Dear World and Future Patients,

If I ever act this superior to my patients, you may promptly slap some sense into me.

In this Ask Metafilter thread , Geoff is concerned about an endoscopy (where they stick a tube down your throat with a camera on the end):

So this upper-GI endoscopy thing I keep hearing about. Uh, is there anyway you can request one of those new capsule endoscopies? Apparently the also don’t knock you out. Personally I’d rather have to swallow a capsule then have them snaking a tube down my throat while I’m awake. Can I demand being knocked out? Am I the patient that doctor’s roll their eyes at?

So yeah this is hitting one of those “phobias” that we all have. God is smiting me. Here’s the conversation:

“So uh, they don’t knock you out?”
“No.”
“I see. This is stupid, how much does it hurt?”
“Well, many people have it done. You can still breath during it.”

Well thank God, I won’t suffocate. I want a capsule. My internet search results in it being FDA approved. How does one go about finding a doctor who does it? Can any doctor do it if I can find a place to order it? The doctors I’m dealing with are kind of, uh, “just do it, don’t be a wuss.”

After multiple responses, including the fact that a capsule won’t work for an endoscopy, some new Metafilter user doctor replies:

If I may take a breather from rolling my eyes…

Unfortunately a capsule basically won’t cut it. It’s used primarily to visualize the distal duodenum and small bowel, and only because you can’t get to it with a normal EGD or from the other end. The capsule essentially yields much less information because it’s under the control of peristalsis alone, and can’t be guided by a tech or doctor. So you end up catching only glimpses of things. It’s useless in your case because the area of interest is actually the larynx/esophagus, where the capsule would be for only a second before making it’s way to your stomach.

But there is an alternative perhaps, if you’re really against the EGD. If your problem does reside in the larynx, around the vocal cords (for example you may have a polyp there), then it may be worthwhile to see an ENT who can do some basic indirect laryngoscopy (painless), or (the slightly less invasive but still obnoxious) transnasal flexible laryngoscopy. Of course, this won’t tell us anything about what’s going on in your esophagus.

I can see where the doctor is coming from-to him (or her), there’s much worse in the world; more painful procedures, more gruesome operations and accidents. I’m sure it’s difficult, but as physicians we have to always remember that our experiences are not the same as our patients’. Most haven’t seen chest tubes in people. Most are totally outside the realm of medicine, hospitals, and procedures.

Dreama sums it up nicely:

drpynchon, I left a hospital AMA earlier this year because of a doctor who rolled his eyes as I cried my way through questions and belittled and brushed off my fears and concerns about a procedure I needed (actually, a modified endoscopy). If you can’t deal with patient fear without being condescending, arrogant and rude, please do everyone a favor and become a pathologist.

And most certainly spare us your attitude in AsMe.

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