Adventures in Healthcare (Aka My Quest For a Family Doctor)

Doctors.  For the past five years I haven’t gone to one unless it was an emergency.  I went to the ER when I shattered my wrists, I went again when I had my miscarriage, and I reluctantly went once to a med check when a head cold set off my asthma and I could hardly breath.  I didn’t have a regular doctor, and the idea of it even seemed foreign to me.  Not because I wouldn’t have loved to address some of my issues, but because the care I was typically afforded simply told me three things: I’m too fat, I’m clearly too dumb, and I don’t merit more than a moment of the doctors attention.

UTI’s, known by the longer name of “Urinary Tract Infection” tends to run in my family.  I wasn’t really aware of this till many years later, but when I was a teenager, living on my own, I found myself in a weird situation:  I had to pee, and couldn’t.  I remember it pretty vividly.  I was living with my boyfriend at the time (I was 17, and emancipated), and had gotten out of bed early one Saturday morning to use the bathroom.  I went to the bathroom, did my business, and went back to bed.  But the feeling that I needed to pee persisted.  So I got back up and went back to the bathroom and tried again.  I tinkled a few drops and that was it, and so I went back to bed.  This cycle persisted a few times till he finally woke up from all of my ups and downs.  He was irate to be woken up in such a fashion and thought I was being silly and insisted I went back to bed.  I tried… and minutes later I couldn’t take it any more, and was back in the bathroom.

You see, trying to pee only resulted in a few drops, but it partially relieved the extremely uncomfortable feeling of urgency.  I certainly didn’t want to do that in my underwear, but the feeling was otherwise maddening.  We were poor kids, and I didn’t have insurance, so after a couple of days and a lot of eye rolling we decided I should go to a doctor which was a big deal for us.

I don’t remember how we managed it, his mother might have helped us financially on this one.  But into the doctor I went.  I was ashamed of the problem, and I partially thought I was crazy because I had never heard of such a thing before, but I *knew* this wasn’t all in my head.  This was back in 2002, and the internet wasn’t quite what it is today, so a simple Google search didn’t yield much help.  So when I went into the doctors office, an immediate care facility, I shyly started to explain the problem to the doctor on hand.    I didn’t even get more than a sentence into my explanation of what was wrong when the doctor stopped me, and with a look of exasperation on his face, told me that this was likely a UTI and he would have his nurse come back in for a sample.  Then he left.  He interrupted me, down played what was wrong, and left.  I couldn’t even get a word in edge wise.  I had no idea what a UTI was, and my inability to diagnose myself given his reaction made me feel extremely dumb.

Now, in retrospect, after having dealt with this problem many times now, the doctor was right in one regard, it’s not a big deal.  Well, it’s easily and inexpensively treated, anyway.  But to a scared teenager who doesn’t understand what is going on with their body, this was a huge deal!  I felt miserable, I was terrified of what could be wrong, and I felt extremely vulnerable given the symptoms.   He didn’t even really explain what UTI meant, Google did that later.

In general that experience with the UTI played into the overall negative narrative I had with doctors.  Even when I was little my experiences with doctors had been subpar.  Doctors were always picking at my weight, and yeah, I was a chubby kid but nothing terribly far off course.  I’ve always had meat on my bones, and probably always will.  But everything came around to my weight, if only I would lose weight.  If only I would eat healthier.  Going to the doctor’s office was less about health care and more about getting a lecture on why I wasn’t good enough.

Dentists played into this as well.  Now, no one likes going to the dentist, that is true.  However, when I was in my early twenties I decided I was going to be a responsible adult and get some needed dental work done.  I had a lot of pain in my back molars any time I ate anything even remotely sweet.  Ten years later I now know that is because there were massive cavities forming that were eating away the tooth.  But when I told this to the dentist his reply was that I “shouldn’t be eating sweets anyway”.  Firstly, fuck you.  Could you imagine not being able to have a piece of birthday cake at a loved ones event without pain?  Secondly, if there is pain, there is a problem.  This dentist insisted on wanting to do periodontal cleanings before he would address anything else.  I put my foot down firmly, because I had been down this road once before, I would get the fancy cleaning done and then I would run out of money and nothing would ever actually get fixed.  So I firmly said no, that I wouldn’t authorize a cleaning.  That I wanted to have my cavities fixed.  He smugly presented me with a list of over fifty cavities, and thousands and thousands of dollars in work.  I got discouraged at that and never went back.  Years later I wound up in the chair of another dentist and told them that I had all of those cavities and they laughed, saying that I had a couple, but nothing major (this was after some extractions of those problem teeth I had originally complained about).  It seemed the first dentist just didn’t want to work with me, and deliberately tried to bully me out of his chair.

So that brings me to today.  For the first time in five years, I have insurance again.  I have a couple of chronic health problems (acid reflux, asthma, etc), and so I sought out a recommendation for a doctor so I could hopefully get these things cared for.  My trans support group recommended Dr. David Blackwell of Indianapolis, and I decided to follow their recommendation and set up an appointment.

Leading up to that day I got more and more nervous.  I just felt like I was going to walk into the room, be fat shamed, talked down to, and sent away.  I was determined I wasn’t going to let that happen.  I came up with a bullet point list of things I wanted to talk to the doctor about.  Four items.  Four simple items that were going to make a big difference to my quality of life: three A’s and a B… acid reflux, asthmas, anxiety, and babies.  I was determined to stand my ground and insist that they talk to me about these things.  I brought back up.  Your loved ones are often your best advocates, and so I brought Amber with me.

The doctors office had sent me some paperwork ahead of time to fill out, to make things go smoother on the day of the appointment.  I wanted to be treated like the man I am, and I knew it was important to establish that now, given that this was the man I would later have to get my HRT from.   So I filled out all of the paperwork as “Collin”, even signing my name, which I think was the first time I had ever signed my name (we live in a very digital world most of the time, so there isn’t much need).   Of course I included that I am FtM for my “sex” and included my still legal name for the insurance.  The day before, and the morning of, I fretted about whether I should have used my legal name.  I kept replaying this idea in my head of the nurse throwing the paperwork back in my face and refusing to see me because I had “falsified” the documents, or making a scene in the waiting room.  I kept thinking that maybe I should print a second copy and fill the paperwork out a second time with my dead name, and then present them with the option.  I was a nervous wreck.

I arrived approximately a half hour early.  Apparently I was the first patient of the day, and the door was still locked when I arrived.  Now my mind was reeling in a completely different direction.  Did I have the right day?  Did they rotate locations during the week?  I started to panic just a little bit as I went scrabbling through all of my emails with them.  But no, this was the right day, time, and location…

A few minutes later a woman pulled up in front of the clinic, wearing scrubs, and headed to the door briskly saying that she was sorry for the wait, she had some trouble getting her kids off to school today, and that I must be her new patient.  I nodded and smiled politely.  When we got in, and she got settled behind the receptionist desk, I handed over my paperwork.  She was very sweet and polite, and didn’t say a word about my paperwork other than the fact that she was very pleased it was all filled out.  I let out a sigh of relief, but only partially, because after all maybe it all hadn’t dawned on her yet.  But as I sat there, nothing bad happened.  No embarrassing moments at all.

When we went back to the room, I was given the usual set of questions about my medical history and my families medical history.  She rattled down a list of conditions and told me to stop her each time we hit upon a condition that I had been diagnosed with.  When we got to “obesity” I stopped her and said “well, yeah, I mean look at me”.  She stopped me and asked if I had ever been formally diagnosed with that as a problem, and I said I didn’t believe it was ever anything so formal, and so she said that we wouldn’t mark it then, and went on.  Wait, I’m not obese?  For the first time in my life?  I was flabbergasted.

Later the doctor came in, and I was ready.  I was ready for him to be short and curt.  I was ready to be talked over.  I was ready to have to fight in order to get the things I wanted to be discussed listened to.  I came in with a game plan, and I mentally ran through the items again “3 A’s and a B”… Acid reflux, anxiety, asthmas, and babies.  Three A’s and a B… three A’s and a B… deep breath…

The doctor introduced himself, asked what brought me in, and actually waited politely for me to answer.  No rushing out the door.  He listened, and seemed to actually hear what I said.  We took everything one point at a time, with me describing the problems I had encountered, and when I had obviously finished my piece, he gave a thought out response.  More over, in each case where he wanted to prescribe a medication, he asked me if that was ok.  And then proceeded to answer further questions about those medications and their possible interactions.   We talked about my plans for the future:  Babies and HRT.  He assured me he would be happy to help me get on testosterone when I was ready, and affirmed my decision to wait till after we had a child.  He asked where I heard about him from, and I answered him honestly, he seemed really pleased, and said he was happy to be able to service so many people in the gay and trans communities.  He was genuine.  He was thoughtful.  It was amazing.

Leaving the office I was ecstatic.  I went up to the desk to settle up my co-pay and set up the free “Obama Care” physical for a later date.  We settled on a date and time and as the nurse was putting in all of the information, she paused for a moment, very thoughtfully and scribbled something on a sticky note.  She then flashed it to me, and I took a moment to read:  Do you need a pap?  In the moment, I was confused by why she asked me in such a fashion, but later that day it dawned on me: she was being careful not to out me to anyone in the waiting room who might over hear.  This presumably-cis woman, who had just met me this morning, went out of her way to make sure that I felt safe in their facility to the point that she was extremely careful to not out me as trans to anyone else in the room who *might* overhear.   When I realized that’s what had occurred, I was floored.  Absolutely floored.

I left the appointment, and dropped Amber off at work and then headed to my own office.  On the way the magnitude of this extremely positive experience was simply overwhelming and I cried.  All of the baggage I had with doctors when I walked into their office was met with extreme professionalism, and more importantly, extreme kindness.  It’s almost strange to think of a positive doctors appointment as something that would bring tears of joy, but for me, that’s exactly what happened.

Next month I go back for that physical that I mentioned, and this time, I’m not dreading it at all.

 

 

 

 

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