Family Webicine

By Rod Moser, PA, PhD

People would be shocked if all tasks went as planned. Why are we so disappointed when tasks take longer than anticipated, since it happens so often to everyone? No one promised us a smooth road through life. No one ever promised a road without bumps.

When facing life’s many bumps, you only have limited courses of action. You can

*Go over the bump slowly and carefully
* Change your route entirely. Go around the bump
* Turn around; retreat and don’t challenge the bump
* Try and smooth out the bump
* Stop. Do absolutely nothing
* Give up traveling entirely

Of course, one of my bizarre pleasures in life it to surgically remove real bumps, so I guess another bump choice would be to “remove it and send it to pathology”.

I have spent my clinical career as a medical “travel agent,” helping people navigate their diseases, conditions, or injuries. My own experiences as a “patient-traveler” was limited to a teenage appendectomy, two bouts of kidney stones, and my most recent double-bump: recurrent rotator cuff tears. I much prefer to be on the other side of a medical encounter.

I shouldn’t complain. I have children in my practice that had more surgeries in their first year of life than I had in sixty years. A five-year old proudly shows me his heart transplant scar. I see children with cerebral palsy trying to navigate walking. I see adults trying to cope with one of the largest bumps in the road — cancer.

In the medical profession, we are often judged by what we don’t know. I have long given up the idea that I must know everything in order to safely practice. I found that I don’t really need all of the answers. I just need to know where to find those answers. I take pleasure in telling people that “I don’t know, but I will find out.”

I am often shocked by the nonsense some medical providers tell patients when they are asked simple questions. Rather than say, “I don’t know,” they just make up some wild and crazy story that may not make any biological or anatomical sense. I think one of the reasons why some medical providers leave the room so quickly is that they are unprepared to address questions; unprepared to help their patients navigate clinical bumps.

Not all medical treatments and therapeutic interventions work. Some people get better on their own and their medical providers will take credit for the cure, but there are many, many treatment failures. When facing this sort of bump, medical providers initially “try something else” — a logical course of action to see what happens. If it works, great. If it doesn’t, then it is back to the drawing board to try yet another course of action. Non-surgeons prescribe their pills and capsules. Surgeons cut and/or remove. Dentists pull and drill. Chiropractors adjust and readjust. Acupuncturists puncture. Herbalists make tea. Psychologists analyze. Faith-healers lay hands on and pray. Quacks and charlatans see the void and quickly rush in.

The patient does not get better. What then? Some clinicians throw in the towel and leave patients hanging. Some punt and refer to other specialists. Some clinicians will just keep plugging along, trying different ways to navigate the bumps, until there is no more that can be done. Loyal patients stay; the frustrated ones will leave and start this crazy dance all over again with a new clinician.

At some point, when every test has been run, every medicine tried, and every clinical stone unturned, and the bump remains.

At what point do we accept the limitations of science (and pseudo-science) and just “accept the bump” and move on with our lives? A severed limb will not re-grow no matter what we do. You can get an artificial limb or learn to live one-handed. Chronic tinnitus is annoying but invariably incurable. Diabetes requires significant lifestyle changes. Cancer may win.

A person with insurmountable bumps can still live a happy life; bumps and all.

All it takes is a decision.

Never let a bump in the road ruin your journey.