120 Becoming a Patient
and‘‘ patience’’ derive from the same Latin root, patientia,‘‘ to suffer’’( 31). Often, illness and treatment take unpredictable amounts of time. Unforeseeable courses of illness make needs for follow-ups uncertain. Emergencies are unplanned. Many patients miss appointments or arrive late. Moreover, health care workers and institutions frequently structure medical events around their own ongoing needs, demands, and priorities, rather than those of patients. These data illustrate how physician-, rather than patient-oriented, medicine persists. Hierarchies in medicine and managed care’ s competition for physicians’ time compound each other, aggravating these problems.
Preferences Concerning Time of the Day
Doctors and patients conflicted as well over what hours of the day were most ideal or convenient for medical treatments. Physicians often forgot patients’ timetables and sense of time. For example, these physicianpatients became aware of the disadvantages of doctors— especially surgeons— visiting hospitalized patients early on‘‘ morning rounds,’’ waking patients up. Deborah observed how surgeons visited at dawn, disturbing patients.‘‘ They put the light on, and eight people scream, shout, and drop things. They don’ t give a damn that the patient in the next bed is half-dead.’’
Moreover, some physicians may prescribe medications for times of the day such that side effects harm patients more than otherwise. Sally, for example, was given medication at night that gave her explosive diarrhea. The drug could have been administered much earlier in the day. She complained to the hospital staff, but in vain. Eventually, only by going‘‘ on strike’’ could she change the hours of dosing.
I felt like a test tube, not a patient. I was on kayexalate, which gives you massive diarrhea. They gave it to me in the morning, and I got‘‘ my business’’ finished before sleep. But then, only because they didn’ t think about writing the order until 9:00 P. M., they gave it to me at 10:00 P. M. It was the first day I was allowed out of bed to use the commode. I had all these IV lines, and an oxygen mask, and it was a big production to move six feet to the commode. I knew how explosive the diarrhea was. So I was up until 2 A. M. waiting for it to happen. I talked about it with the house