Dear Annie,

sometimes, after we have had multiple disappointments and traumatic experiences, we lose sight and it is hard for us to look with new eyes at what is in front of us.

It's like a girl who has been raped, finds it hard to trust other men.

But, we punish ourselves twice and deprive ourselves of good and healthy relationships if we do that. This girl, if she lets herself trust people again, can meet a wonderful and caring man, who will become her husband and father of her children.

Likewise, not all physicians are like the ones you have met. Many are wonderful caring people, who truly want to do their best so that their patients will have the longest and best possible life.

I think from what you wrote about this doctor, that he is excellent. He did not "blow you off" , despite a very complicated clinical picture, and numerous previous encounters with physicians who did not seem to find an edge of a rope. He seems to at least try to pick up and put together pieces of the puzzle and at the same time provide you with some form of symptomatic treatment, according to what you told him has helped.

He probably did not understand every aspect of your illness in this one meeting, and if he is indeed a good and caring physician as he sounds, he will continue to think about you, and address all those issues with time, possibly consulting other colleagues, such as your pulmonologist.

The fact that he wants to see you in two weeks shows that he understands the urgency of your situation, and wants to get to the bottom of this and provide proper help as soon as possible.

There are many areas in medicine that are "uncharted seas". Because modern medicine with all its achievements has not seen everything and can't explain everything. If this was not the case, we could diagnose and cure everyone and live forever and there would be no place for any further research, development of better diagnostic tests and better management approaches in a variety of diseases.

physicians (and patients) approach those areas in different ways-

among physicians-

there will be those that will just sail away and leave you there in uncharted waters, many times telling you that those are just "imaginary" waves that make you feel you are about to drown;

those that will insist on using wrong charts that will lead to your crashing against the icebergs and sinking like titanic many times blaming you for crashing like that!

and those that will try, together with you to find the proper charts, taking every effort to understand, looking at every seemingly unimportant detail, and even seeing this as an opportunity to gain a better understanding of this illness. This approach requires a lot of patience from physicians and patient alike and may involve quite a bit of trial and error. nearly crashing, but changing direction on time. it requires mutual trust and respect. it requires a true understanding of the limitations of medicine by both.

Patients too have different approaches-

There will be those that will blame their physician for not having the proper charts, and keep on searching for one that does. (when in fact none exists).

There will be those that will force their physicians to sail in a certain direction because they are convinced they know the charts much better, and many of them will eventually find someone who couldn't care less and do what they ask for, even if he/she does not think it is in their best interest.

There are those that will look for someone to be their true partner, help them gradually find the best approach to sail those seas, be ready for the trial and error involved in the process. be ready to turn around and think together of an alternative route that can lead somewhere. be ready to stop for a while in a small island, before embarking again on the journey to get to a safe shore, and be ready to understand that possibly they will never find the way, but at least some one will do their best so that they don't drown.

Only a physician and a patient who are ready to explore together, stand a chance to succeed.

alice