Tuesday, 29 May 2007

2005 - The Family Doctor Has His Say

We belong to a reasonably-sized medical practice with around 8 family doctors, many of whom have specialities. The head of the practice was a snappily dressed, affable chap with what seemed to be an almost casual, but sympathetic attitude, whose speciality was heart problems and learning difficulties (mental disabilities). I got to know him quite well as he looked after he interests of my son (with severe learning difficulties) and cared for my father right up to his last days (stroke and arterial sclerosis) with great skill and empathy. He had also been instrumental in introducing Marie to the local mental health team as well as the (so-called) cognitive behavioural practitioner (have a look at the posts with the labels NHS and CBT).

After Orla was born, Marie's agoraphobia worsened. She had trouble getting from the car to shops, although once inside she could negotiate her way around most of them. She decided that she would apply to the local area council for a disabled person's parking permit. Armed with one of these on the dashboard, one could park almost anywhere and ignore "normal" parking restrictions. There were also special disabled parking bays in front of larger stores and most parking fees were waived. "Disabled badges" as they are more commonly referred to are like gold dust! Marie believed that she would be able to get one since her agoraphobic condition made access to shops and offices more restricted to her than, for example, a man with no legs.

I was against getting the permit, arguing that all the previous improvements in her condition took place without a parking permit. I was also worried that if we had one, Marie would have less incentive to expand her capabilities.

So we went to see our family doctor for his opinion and, possibly, his assistance. He greeted us warmly as usual and informed us that he might not see us again since his retirement from practice was imminent. Marie explained why she wanted this permit and I stated the case for not having one. The doctor explained that the criteria required to get a permit had changed. Only persons with a serious physical disability would be considered. Persons with any other type of disability, no matter how severe, would no longer be considered.

Marie was obviously disappointed, but neither of us was prepared for what followed.

"I agree with you, Robert," he started off, "that getting a disabled person's parking permit would be detrimental to Marie's long-term recovery (from agoraphobia) prospects. In fact," he continued, "the best thing you could do for Marie would be to leave her. You would almost certainly get custody of your 2 children since your partner is incapable of looking after them by herself. You should tell her that if she really wants to see them again she must sort herself out."

"But she would only go to her parents' house," I replied, shocked, "where her mother would pander to her every need, and she would get no encouragement to get better."

"Yes, that is a problem," the doctor agreed. He had met Marie's mother when she tried to enlist his support for the abortion of our first child. "But while she's with you and you arrange your and her life around her agoraphobia, you're making things worse." He became more animated. "These situations arise when it is mutually advantageous to both parties. Marie here can avoid growing up and making the sorts of decisions that a woman of her age should be making. By living with a man old enough to be her father, she can avoid taking responsibility for her decisions, her actions, her life. And the situation suits you because you obviously like to be in control. It could be argued, however, that by behaving the way you are, you're actually ruining a young woman's life! She'd be better off without you!"

Marie was dumbstruck. I replied, "You still haven't told me how this would help, since she would obviously go and live with her mother."

He shrugged his shoulders and didn't offer any further argument. Instead he dismissed us, and we, mentally disoriented, took our leave. He retired from the practice the following week, and we haven't seen him since that day.

I didn't take his advice.


Ruby said...

Oh my God! Unbelievable. I can only imagine the damage that could've been done if you were both vulnerable and listened to this doctor that wanted to go out with a bang,
...and people wonder why so many refuse medical treatment or are very sceptical of the ones that offer their help as the best on the market.


Robert said...

This story just shows how little family doctors know about agoraphobia and panic/anxiety disorder. It seems obvious to me that this doctor had kept his opinion to himself until the end of his working days. Now my opinion of him as a doctor will always be coloured by this incident.