I don’t know about you, but I navigate a lot of how I feel through music. With the medical anxiety I have, and my desire to gain better perspective of it, I have been thinking a lot about why I have this particular type of anxiety. Part of it is definitely a distraction from what I am actually anxious about. I get that and have written about it here – but I have been mulling something over in my mind about doctors and why I have feared them at the same time as I have revered them (hmm… that’s similar to how I experienced God as I was growing up).
So what does this have to do with music? Well, there is a line that is going through my head when I think about this: “I am not a Doctor, I’m a God” which of course isn’t an actual song. Instead it’s my little parody of the Halsey song called “I am not a woman, I’m a God” and so this phrase has been rolling around in my head to the tune of Halsey’s song.
What I have been thinking about is how in America, doctors are placed on a pedestal as if they are gods. And many of them act that way. My very young mother often turned to the paediatrician with every concern. Of course back then she didn’t have the blessing/curse of the internet to turn to, so she probably turned to her mother first, who told her to turn to the doctor. My grandparents totally revered their doctor. We knew the name of their godlike doctor as they talked about him all the time! And down the line it went – any time my children get a slight fever, my mother encourages me to take them to the doctor. I am more of a wait-and-see type of mother. Maybe that’s partly generational because when I was a kid, doctors seemed to give a penicillin injection or some type of medication on every visit. Now they tend to tell us to wait out a lot of colds and such due to overuse of antibiotics.
Subtle differences with not so subtle results
I grew up with the belief that doctors are all-knowing gods. But I also have the perspective of experiencing medical care in Australia. This has given me the ability to make a comparison that many people don’t have. And I really didn’t notice some of the differences for a long time. Yes, there are some very obvious differences such as there isn’t a ‘middle person’ in Australia. When you get called back for your appointment, you get called back by the actual doctor, and not some assistant. You don’t have all of your vitals checked at every visit. You aren’t asked to step on the scale every visit. And you don’t see logos for pharmaceutical companies on promotional swag everywhere you look.
But there are some subtle differences that have helped me see why I have been so fearful of going to see a doctor. In Australia, doctors often refer to themselves by their first name. So for instance, I am seeing “Kate” instead of “Dr Jennings”. Subtle, but it does make a difference in that it humanizes the doctor, and makes me more comfortable. It’s much less imposing. Less threatening.
Another difference that helps is that doctors in Australia seem much more comfortable saying “I don’t know” and if it’s not really relevant or important to my health, they don’t feel the need to investigate until they can give me a definitive answer.
I tend to become hyperaware of what is happening in my body. And I love to ask “why” and I love to know the answers to everything. In America, it seemed like the doctors were quite happy to investigate when they probably wouldn’t have here in Australia. I would guess that it’s in part due to many doctors in America being part of hospital systems, so perhaps there’s a conflict of interest. They refer patients for tests run by their hospital system, so could there be a financial incentive? And then there’s probably also a legal component. If I mention symptom X and they don’t do any tests, and I die of a curable disease, would they get sued for malpractice?
When a child is diagnosed with autism as a child in Australia, they are referred to supports such as Occupational Therapy, Play Therapy, and Speech Therapy. In America, I have been told that it’s standard to have a whole battery of genetic testing once an autism diagnosis is given.
Another instance of overkill that I can recall is when I last saw a doctor for myself in America in 2019. The doctor offered to schedule me for a hysterectomy because I had minor menstrual cramps during the first day of my period. That was a bit of a shock, and I declined her offer and never returned to see her. Overall I would describe her as arrogant, and abrupt. I may have even seen some eye rolling over my unwillingness to follow her advice. She definitely had that air of ‘I am not a doctor, I’m a God’.
Different perspectives, different results
Doctors in Australia seem to have a different perspective on medical care. And that’s helped me to change my perspective. At first, it seemed like doctors in Australia were just fobbing off my concerns. I was in my early 30s, my autism was undiagnosed. I had a three year old daughter and a small business to run, and just wasn’t coping. I was having panic attacks but I didn’t know the symptoms were from panic symptoms and always thought I was dying.
When I went to the doctor in Australia, I didn’t understand the cultural differences at first. I think they were able to see my symptoms as mental health symptoms although none of them mentioned medical anxiety or even panic disorder. It was always Generalised Anxiety Disorder. And I was very resistant to any kind of mental health treatment. I was fully against any more Cognitive Behavioural Therapy, which was what every doctor in Australia wanted to send me to. I previously had years of therapy and didn’t see results. I was also fully against taking medications because I was so proud of the fact that I had quit taking them. So I would carry on about my symptoms until they would send me for tests.
But after years of putting myself through a variety of medical testing both in America and in Australia that turned up nothing of concern, and another massive bout of medical anxiety, I have a much better understanding of how the differences in medical care have impacted my medical anxiety disorder.
I think that in America, the god-like status of doctors, the entanglement of medicine and money, the culture of illness and the culture of litigation have contributed heavily to my medical anxiety issues. At first in Australia, the loss of that doctor-god that I could turn to for definite answers, combined with a less interventionist approach left me more worried because I was sure they weren’t as good as American doctors, or they were going to miss something because they weren’t so test-happy.
But now I see that it’s just a different perspective, a different culture, a different approach. I am not saying that Australia has a perfect system – far from it! But I find that overall I do prefer the approach I’ve experienced here.
They’re not gods, but they’re great doctors
When you have complex needs like I do, it’s important to do all you can to put together a great team. It’s taken some time, and a more open mind to both physical and mental health services, but I feel as though I finally have a team that I can trust. The general practitioner that I now see is the mother of an autistic person. She fully understands my medical anxiety and is incredibly thoughtful in her approach when I have an appointment. My mental health concerns are always taken into account, and I am given the time to ask all of my questions. She never seems exasperated with me, and is very patient and kind.
I have a therapist who is also a general practitioner and specialises in autism in adults and adolescents, so he is also able to help when I am find my head spinning with a million medical worries. He has also been very thoughtful in his approach to medication. For the first time, I have a doctor who is not overmedicating me into zombieville. With my history of quitting medication cold turkey without telling my doctor, I know how important it is that I can actually talk to my doctor openly about my experience on medication without feeling like I am just going to get more and more pills piled on me.
Continuity of care is so important for autistics. Not just because change itself can be difficult, but because it’s frustrating when I have to start over with a new doctor and hope that they aren’t intimidating, or rude. I’m never sure that a new doctor is going to get what I am going through – how difficult it can be just to walk into their office and to talk about the things that are so anxiety-provoking to me.
I am very grateful to have the team that I have. And as I type this I get that rising fear that I am going to lose someone from my team just because I have dared to be grateful for something! But that is something I work on in therapy – now that I am with a good therapist that I trust.