "Remember? You cut the dosage in half last time."
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