Three speech bubbles in with hands covering what would be it's eyes, ears, and mouth.

The Problem with Real

I have been contemplating the meaning of real.  In popular culture, we sometimes use words that mean the opposite of "real" as part of an idiom.  Like for instance: "pie in the sky" - a big idea which is impossible to make real. Or "phony as a three dollar bill" - not real; not truthful; fake; artificial.1 

Some idioms involve the words "for real" as in, "Are you for real?", "Is he for real?" or, the one I used to use all the time, "Are you for real?"2  We use real in so many ways that it is really almost too much (see, I ignored Grammarly, my English checker, which flags and asks me to eliminate the word "real" when I wrote that one).

Are your RA symptoms real?

Despite what my high school English teacher and Grammarly say, the worst "real" happens in the doctor's office. "Are your symptoms real? Is that a real problem? I do not see it in the blood work; it must not be real."  When doctors use those words to talk to us, they are usually casting doubt on problems that we have identified and that are very meaningful to us.  Yet, they seem to dismiss our issue.

Doctors must honor our input about our health

I count on my doctors being my experts, people I hire to help me deal with my medical issues. I do not rely on them to be perfect or even to agree with me. I rely on them to uphold what is in my best interest. Even if I am asking for something that is not, I still expect them to say no. I hire them as experts. I need them to be experts in their area of responsibility.

But just the same, I demand that they let me be an expert in my area of responsibility - namely, me. Doctors do not know how I feel, how I am, that I cannot move, or that I hurt all over. It is, after all, my body and my area of expertise that we are discussing. If we are to be equal partners, then I must honor the doctor's part, but they also must honor my part.

Lack of trust in the doctor-patient relationships

It seems to me that trust is the main problem with most doctor-patient relationships. One side or the other fails to acknowledge the other parties' professional expertise. Instead, we tend to venture into each other's areas of knowledge and often with tragic consequences. At best, those consequences include one or the other being angry, and at worst, it results in medical mistakes.

I watched a program on Amazon Prime the other day, and it showed doctors and patients caught in utter frustration trying to get the other side to listen to them. The patients were trying to explain that yes, they have a condition and doctors were telling them, no this is a psychological issue. The patient was seeking pain relief while the doctor was offering therapy and antipsychotic medication. Both were angry; both said they were right, and it seemed like the two sides refused to speak even a common language.

Common stories or dismissed RA symptoms

It reminded me of similar stories I have heard about in the arthritis community for years -  people who go to the doctor and tell them of symptoms only to have those issues dismissed. 

This phenomenon often occurs around diagnosis, but it also happens far too much when established patients tell doctors that the treatment is not working.  Not taking patients seriously leads to frustration, mistrust, and often a lack of treatment for patients.

Could it be different?

What would it take to turn the table?  What would it take for doctors to treat such issues as real? It seems like it might take a monumental shift in how patients and doctors interact.  Or, it might be simpler than that.  Maybe a sea change could happen if doctors always did the most important thing first.  What would happen if they listened to patients and then treated each issue, not as a complaint or a challenge, but as a serious matter? 

In short, what might happen if doctors treated each reported symptom like it is real?  Because even if the blood work does not support it, the issue is real to the patient.  After all, what partnership can flourish unless the partners treat each other's issues like they are legitimate and real?  We would never bring up a problem unless it were real and, if you hear us, I wager we will give you equal respect, and we will hear you and treat your issues as real as well.

Do medical professionals treat you like the symptoms you describe are real?

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