Why Do Conversations with Doctors Go So Wrong

I've got a personal reason for writing this, this week. I've had whooping cough. I was misdiagnosed three times. The third doctor took one look at me, ignored my description of classic symptoms (whooping!) and decreed "You're not really ill". He then prescribed a steroid nasal spray. After talking to an ENT specialist last week it seems likely that the steroids have significantly extended the length of the illness (101 days and counting!)

So how did this happen? We can all be unlucky. We can get a bad doctor. We can also all get a good doctor on a bad day. And that happens more and more as the system puts doctors under pressure. And if you've read my last article you'll know that things go wrong more often for women.

But I also know I could have handled things better. I know how to do this. I frequently advise other people on how to make these encounters go better. And I didn't do the things I could have done.

I could have done the following.

?? Printed out the NHS webpage on Whooping Cough, put ticks on every symptom I was experiencing and handed it to the doctor.

?? Explicitly asked the doctor to test me for whooping cough.

?? Waited until I was confident that the doctor was listening and repeated every thing I'd said until the symptoms I'd described had been acknowledge.

??Gone back sooner when I felt the treatment prescribed was making things worse. It's not easy - it usually involves queuing outside the doctor's at 8am. But I could have done it sooner and didn't.

So far, so good. The more interesting question, is why didn't I do those things - given that I know those things are effective.

?? I wasn't confident in my own diagnosis. I was screeching for air between coughing fits, coughing until I threw up and pulling several muscles. Classic whooping cough symptoms. But it seemed far fetched. I'd been vaccinated. No-one I'd been with had caught it.

?? I didn't want to make a fuss. I'm fairly physically resilient. It was unpleasant but I was coping. Maybe I could tough out whatever it was.

?? I didn't want to believe I had whooping cough. Denial is a curious thing. We can push away unpleasant, inconvenient truths, sacrificing our physical wellbeing for a little emotional peace. I was too busy to have whooping cough!

?? Talking was painful. I was exhausted. Pushing to make myself heard was hard work and I bottled out of it. I got overwhelmed, dispirited and depressed.

?? Being dismissed is humiliating. Having to protest, plead even feels even more humiliating.

?? When we feel vulnerable we want someone we can trust. That ought to be our doctor, but sometimes it isn't.

Sometimes we need to trust ourselves, our experience, our understanding of our own bodies. And we have to do that in a situation where we are tired, vulnerable and unwell. And that's hard.

That's why I do sessions to help those struggling with perimenopause and menopause to prepare to speak to their doctors.

And that's not because I always get it right! It's because I know how easy it is to get it wrong and how much difference it makes to have someone on your side.