A Tale of Two Physicians

“The house of cards still stands,” I say to my primary care physician, and only then wonder, “is that an apt metaphor?” She nods her head, as she continues to read my MRI report.

I’ve already heard from my neurologist who favors monologue over dialogue. Nor is he one for metaphor or talking about arthritis. Not his field, that rheumatology. His is a very narrow vision but he knows what he sees.

The house of cards is my cervical spine, inflammatory and osteoarthritis crammed into the spinal canal and somehow no vertebrae is pinching the spinal cord, which is not to say there isn’t compression. The house stands. Who knows why.

There is some mild flattening of the cord, fluid (inflammation) wanting more space where there is none. Always taking more, that arthritis. Is that not the human way? And why is that.

The neurologist’s concern is my “wonky” or hyper reflexes. He favors that word, wonky, although he never explains why. My primary care physician considers the wonky word each time we discuss an MRI report and never comments.

This may sound like a lot of silence, but it is discussion delayed. I bring what I remember of the neurologist’s monologue to my primary care physician, as well the actual report, which is longer than the monologue–every time.

It’s hard to characterize the report as anything other than the spinal cord is not compressed so no surgery. With each MRI there seems less space in the canal, as with age it narrows so any extra baggage, like arthritis, requires a delicate balance. No card can fall without consequence to all.

And whether it is a monologue with the neurologist or a dialogue with my primary care physician it always comes down to this: everything that can be done is and nothing more can be done.

Far too Zen for the neurologist but the primary care physician is wryly amused. The neurologist is concerned that I do not accept the state of my house for if I did, I wouldn’t have anything to say. The primary care physician understands that acceptance is worthy of discussion.

Yes, I am fortunate to have a mindful primary care physician and a focused neurologist. After all, my spinal canal is very narrow. I respect his expertise but I am in awe of my primary care physician. She finds space where there is seemingly none.

The house still stands.

Aim for Even posts offer equanimity a dose at a time. No day or dose is ever the same, even if the aim is. You may read about the origins of Aim for Even here or on this site’s About page.

9 thoughts on “A Tale of Two Physicians

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  1. What a wonderful combination of doctors! Thanks for letting us know how you’re doing. We are wondrously and mysteriously made, aren’t we?

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  2. It is wonderful you’ve found a doctor willing to be “in dialogue” with you. So much healing can come from conversation between human beings. But, of the two, probably better that your neurologist is the less conversational!

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  3. The monologues, one supposes or hopes, reflect the analytical process, externalised. I do wonder, sometimes, about the way medical specialties have been divided, though: neurology, rheumatology, and so forth – as you mentioned over on my blog, labels lead to assigned patterns. The labels and divisions into which medicine has fallen, to me, are artificial; and conditions or illnesses can’t really co-operate with the artificial boundaries of human intellectual endeavour. Your primary physician sounds very wise, though!

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    1. I could not agree more about the artificial boundaries. My primary physician understands I live with a conflation of autoimmune and spinal cord disease. Her word, conflation, and not mine. It has been very helpful to me in terms of living with chronic disease but my neurologist will not hear of it so I am the one who listens. Thanks so much, Matthew.

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