Blog | Thursday, May 17, 2012

Plumbers, ninjas and doctors

When my wife told me about her encounter with the plumber, all I could think was: "What a jerk!" Then I was hit with an eerie sense of familiarity. OK, it wasn't exactly eerie, but there was some creepy music in the background.

We had a shower fixed about a year ago, costing us a bunch of money. I would do it myself, but past experience gave me frightening images of water dripping through the ceiling, and bathrooms falling in to the middle of our garage. I still awake with cold sweats from previous plumbing experiences. So we found a plumber with good recommendations on Angie's List, so we thought we were safe.

But after paying a whole lot of money, we were left with a faucet that seemed like it was made out of a plastic-metal alloy and took about half a turn to get any cold water. We were afraid to call the guy back, however, given how much he charged us for our previous encounter. Despite the cheap faucet, we had no leaks and experienced no sudden appearances of bathrooms in our garage.

Then last week my daughter told us the shower wouldn't turn off. Through the fine art of faucet jiggling I was able to get the shower to stop (and she was quite impressed by my mad skills). But another night's shower had the same complaint from my daughter, and my skills were not as mad as I was. Since it had been about a year since our last repair, and since the faucet seemed chintzy, we called back the same plumber and he came over to assess the damage. It seemed like it was his fault.

The plumber, being the trained craftsman he was, quickly found the source of the problem: us.

My wife explained what happened, as well as the elbow pain we all experience turning the cold water, and he shook his head. He noticed the caulking around the cold water faucet was missing, and told my wife that someone had "obviously" done something to that faucet. When my wife explained that my mortal fear of plumbing (and her mortal fear of my plumbing) made this an impossibility, he looked at her with a condescending skepticism. It seemed "obvious" to him that either my wife was not telling the truth, or that a plumbing ninja had infiltrated our bathroom to remove the caulk without our knowledge.

Things got worse when my wife suggested that the hardware installed wasn't very high quality. He seemed offended at the suggestion that he would use anything but the best. How could a mere mortal non-plumber suggest that the shower that she uses every single day is anything but the best? Her suggestion that it shouldn't take so much turning to get cold water was clearly a statement of ignorance, or a fabrication designed to slander this highly trained professional.

The good news was that it was just the white cartridge thingy that needed replacement and so it took only $75 to get rid of this jerk and get our shower back to its previous sorry state. I suspect that because the faucets have so much play in them, my daughter cranked them harder than she should to turn them off and so damaged the cartridge thingy. Either that, or the plumbing ninja was at doing more than going after the caulking. I shouldn't think about it too hard, though, because I've actually created leaks in pipes by prolonged contemplation.

Unfortunately, this encounter with the demigod of plumbing reminds me a lot of what my patients get when they see certain specialists. Several aspects of my wife's experience are eerily similar (there goes that music again).

The plumber's reality trumped anything my wife experienced. Despite the fact that she showers in it every day, she was not given any credit for her own experience. The plumber's self-centered view of the universe made it impossible to consider my wife may know something about the shower. In the same way, patients are treated like they simply can't be having the symptoms they are having because it doesn't make sense to the highly-trained and extremely intelligent doctor specialist.

My wife's suggestion that the plumber may be wrong was something she was made to feel guilty about. It's not just that she was wrong in her reality experience; she should feel shame for experiencing anything the plumber said wasn't true. This is exactly the same as my patients who visit doctors with the same reality-distortion field. They are bad people for experiencing what they do.

Our experience with the plumber makes us want to avoid further encounters with members of the profession, and to seek alternatives if possible. Why is it such a mystery that patients seek alternative medicine when they are made to feel stupid when they go to the doctor? Nobody wants to be made to feel guilty for symptoms they don't want in the first place.

We feel like our ignorance (and mortal fear) of plumbing is an opportunity this guy used to pass cheap material off on us for a premium price. My patients come back from specialist, ER, or hospital visits with enormous bills and often feeling they are not listened to.

I don't mean to pick on specialists, as there are plenty of primary care docs who treat patients in the same condescending way. Our profession has a bad reputation that we've been working hard to earn, so I have to share the credit with doctors of all kinds. I have patients actually tell me that I am "the first doctor who has ever listened to me." While I think that is an exaggeration, the perception is rampant: We docs are arrogant know-it-alls who charge too much.

So what next? I am going to Angie's List and am going to write a bad review of our experience with this guy. I owe it to other plumb-o-phobes so they can steer clear of this doink. I can't do this without hearing the shrill cries of doctors detesting their patients who give them bad online reviews. How can I complain about this guy? What do I know about plumbing? I should just be glad I don't have a shower in my garage!

We need to wise up. Some of this arrogance stems from a system which turns patients into E/M and ICD-9 codes, forcing doctors to pay more attention to documentation requirements and achieving "meaningful use" than to what the patient says. Doctors are sick and tired of the system, and sometimes facing a patient who blames us for the system that makes our lives hell gets under our skin. But nothing excuses arrogant reality-distortion fields like this plumber and many docs emit.

Nobody wants to see a jerk.

After taking a year-long hiatus from blogging, Rob Lamberts, MD, ACP Member, returned with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind), where this post originally appeared.