Poor Bedside Manner

By: Loolwa Khazzoom, Founder, Dancing with Pain

July 5th, 2009 • Patient AdvocacyPrint Print

On Tuesday I went to have my lower right molar drilled down to oblivion, with a temporary crown replacing it. I’ve had wicked headaches and jaw pain since then. For the first 30 hours, I was just rolling with it, accepting it as a setback and planning on laying low for a few days. On Wednesday morning, I got some cranio-sacral therapy, which always helps with anything head-related (assuming it’s a top-notch practitioner).

But on Wednesday night, just before 11:00 pm, I suddenly felt as if I were going to collapse, just go completely unconscious. It was fairly terrifying. I called the dentist on her emergency number (presumably her cell) and left a message. That took courage and self-advocacy, because I feel quite uncomfortable calling after-hours. I don’t like to disturb people who may be asleep, and I feel apprehensive about the reaction a practitioner may have if I call in the middle of the night.

I got the dentist’s voicemail. I described my symptoms and asked her to call and inform me of the chemicals in the novocaine compound she used. During the procedure, she had mentioned using some kind of anesthetic, apparently in addition to the novocaine itself. As I expressed in my message, I wondered if I was having a chemical reaction on top of any musculoskeletal sensitivity I was experiencing.

It was a hell of a night, and I had my dear mother calling every couple of hours to wake me up and make sure I was still conscious. At 6:00 am, the dentist called and left this message on my voicemail: “I’ve never had a base patient, in the 22 years that I’ve been practicing, have a reaction to having a crown or have a delayed reaction to anything I’ve given them for anesthetic…I really don’t think what you’re experiencing is related to the dental work.”

When a patient calls in pain, especially if it’s urgent enough that she calls after-hours, good bedside manner dictates expressing concern, first and foremost. Playing on the patient’s team. Validating the experience. Offering suggestions for self-care. Assuring the patient that it was smart to call. Offering to see her in the office on the next business day. Providing some emergency contact information meanwhile.

Telling me that I’m the only patient who has ever in the history of her practice had any sensitivity whatsoever (which I find hard to believe) only serves to alienate me, implicitly blame and shame me, and otherwise make me feel uncomfortable and anxious about communicating anything else about how I’m responding to the dental treatment.

To her credit, the dentist did give me the contact information for an oral surgeon who has both medical and dental training. And she did tell me to call her later and let her know how I was feeling. I did not, however, get the feeling that she sincerely cared.

I did call her again, but only to get the information I’d requested about the chemical compound, being that she had not responded to that query in her message. In that follow-up conversation as well, the dentist did not express any care for what I was going through. She just stated that my experience couldn’t possibly have anything to do with the chemicals either, because they should have cleared through my system by then.

Mind you, both during and after the procedure, I expressed to this dentist that she had done a great job. In addition, in my voice message, I clearly expressed my assumption that my reaction was a result of the current hypersensitivity of my body. I neither felt nor asserted any implication that the dentist had screwed up in her work, so there was no reason for her to get defensive.

It has been my experience, however, that regardless of how I approach them, practitioners are often more concerned about covering their own asses than about helping me figure out what is going on and how to alleviate my symptoms. Prior to a procedure, I’ll have no symptoms. Following a procedure, I’ll have severe symptoms right in the area that was worked on. And yet I’ll be told that the symptoms I’m experiencing have nothing to do with the procedure I had.

I’m left not only with the fallout of a procedure, and not only fending for myself seeking treatment, but also having to deal with practiitoner invalidation and denial as well. Among other things, it’s just plain crazy-making.

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