#cf my recent complaint posts etc sdfgh
i think doctors can get into problems which are caused by the way they learn the discipline. because there is an enormous amount of information to assimilate, the correct recall of any part of which can be a life or death matter, there is a great emphasis on memorization of values. there’s no way around this—you must know these names and numbers. but it does lead to interactions like this: as a diabetic i suffer hypoglycemia. hypoglycemia is when my hands shake, i feel faint, i cannot stand or move easily, i have a tremendous urge to eat, and things like that. the cause of all those feelings is that the blood going to my brain lacks sufficient sugar for my brain to do its work, which causes the brain to enter an alarmed state and my body to produce emergency resources like epinephrine. this is how i understand hypoglycemia. it is not how a doctor, especially one who is not an experienced diabetic specialist, is likely to understand hypoglycemia. they will understand hypoglycemia as a state the body enters when the blood-glucose levels are below 4.0. when the blood glucose levels are below 4.0, the body will do what i said. this is not true. the body will do those things when it needs to. it is normally true that it needs to do those things when the blood glucose levels are below 4.0, which means that for the purposes of clinical experiments and statistical reviews, a blood-glucose level of below 4.0 can substitute for ‘hypoglycemia’, and anyway, ‘below 4.0′ is easy to remember, and also easy to check in a clinical situation, and for all of these good reasons it appears in the textbook, and will appear on your flashcards, that hypoglycemia is ‘below 4.0.’ but i do not enter hypoglycemia at below 4.0, i enter hypoglycemia at below 5.0. it has always worked that way for me, and it has never not gone that way. it is simply the case that, whatever it is about my body, it needs slightly more sugar to do what it does than most people. this is of course completely possible, just as it is possible for one to only enter hypoglycemia at a lower number. but i can never convince any doctor about this; they always think i am misinformed and they correct me, because they have the right number memorized and i’ve given them a chance to exercise it. then, because i’ve made that mistake, they think nothing is really wrong—i am not chronically experiencing low sugars, just chronically misinformed—and send me off. now i have to lie and say that i was ‘below 4.0′ because they want to hear it, and they’ll never learn from their mistake. if there is a good solution to this miscommunication it isn’t available to the patient during the appointment.
