Oracle Oy

I’ve been trying to write this post for 6 weeks.  Then, just when I’d come to the horrible conclusion that I’d lost my Oracle mojo, came a Big idea!

Here’s what I wrote 6 weeks ago:

When last you tuned in, I was about to schedule a surgery to repair my fractured femur.  The bone wasn’t growing together in the way it needed to.  The I Ching Online had declared that the surgery would be miraculous because I was miraculous.  In fact – well not in fact but In Ching – I am the transcendent spirit of the age.

So I was not a little disgruntled when a bone specialist advised against the surgery.  It would be too hard on me, he said.  Instead, he recommended – urged – a bone-building drug called Forteo.  He showed me a model of a slice of pelvic bone before and after.  The change was seriously dramatic, like Times Square Before Disneyfication (BD) and After (AD).

FULL DISCLOSURE:  The Oracle liked the BD Times Square better.  Also, she has a bias against prescription medicines.  You take one, then it causes some new problem, then you need a new prescription medicine, and so on ad nauseam…and then you have to take anti-nauseam medicine.

Plus when I asked, turns out it took 18 months for the pelvic bone to get from BD to AD, although in my case, the doctor assured, the bone might heal enough in 3 to 6 months for me to start getting my life back.  Great.  By then I’ll have been in a wheelchair for almost a year!  I’ll have missed the INK conference in India in mid-October and the TEDx in Budapest at which I’m supposed to present.  Oh, and did I mention that I’d have to inject myself with this drug every day for 2 years?  I know surgery's invasive but if it’s a choice between one big invasion and two years worth of little ones – or, as my son-in-law-to-be Jared put it, a choice between an itch for two years and a punch in the face – I’ll take the punch every time.

But the punch was not to be.  My primary care doctor whom I had to see for the pre-op check-up opted instead to use the time talking me out of surgery, raising the spectre of POCD – post-operative cognitive decline.  Five doctors later, including my own surgeon and a friend who’s a surgeon (Ken Kamler, a hand-surgeon and extreme medicine doctor), a plan was agreed upon: take the drug for two months, then do images.  If the drug is working the way the medical doctors think it will, I can avoid the surgery and start getting on with my life.  If things go the way the surgeons think, the bone will be in better shape for the surgery they think is inevitable.  As Ken explained, while the Forteo may grow bone, there’s no proof that it grows bone together.

Talk about a punch in the face!!!!

FULL DISCLOSURE:  The Oracle is furious.  Two doctors advocated passionately for a course of treatment without telling her there’s no proof it will work.  Maybe they thought I was too irrational to make a good decision.  Possibly they don’t accept the I Ching Online as a reliable prognosticator.  Also – truthfully – I hadn’t really registered the severity of my condition, how – to use their technical term – “mushy” the bone was and how difficult the surgery would be.  I was focused on getting to India and Budapest.  Perhaps that struck them as, well, insane.  Whatever.  The point is they might have felt, since I seem to have abandoned reason, that their job was to guide me to the right decision.

But even if they were acting in my best interests, and even if using Forteo is the right decision – which, by the way, it is, I’m not contesting that – I’m still angry.  I’d felt good – okay, bragged – about my relationship with these two doctors.  Both seemed to respect my intelligence and worked with me as an active partner to maintain my health.  Now I feel manipulated.  My trust in them is eroded.  And – did I mention – I’m furious!!!

FULL DISCLOSURE:  This is where the Oracle stopped writing 6 weeks ago.  Fury doesn’t inspire Oracle visions.  Also, since then, I’ve gone on the medicine, been exercising daily in my sister’s pool and moved from one thought-frame to another.  From a New Thought Frame to a New New Thought Frame.

The Old Thought Frame was based on the Active doctor and the Passive patient.  The word “patient” even comes from a Latin word that means “she who suffers,” “she who suffers having things done to her, she who is penetrated. " (Think tongue depressors, speculums, CAT scans – don’t get me started.)

The New Thought Frame features the Active Patient.  The Active Patient does research, has access to his medical records, and according to this week’s New Scientist, “self-tracks” with technology, keeping daily records of heart-rate, blood pressure, food-intake, number of steps he has taken each day – whew.  And I thought it was the medicine making me tired.

But here’s what makes the New Thought Frame old: quantum physics.  The Heisenberg Principle of Uncertainty!  I’ll explain Heisenberg some other time – when we’re all on Vicodin – but long story short, there is no Active and Passive.  There’s only Interactive.

Okay, maybe that was too short.

Basically, thanks to Heisenberg, the Doctor/Patient relationship is now interactive: the Doctor-Patient Relationship.  Doctors impact on Patients and vice versa.  The relationship evolves over time through interactions.  You don’t break up with your Doctor just because he does one thing you don’t like.  You work through your issues.


FULL DISCLOSURE:  This is where I stopped writing yesterday when I realized how much work the Interactive Doctor-Patient Relationship was going to be – like all relationships.  The very reason the Oracle avoids them.

But then today, the New York Times featured readers’ letters about this very issue.  It’s not just me, other people are grappling with this.  And – finally – I had a Big Idea.  A new healthcare specialty:  Doctor-Patient Relationship Counselors.  They’d be licensed.  Certified.  Think Dr. Phil.  Plus think of the number of Counselors you’d need – talk about job creation!  This Idea heals people and the economy.  Now all we have to do – and when I say “we”, I of course mean “you” –  is to persuade the Insurance companies to cover it.

Good luck!