Wait what’s a buildings fire evacuation plan if you aren’t supposed to use the elevator to get down
You go down the stairwell/fire escape. Is that weird?
But what if you have a walker or a wheelchair??
in america at least, in this situation, there isnt one. either your loved ones or the firemen can get you out using the emergency fire escapes or stairs, or you die
That’s fucking horrific, thank you
“fun” little story:
last summer my friend who is an amazingly talented artist and i were in this super tall building, and she’s in a wheelchair and i’m pushing her around the room. it’s an art exhibit and some of her art was chosen to be showcased there and so it’s all fine and dandy until suddenly an alarm starts going off
a FIRE ALARM
everyone starts running for the stairs and my friend just looks at me with this forlorn look on her face
“i can’t go down the stairs”
but i’m a stubborn bitch “i’ll carry you”
“what about my chair? it’s too expensive for me to be able to get another one if i can’t get this one back”
“i’ll carry that too”
and i did. we went to the stairs (by then most people from our floor were gone) and i lifted her up in a fireman’s carry over my shoulder and then lifted her chair up and used the ridiculous amount of adrenaline that was coursing through my veins to make it down approximately 20 half-flights of stairs until we met some people exiting lower floors, one of which who kindly took the chair. I changed positions so i was holding my friend bridal-style which was, somehow, easier and the person who took her wheelchair (with her permission to handle it of course) accompanied me to the ground floor and then out the doors
basically there is no real protocol for people who can’t use the stairs in an emergency. it’s up to the people with them, if anyone, to help them or the person to somehow make it down the stairs alone, unassisted
thank fuck that it was just a faulty alarm system, because if i was unable to carry her down those stairs and the building was on fucking fire???? then i don’t know what would have happened to her, but i don’t think it would have been very good.
it’s fucking ridiculous and ableist to the absolute max.
I use a cane. When I did a day-long fire safety training at my northeast American university (UMass Amherst), I asked that exact same question: “what am I supposed to do if the fire alarm goes off and I’m in my lab on the twelfth floor?”
the fire marshal hemmed and hawed for a while and then said to take the elevator- you’re supposed to leave it free for the fire department to use and they want able-bodied people out fast not waiting for elevators. if the fire alarm has just gone off the building probably hasn’t suffered enough structural damage to make using the elevator dangerous, and modern elevator wells are heavily reinforced. many large and high-trafficked buildings on my campus have fire rated elevators that link in with the fire alarm system so they won’t let you off on a floor with a possible fire.
if the elevator isn’t working, wait in the stairwell and call the fire department to let them know where you are. modern stairwells are also heavily reinforced- it might not be pleasant but modern building code usually requires fire-resistant stairwell doors in office and big residential buildings, also to help firefighters get in and out safely. older buildings’ stairwells may or may not be retrofitted with fire-resistant doors but a stairwell is generally the safest place to wait if you can’t get out.
what happened to your friend was horrible, and i’m very glad you were there to help her out, but you can absolutely use the elevator to evacuate if it’s not shut down. those don’t-use-the-elevator rules are for abled people.
This is GOOD TO KNOW. why do they not tell people this??
Okay, firefighter here. If you are not physically able to use the stairs, and the elevator is NOT compromised, use the elevator. But you MUST be ABSOLUTELY CERTAIN that the elevator is NOT compromised before you get into it, because there is always the chance that once you get into it, you may not exit it. Power could go out. The elevator may actually BE compromised and you just couldn’t tell from where you were until you were in there, and it suddenly shuts down on you. Something else could happen.
Understand that once you enter the elevator, you could POTENTIALLY be taking your life into your hands there.
It is NOT LIKELY, to be perfectly honest. It’s only in a pretty catastrophic scenario - think the Twin Towers, USA, on September 11th - that the elevators will be compromised and out of service. But there is a NOT ZERO PERCENT CHANCE and you need to understand that and accept it.
As for leaving the elevators free for the firefighters, okay, here’s the deal. Unless your nearest fire station is literally right next door? Your first on scene fire truck is NOT likely to be there on scene and needing that elevator before you get to the ground. It takes us TIME to find the address, gear up, and drive to the building. Then we need to hoof it into where the elevators even ARE, so YOU HAVE TIME to use the elevator to get down to the ground floor… BUT ONLY IF THERE’S NOT A RUSH ON THE ELEVATOR! And THAT is WHY we don’t tell people this shit. That’s WHY we tell people to NEVER USE THE ELEVATOR… because every self-entitled asshole will use it because they don’t feel like walking, and then put YOU in danger by delaying the elevator’s arrival to you.
IF, however, the elevator IS compromised, or you just can’t get it to come for you, or whatever, and you either don’t have anyone with you who has the adrenaline fueled BALLS to be able to toss you over their shoulder and hoof it down the stairs with you - because, let’s face it, that is RARE AS FUCK, then HERE IS WHAT YOU DO:
You call 911 and tell the call taker that you are in the building that has a fire alarm going off, and you are not able to evacuate because of a physical disability, and you tell them what floor you are on, and EXACTLY what stairwell you are waiting at. And the very FIRST thing that the firefighters are going to do once they arrive, if it is, indeed, a REAL emergency, and not a false alarm, is come get your ass and bring you down. Whether that means carrying you down the stairs, or whether that means locking out the elevators so that no one else can override them and coming to get you themselves, they WILL come get you FIRST THING if it is a real event. And if it is a false alarm? You will probably be the first person who is not involved with the building to know, because the call-taker is going to stay on the line with you until you are under someone’s care and out of danger, or until the scene has been sorted out as real or false, and you are out of danger that way.
These are pretty standard operations in the fire service throughout the United States. There may be some minor variations based on specific municipalities, but, for the most part, this is pretty typical: LIFE BEFORE PROPERTY. So, as long as SOMEONE knows where you are - hence why you call 911 - Firefighters will come get you. You are NOT alone, and you have NOT been abandoned. I PROMISE. It’s like, our whole reason for doing the shit we do: to save lives and to break shit. Sometimes, we get lucky enough to do both at the same time.
High rise fires suck ass, and I always hated them. But the very FIRST thing I asked anytime we got one was if we had “any entrapments” - which is what we call anyone who could not self-evacuate for ANY reason. We ain’t leaving you behind. And yes, your friend who doesn’t have the stamina to carry you down can stay with you, too. Because I would never ask that of someone, honestly.
Also, just a little FYI… MOST fire alarms are false alarms. Not to make anyone complacent or anything, but, yeah. Most of them are either system malfunctions, someone accidentally hit a pull station, or someone burned popcorn in a break room. So don’t let a fire alarm freak you out until you need it to - by smelling or seeing smoke or flames.
i have had multiple nightmares about this very thing because NOBODY BOTHERS TO ACTUALLY TELL WHEELCHAIR USERS THIS STUFF
First image: Black text on a distressed red background that reads “Disability is not a slur.
Second Image: Black text on an orange distressed background that reads "Autism/Autistic is not a slur.”
Third image: Black text on a yellow distressed background. It reads “We need to destigmatize the word disability. It’s not a slur, it’s not a swear word, and it’s not dirty. It’s simply a descriptor/label. But you know what are slurs? Words that actually hurt disabled people? The r-slur, cripple, lame, dumb, handicapable, deranged, deformed, crazy, insane. Most of these are still used as insults. Or equated to something bad.”
Fourth image: Black text on a red distressed background. It reads “Disabled people are already living in a world that was not made for us. A little consideration, even just about word choice, can make all the difference.
Fifth image: Black text on a yellow distressed background. It’s titled ‘Sources’ at the top of the image, which is then followed by a list of sources:
Something that I was unable to mention in the above infographic, the reason that words like insane or crazy are harmful because they reinforce that those are morally awful, horrible things, or at the very least something to be ashamed of. This is inaccurate and it only adds to the saneist propaganda already out there. The same goes for using the words 'blind’ and 'deaf’ in the wrong situations, like saying "Man I’m so deaf hahaha” or “Wow I really must be going blind.”
Me:* an autistic person vibing to a song and taking every word of the song literally. *
People: ACTAULLY THIS SONG AS A SUPER DEEP AND HIDDEN MEANING! YOU’RE A BAD/DUMB PERSON IF YOU DIDN’T INSTANTLY GET IT!! HOW COULD YOU NOT SEE THE SUPER DEEP HIDDEN MEANING?!
Saying “that’s karma” about people having disabilities or getting diseases is very ableist.
TW + CW: ableism
I saw two reddit posts today
1. A six year old girl gets a agressive form of cancer and may die.
2. A 11 year old girl gets paralyzed in a tragic accident
So what were people’s reactions??
Saying that’s karma because the parents, kids or someone tbe kid knows did something “ bad ” so people claiming the kids “ deserved ” such things..
I see this a lot. People claiming disabilities and illnesses are “ deserved ” and “ karma” because the person or someone they know did something bad…
Like it’s so messed up to say that such things are deserved and karma.
But also it has some really f×cked up underlying implications that people truly believe those with disabilities or illnesses are bad people that deserved it or in somehow karma.
I have seen a lot of posts on here talking about individual extensions for chrome to help people, but I haven’t seen a place where they’re compiled together. So here you are! (If you find anymore, let me know!)
edit: ublock, stylish with lowercase text theme, and No more Tumblr players was added, other extensions masterposts section added, no caps was removed
font/text
no caps - Makes everything lower case (found to contain malware)
Stylish: download different themes that can help with accessibility (lowercase text theme can be found here, works like no caps)
Open Dyslexic: changes the font to Open Dyslexic and makes it larger. Personal favourite.
Dyslexie: changes the font to dyslexie and allows change to font size and colour (blue). Can be turned off. (Doesn’t seem to work on facebook)
Font Changer: Allows you to change the font on specific website or on everything using a Google Font. I believe you can also upload your own, if there’s a specific font you need.
BeeLine Reader: Uses a gradient so your eye follows along one line to the next
I know it’s not the worst aspect of being disabled, but I loathe the sheer amount of rubbish I generate from all my medication boxes and blister packs, and a lot of it isn’t recyclable
• Don a flower crown. You can make it yourself or buy a ready-made version! No matter the day or season, a flower crown always makes me feel absolutely magical. If you have allergies or sensitivities, artificial flower crowns are just as magical!
• Highlight your mobility aid. I remember when I first got a wheelchair, I was really self-conscious about it. My best friend came over and painted it purple for me! Before the pandemic, she’d take me on walks in my chair, and I got loads of compliments on it. Instead of trying not to draw attention to yourself, celebrate the things that give you a higher quality of life. That wheelchair allowed me to get out into nature rather than staying stuck in my bed all the time. That was definitely worthy of celebration!
• Decorate your health aid. Put a pretty sticker over your feeding tube. Paint butterflies on your cast. Attach a little flower to your hearing aids, or hang strings of beads from your glasses. Fill your life with beauty—even the parts that might not feel beautiful at first.
• Remember that your flaws aren’t. Seek out role models who have the same or similar conditions as you and allow yourself to see them as magical, so that you can see that in yourself too. Highlight your vitiligo. Draw flowers around your moles. Look for shapes and constellations in your scars, like you would find in the clouds above. Notice how your body mimics beautiful patterns found in nature.
• Ask for help. If you don’t have the energy or ability to dress up as the faerie royalty you are, see if a friend will come help you!
• Embrace beautiful scents. A little floral perfume or essential oils nearby can instantly transport me to fairyland. You deserve the pleasure of smelling something lovely, whether you wear it for others to enjoy too or not.
• Know that nobody has to witness your magic for it to be real. I still sometimes put on sparkly makeup and a crown when I’m confined to my bed, even though nobody else will see me. It makes me feel magical, and that is reason enough.
• Remind yourself that you are worthy of feeling special. It can be hard to get past the blocks of insecurity that come from visible disabilities or health conditions, but you are just as magical and worthy as anyone else. Remind yourself of that from time to time. You deserve magic because you are magic.
First image: Black text on a distressed red background that reads “Disability is not a slur.
Second Image: Black text on an orange distressed background that reads "Autism/Autistic is not a slur.”
Third image: Black text on a yellow distressed background. It reads “We need to destigmatize the word disability. It’s not a slur, it’s not a swear word, and it’s not dirty. It’s simply a descriptor/label. But you know what are slurs? Words that actually hurt disabled people? The r-slur, cripple, lame, dumb, handicapable, deranged, deformed, crazy, insane. Most of these are still used as insults. Or equated to something bad.”
Fourth image: Black text on a red distressed background. It reads “Disabled people are already living in a world that was not made for us. A little consideration, even just about word choice, can make all the difference.
Fifth image: Black text on a yellow distressed background. It’s titled ‘Sources’ at the top of the image, which is then followed by a list of sources:
Something that I was unable to mention in the above infographic, the reason that words like insane or crazy are harmful because they reinforce that those are morally awful, horrible things, or at the very least something to be ashamed of. This is inaccurate and it only adds to the saneist propaganda already out there. The same goes for using the words 'blind’ and 'deaf’ in the wrong situations, like saying "Man I’m so deaf hahaha” or “Wow I really must be going blind.”
if you are not wheelchair bound, and need to step out of your wheelchair, please do it.
even if youre in public, dont worry about what people will think or say, if you need to get out of your wheelchair, do it.
you dont owe them an explanation, you dont deserve whatever stares or comments youll attract, and you are still disabled, you still need the wheelchair even if you dont need it constantly.
dont let what people might say or do stop you from getting out of your wheelchair.
I get weird looks when I’m out on a walk and have to get up to fix my smart drive motor, when I cross my legs, when I pull my own chair out of the trunk and put it together. But none of those things mean I’m not disabled and don’t need my chair. Use your mobility aids!
does anyone have any tips on hygiene and chronic illness? I dont have enough energy to brush my teeth, shower, brush my hair etc. most of the time and it’s not great. thank you!
Do not just come up behind a wheelchair user and start pushing them. It. Is. Not. Ok. It’s like someone coming up behind you, picking you up and carrying you away. If you think someone needs help. Ask. We are not toys.
There is only one appropriate time to ask someone what their disability is. This being, if you are a medical professional who is currently treating them. There is litterally no other time when this is ok, if someone wants you to know. They. Will. Tell. You. Otherwise it is none of your business. This includes mental health problems.
I’m going to start this off by saying, mobility aids shouldn’t be used as a fashion accessory, however, if you need one. You have every right to make it look nice.
1. Stickers, this is probably the easiest and can be used on most mobility aids. You can get stickers online (amazon, red bubble etc.) Or if you find any in stores, that works to (obviously). They can also be low energy to apply.
2. Painting, this might take alot of energy for some people, but if you can, painting is a great way to make it look nice. For wheelchairs you can paint the back or if you have solid wheels you can paint those too. Crutches, walking sticks and walking frames can all be painted on the bar part (I’m sorry I dont know what its called)
3. Duck tape, a great alternative to painting.
4. Grips, these can be expensive but you can get grips for the wheels on wheelchairs and the handle on crutches, I’m not sure about walking frames.
I hope you find this helpful, I’m sorry if I got anything wrong, feel free to correct me if i did. I hope you have a good day :)
Gotta love hefty doses of ableism and non disabled people defending it because “it was for his own good” and “it was a different time”. Not to mention the racism and sexism! I hate this book and will fight people over it.
After will smith incident, are all who have any sort of disablity or illness now finally allowed to hurt people who laugh about their health flaws without fear of losing jobs or being looked at as freaks for trying to stand up for their dignity?
This article is harrowing. This is the experience of a doctor with a chronic illness, how, how the HELL are we supposed to, how the hell are we supposed to get treatment and be treated seriously when this is what actual members of the medical community come up against?
This is how they think of us.
Some highlights:
I told him I couldn’t do schoolwork, feel the cold, or understand a book. He suggested I go on walks if I was stressed.
This breakdown in communication, in which patient and doctor seem to live in different worlds, is well-documented by disabled people. Many feel they have to translate their experience, because disability and medical structures seem incompatible.
“I remember, even as a med student, having the vocabulary to explain what I was going through but feeling like I had hit a brick wall,” she says. “I actually didn’t know how to describe it.”
“If I said the word ‘pain’ [colleagues] took it as coded language for ‘I’m lazy’ and ‘I can’t do my work’.
“They would challenge my reality,” she says, something which led her to conceal her symptoms. “I felt like everything I shared was going to be weaponized against me. They would say ‘you walked two days ago so why can’t you walk today?’ Almost like they caught me in a lie.
”The baseline understanding of what it means to be disabled is not there.“
Disabled people make up about 20% of the population in the UK and US but only 2% of British and American doctors.
”It’s completely baffling to me how we can expect patients to respect us when we won’t even believe what they’re telling us.”
.
..medical experts often perceive disabled patients as incapable, unreliable, and emotionally unstable, leading clinicians to “downgrade the credibility” of what disabled patients say.
“I wish medical students were taught to be open to information disabled patients provide,” she says. “It’s okay for a medical student or doctor to admit that they don’t have the answer. That’s so much more helpful than gaslighting the patient.”
As a disability activist who’s proud of being disabled, there’s a vocabulary of identity that I can’t use with doctors,
With a disabled doctor I wouldn’t have to explain so much because we’re speaking the same language,“ they say. “My care outcomes would be so much better because I would be understood.”
As a disability activist who’s proud of being disabled, there’s a vocabulary of identity that I can’t use with doctors,
Yes! You have to dial down your understanding of your own disability, because they’re suspicious of you for knowing about your condition, or they have no idea, or both.
I spoke to a psychiatrist once who patronisingly informed me that delayed sleep phase had nothing to do with ADHD, despite the fact that some research shows that a majority of people with ADHD have issues with it.
I actually had surgery once, with a badly broken leg. A surgeon put 7 screws, a pin and a plate in my leg, and that afternoon told me I didn’t need painkillers to take home because I have chronic pain.
A month later, two different GPs at the same practice waved me off when I told them I had had a fever so bad I sweated completely through my duvet, soaking the entire thing. The third GP sent me straight to A&E, where I was immediately admitted and still almost died. Because I was in sepsis, but anything I talked about was dismissed as exaggeration.
These are attitudes that make our lives difficult, make it difficult or impossible to get treatment, and that can and do kill.
Genuine question for me is where so many doctors get the idea that patients routinely exaggerate and lie about symptoms?
A coworker of mine once spent over a month being completely unable to eat anything but the tiniest portions of the blandest foods without immediately throwing it back up, and suffered from intense stomach cramps that left him unable to sleep, and his doctors shrugged their shoulders and told him it was probably not a big deal.
He didn’t take me up on it, but I was willing to go with him to the Doctor and make a scene until they fucking treated him because brushing those symptoms off was fucking insane.
There’s a very good chance that disabled people or minorities get this more, but he’s an able bodied white guy and he still got the, “it’s probably all in your head” treatment.
I’m baffled by this kind of thing, because as far as I can tell people very rarely lie about things like “I am in intense pain” or “I can’t keep food down” and, additionally, as far as I can tell “I’ve been throwing up everything for weeks” is not a usual symptom of missing a couple of nights sleep or being stressed about schoolwork or whatever.
Part of it is hypervigilance about stuff like “drug seeking”, part of it is awareness that lying to doctors is very frequently rational behavior, especially when the patient understands the medical system (I know I will have to lie to doctors very frequently in order to transition - they know that too).
Additionally, doing medicine on conscious human patients requires doctors to consider their patients to simultaneously be a regular person for social purposes, and a messy biological automaton for medical purposes. This means constantly switching between a holistic and a reductionist perspective, which is hard. Doctors are experts on the latter, so they default to that understanding, which means they are liable to neglect the humanity of their patients.
Really, though, I think most of this is just the manifestation a social problem. Doctors are a distinct class (with their own social position, title, rituals, and a separate moral code) that often appears to consider itself in conflict with, and superior to, patients. They keep trying to fix people who are broken, but people also keep getting broken, which is very rude of them. Some patients are resistant to treatment for whatever reason, which generalizes to “patients are resistant to treatment”. Their public health training teaches them that the greatest obstacle to public health is the public. If their patient is cooperative and leads them to the diagnosis, or even worse, already knows what’s wrong with them, then that’s an implicit threat to the exclusivity of their social position, and must be punished.
Former EMT from a family of doctors, NPs, and army medics: patients absolutely lie about their symptoms, constantly. They will lie about pain levels, they will lie about what caused symptoms, they will weave things they read on WebMD into the narrative of their relevant history, to support the diagnosis they know is right anyway (it isn’t).
I’m no better. I got terribly itchy spots on the backs of my hands after I kept exposing my car-accident scrapes to near-boiling water, somehow convinced myself it was scabies, and spent the better part of two hours digging out suspicious pigmentation spots with a hypodermic needle. I cannot tell you the shame I felt reading the Derm’s “I must control my expression because he can’t know I know he’s an idiot” face, because I’ve worn that face so many times.
Patients are panicky, self-deluded morons (myself included), and if you somehow experienced illness without actively sabotaging every effort made to diagnose or treat you, then you are God’s noblest creation, and a better man than I.
But in general, smile, nod, note what they said in the chart, and then run the test anyway because they’re lying to themselves and you.
First off, I’m sorry that you were treated like a malingering, lying idiot because you were anxious about a condition you thought you had
and that the person you went to who you should have been able to trust to treat you with compassion and dignity, didn’t
even if you were wrong about it, even if you knew what had really happened.
If you reached the point of digging into your body with a needle because you were freaked out about having scabies, you still needed treatment.
It shouldn’t have been ‘here’s treament for your scabies’ but it should have been ‘I’m knowledgeable in my field and I can reassure you that this isn’t scabies’
instead of ‘doesn’t this moron know this isn’t scabies, isn’t EVERYONE a dermatologist?’ like the arrogant dicksucks this news article is talking about
And I’m sorry that your cynicism has led you to despise not only yourself but also other patients who you should feel compassion towards (yourself included)
But you’re wrong.
No one is saying that people never lie.
The point is that doctors have a duty of care to their patients to notbelieve that their patient is lying from the get go, and fob them off with ‘you’re fine’ or ‘it’s stress’ or 'get more exercise and drink more water’.
If you take even fifteen minutes to browse through the stories of some people on here with disabilities and chronic illness and see the amount of 'my doctor told me it was nothing and now I’m chronically disabled’ or 'I was left in pain and struggling for 10 years because my doctors didn’t believe me’ you can see that when doctors either become jaded or, for some reason, go into their profession jaded and cynical, it does tangible damage to the people who put their trust in the hands of people who are supposed to know better.
Incidentally, this was a news article specifically about that, I don’t know if you read it
Not to mention the fact that there are a myriad of reasons for a patient to present with a problem they don’t have, lying about it or otherwise.
Health anxiety - formerly hypochondria! the illness of the hysterical and attention-seeking! - is now being treated as an actual illness, as it should be, even if we have to thank ableds getting Corona for people to stop taking the piss.
If someone lies about pain because they’re genuinely seeking drugs, whoops, that’s another issue that should be treated with intervention and not scorn.
And even if people are genuinely lying for the attention, there’s something in that which indicates some kind of help is needed, even if it is just therapy to help them realise they don’t need to resort to those extremes to get what they’re looking for.
Patients are panicky because something is happening to their bodies that their mind tells them is wrong, but they don’t have the tools to navigate the experience like, say, a doctor would.
'Hi, I’m your body, and I know you’ve been relying on me all this time to digest stuff, and keep you upright, and keep you breathing and generally do all those things with no discomfort, but now I’m going to make you puke and fall and mildly suffocate and oh yeah, you’re going to be in agony the whole time’ - yeah, people panic.
That doesn’t mean they’re self-deluded morons, and once again, even if they AREdeluded, even if they AREmorons, doctors are supposed to know better than laymen and they’re supposed to use that knowledge to treat, not to scoff.
If patients knew all the crap the doctors know then we could have a revolving door of part-time workers like a McDonalds, a McDoctors if you will.
As it is, some of us are shown more compassion and understanding and better treatment at fast food drive throughs than at the hands of the very people who are supposed to make us feel better.
You’re either saying that becoming a doctor is piss-easy, or that all doctors are crap at their jobs.
It’s not up to doctors to judge, it’s up to them to diagnose.
You’re fooling yourself if you think that no patient knows that you’re smiling and nodding at them while thinking they’re lazy lying morons behind your plastic smile.
And a lot of the time, the last thing these people get are the tests they deserve to have run, and if they have to put up with smug, arrogant bastards for a while to get them, then so be it; they’ll smile and nod and the whole time think 'just shut up and do your fucking job, give me my results so I can take them to someone who knows better/someone who’ll actually do something about it/hell, WebMD because no one I’m talking to face to face is helping me without acting like I’m a drain on their time instead of their customer base’
That’s not even to begin to mention the farcical nature of a healthcare system that can bankrupt people over an accident and have dangerously injured people literally crying because the cost of taking an ambulance to the hospital will cripple them.
If you have to pay for three separate trips for three tests or treatments for the same issue, facing a callous sneering doctor who barely remembers why you’re there, then yeah, I’m not surprised people try to pre-empt all the faffing around by seeking answers from WebMD or online sources.
But even with all this said, at the very end, I’m really fucking glad that you’re a former EMT and I hope that anybody else in your family who feels like going into a line of work where they have to give a fuck about sick, scared, confused, vulnerable people in pain thinks twice.
And don’t even try working at a fast food joint. You aren’t able to fake the empathy needed for good customer service.
I don’t know if this is a reasonable misinterpretation of what I wrote, or a willful, bad-faith one, so I’ll elaborate and clarify.
The point is that doctors know how easy it is to fool yourself into thinking the worst, into pareidolia-ing yourself into seeing zebras where there are horses. They know it from patients, and they know it from themselves. They don’t call it “Medical Students’ Disease” for nothing. So, when the Derm says, “it’s okay, it’s not scabies, we’re going to fix you right up,” and I realized it got me too, the shame is internal. It’s not the Derm’s fault.
No one thinks they’ll become stupid when the stupid-making thing happens to them,until it does. No one thinks they’ll get a little dehydrated and wander in the same circle for six hours, ignoring the trail blazes. No one thinks they’ll start stripping off all their clothing once their core temp drops enough that the air feels warm. No one thinks they’re six missed meals from violence. No one thinks that a little bit of home-life insecurity, a little food insecurity, a little poverty can so shrink their time horizon until they’re unable to stick to a plan for more than a week or so. No one thinks they’ll slip into the Instinctive Drowning Response and ladder-climb to nowhere/actively attack the lifeguard. No one thinks they’ll immediately turn into a malingerer whose own body feels like a foreign and hostile land and who blows every symptom out of proportion. Until it happens to them.
When I say (as a former camp counselor) that dehydrated people are basically dumb animals who need shade and fluids right the hell then, it’s not a moral judgement on those people. More often than I’m proud of, I’ve been that person. I shouldn’t (and generally don’t!) have to sit down with them afterward and apologize for disrespecting their autonomy by forcing them to hydrate.
The look the Derm gave me, if I had to put a name on it, was “oh, buddy. I’m so sorry you had to go through this. I wish you’d come here sooner.” And I had to be like, “it got me, too, huh? I’m that guy, today?” Like discovering that you’re the drunkest person at a party. Like, “I didn’t want to be that guy, but today I am.”
And frankly, I’d much rather have “No, you’re definitely wrong, it’s not the thing you were scared of. You saw another doctor, did you? Well, were they [specialty]? No, didn’t think so.” than “well, your guess is as good as mine, so here’s a prescription!”
You want a system that believes you about your internal experience (as compared to benchmarks. If you say “this pain is an 8,” then you should also tell them what a 10 would be. If that’s “broken toe,” your 8 is a very different 8 than if your 10 is “obstructed bowel.”), and believes verifiable facts, and doesn’t confuse the two. The patient who says, “I can feel the candida crawling on my skin” is telling their lived experience as best they can, and believing them is malpractice.
there’s a big difference between believing verifiable stuff over the patients expression of their internal experience, and dismissing the patients when they tell you about their internal experience because they’re probably a drug seeking malingerer who is lying.
If you do a test and it comes back, then yeah believe the test. If on the other hand you have a patient complaining about a bunch of things, and you DON’T do any tests to get you some verifiable facts but instead just fob them off and tell them to sleep it off and go on a walk or whatever, which is what’s being complained about, then you’re being a shitty doctor. My mother almost died because when she went to the hospital complaining about the worst headaches she’s ever had and nausea they fobbed her off and gave her anti nausea pills and paracetamol, and then a a little bit later when she missed the anti vomiting pills and started vomiting a ton and when she went to hospital again the doctors were going to fob her off again until my brother insisted on getting some scans done or something and then they were like ‘wtf you’ve had a brain anyeurism and it’s a miracle we caught it and you’re not going to have permanent damage, we’re gonna keep you in and give you brain surgery’.
I have a friend who had a seizure, when she went to the doctor the doctor said she was making it up because that’s what teenage girls do, and they only gave her an MRI because her dad threatened to sue the doctor and it turned out she had an autoimmune disease that gives her serious brain damage and was causing her seizures and the doctor was surprised she was still able to speak coherently based on how much damage it had already done.
and those are just the two most extreme examples from people i know personally.
You know, this is a fair distinction to make, and I admit that gladly. I also imagine it varies by specialty, and I likely have a skewed sample (3 emergency medicine docs and a neonatologist who works in a level 3 NICU). I still think my response was a valid reaction to thosearentcrimes saying “most of this is because doctors consider themselves a distinct social class,” and acidxlullaby trying to muddle the distinction between “I don’t feel like listening” and “three other people are trying to die on me right now, how dare you lead me on a snipe hunt,” which made me see red. Like, my sister spends 120 hours a week on the floor of the ED, and has since before Covid started. But yeah, doctors are the problem. Asshole.
But it’s also the case that many practitioners aren’t great at mathematical reasoning or updating their differentials based on information not explicitly part of their internalized decision-trees. I don’t know how to help with that. A lot of people are better at memorization than they are at thinking, and because of the amount of memorization med school requires, you get a lot of those people becoming doctors. And while I’m still tempted to suggest that “the problem here is a moral failing on the part of people who have given up their chance at a normal life in order to help others, which I’ve never even considered doing” is best rebutted by a bracing strike to the jaw (a temptation I can resist, of course, but it’s still there), no one ever said that just because patients can be idiots that medical practitioners weren’t.
I’m going to give my perspective on this based on what I’ve experienced myself as a patient and what I’m taught in med school.
A) Most doctors tend to be very dismissive about what you feel. They flat out don’t believe you and I’ve been accused of both faking and exaggerating my symptoms. In fact if my dad doesn’t insist on this and this fact, I’m most probably walking out of my appointment with no prescriptions or diagnosis or instructions other than don’t stress so much.
B) I went to med school and I always thought that the above point is just my family doctor’s ignorance. But no. This is systematic. My professors explicitly told us that almost all patients are exaggerating their symptoms and more than 50% of them will be just psychological. To make matters worse, we’re only taught the most common problems or things requiring immediate/ prompt intervention.
So when anyone in the disabled community accuses a doctor I’ll believe them immediately. We’re barely taught anything about different disabilities and what they mean/ how they impact anyone’s life.
People like to think that a medical practitioner will know everything when truely we may know less than you do.
