Medical professionals are supposed to tell the truth.
May 31, 2002 9:26 AM   Subscribe

Medical professionals are supposed to tell the truth. But why do they always lie?

I had an exam yesterday and they lied to me again as they always do.

Every time they do the glaucoma test, I have been told that they will get "close" to the eye. I correct them and tell them, no, you're going to touch it. They'll deny it 3 or 4 times before finally conceding that they'll "barely touch it" or something like that.

"The most common way to currently measure pressure inside the eye is tonometry. In air tonometry, a short burst of air hits the cornea. In applanation tonometry, a doctor anesthetizes the eye, then presses against it with a tiny instrument and measures the depth of the indentation." (sorry-- this is where I got the quote-- it's mostly about something else-- even web pages are reluctant to admit they'll touch your eyeball).

I have never recieved air tonometry, it's rarely used and considerred inaccurate.

This only bugs me because years ago a doctor told me he was going to get close to my eye, I could feel him on the surface through the aneshthetic and pulled back. This happened repeatedly. Eventually he told me he had to touch the eye. If he had told me that in the first place, I wouldn't have thought he was screwing up and I wouldn't have pulled back.

Well ok, it also bugs me that a doctor would utter such an obvious lie (you can feel them on the eye and see the cornea distort when it's pressed). What else are they lying about? What are their motives? (I have contacts, I touch my eyeballs all the time, surely they don't think I have an eyeball touching phobia...)
posted by squinky (31 comments total)
 
I would guess that it's a pyschological thing, they're trying to make you think it won't be as bad as it might really be. If your doctor told you before a particularly painful shot that it was really going to hurt, would you perhaps be a lot less cooperative? If, on the other hand, he told you, "This won't hurt a bit", two things may happen: 1 - you will probably be more cooperative regarding the shot, and 2 - you may even trick yourself into thinking that the shot isn't really as painful as it is. Sort of like psyching yourself up.
posted by starvingartist at 9:31 AM on May 31, 2002


where exactly is it said that air tonometry is rarely used and considered inaccurate? i had an eye exam some months ago for a prescription for reading glasses, and i did receive the short burst of air that air tonometry is described as.

squinky, do you suppose next time you could shorten the front page post a bit?
posted by moz at 9:37 AM on May 31, 2002


Hmm. I've only had air tonometry. I still flinch a bit. I understand it's used when there is no previous history of elevated pressure. Once they need to track more carefully, it's the touch exam.

I find problems with many types of physicians. Frequently they assume the lowest common denominator type of behavior instead of asking for what you want. So I don't wait for them to ask, I tell them what I want or don't want. It's hard - many MDs resent it. They're not the MDs I want to see. So I find another. I've been through lots of docs, but I've got some great ones now.

Good luck!
posted by Red58 at 9:39 AM on May 31, 2002


don't you have a blog of your own?
posted by mcsweetie at 9:43 AM on May 31, 2002


Advancements in medical science have led to the unfortunate result that people now live too long. Your doctor does have a motive: to produce a lifelong distrust of the motives of physicians such that you fail to seek medical care when it is necessary. By doing so, doctors restore the delicate ecological balance destroyed by life-extending measures and miracle drugs.

You are right. All medical professionals are lying to you.

Also, if you did not know this already, most surgical procedures performed by doctors can be done at home by yourself with everyday household items and well-placed mirrors.
posted by troybob at 9:46 AM on May 31, 2002


I used to have a girlfriend when I was a teen and I would often ask her to touch it. She always said she would and she got close and closer. But never did. Somethings are touched and somethings better left untouched. It is all in the eye of the beholder.
posted by Postroad at 9:46 AM on May 31, 2002


Medical professionals are supposed to tell the truth. But why do they always lie?

They always lie? Come on. This post seems to be an excuse to yell about your eye doctors. Your first link points to a general discussion about medical ethics and the second is a bland opthamalogic article. Not exactly a burning condemnation of the moral lapses of our medical community. Sheesh, change doctors.
posted by Skot at 9:48 AM on May 31, 2002


You've obviously never had ocular sex, Postie. A little tongue on the cornea can be quite exciting.
posted by chino at 9:49 AM on May 31, 2002


Nah, most doctors are liars. It's just what they are taught to do for reasons I'll never understand. As a doc, though, I've found that telling patients, even kids, that something will hurt gets better cooperation than lying. Really, it's about patient care. I don't lie and tell patients that it's probably not cancer when I know it is, I do advise not jumping to conclusions until we know for sure. Ethical lapses on the part of other docs? Maybe, but it might also just be that they can't handle the truth as well as the patients probably can.
posted by shagoth at 9:52 AM on May 31, 2002


If I want to pay for the privilege of being lied to, I'll go to the movies. Concerning my medical care, I want as much good, accurate, and relevant information as possible. Lying to a patient is malpractice, plain and simple.
posted by rushmc at 10:03 AM on May 31, 2002


Hmm.. I had that spray of air thing done to me a few years ago. And it was at an optometrist's office in a Binyon's at the -- heavens -- shopping mall!
posted by Tacodog at 10:06 AM on May 31, 2002


You've obviously never had ocular sex, Postie. A little tongue on the cornea can be quite exciting.

Go aural and you'll never go back.

It is all in the eye of the beholder.

Poastroad: thanks for the chuckle.
posted by sacre_bleu at 10:09 AM on May 31, 2002


Postroad. Ack.
posted by sacre_bleu at 10:09 AM on May 31, 2002


don't you have a blog of your own?
amen, mcsweetie
posted by matteo at 10:57 AM on May 31, 2002


Obviously, physicians should tell the truth -- we all should. This sounds like a "white lie" to me, though. Ever told one? Let me know how many of you are ready to tell a very sick 8 year old that you're now going to insert the needle into her spine and it may hurt like nothing she's experienced on this planet, all the while brandishing the three or four inch spinal needle before her eyes.

Yeah, an 8-year old's not an adult. But adults fear pain and needles and doctors, and they don't like the idea generally of having metal objects near the surface of their eyes. Docs don't like the idea of people flinching when a metal object is near their eyes. In addition, most doctors themselves feel anxiety about hurting people, or even frightening them unnecessarily. My experience has been that when tonometry is done properly, people don't even realize you've actually touched them....hence doctors trying to save folks a little anxiety.

Give docs a little slack. They're humans too.
posted by fold_and_mutilate at 11:07 AM on May 31, 2002


Truth in doctoring:

Squinky, I'm going to jab this into your eye, and it's going to hurt like hell! Don't blink, okay?

Heh. That'd go down like a tonne of lead bricks.
posted by five fresh fish at 11:13 AM on May 31, 2002


fold_and_mutilate, You're so sensible here on the subject of truth and lies in medicine, I'm very impressed. But how about in politics? Is it all right to tell a lie for political purposes? For instance, in your main page posting (today) about corporate criminals. There are so many lies, distortions and exaggerations in the articles you link to, that I wouldn't know where to begin to refute them. I can't imagine that even the most rapid "anti-corporate" type believes ALL of those heinous accusations. I mean, do you? Or do you think that all's fair in medicine and politics?
posted by Faze at 11:24 AM on May 31, 2002


five fresh fish: with kids it's pretty easy to work with them so long as you're honest. "This part is going to hurt for just a second but then it won't," works much better than lying about the jab not hurting. A kid will hold still for even long sessions of stitching up a wound if you were honest about what was going to happen. They flinch and fight if you lie and tell something won't hurt when it really does.
posted by shagoth at 11:24 AM on May 31, 2002


I *have* glaucoma (diagnosed at age 32) which was diagnosed through the "air puff" method. Ever since then, I've had my optic nerve laser-scanned to check for damage, as well as visual field tests (click n' blink!) to ensure I haven't lost more of my vision.

(For the record, my top peripheral vision is shot -- picture a circle, with a thin crescent cut off the top. The crescent is what I've lost.)

Squinky, dear, I'm with everyone else -- the docs are doing the "white lie" method, because it's a means of *getting you through* whatever's about to happen. It's not like they're lying about your diagnosis. And please, shorter front-page-posts -- a simple "more inside" would've done, if need be.
posted by metrocake at 11:29 AM on May 31, 2002


Two kinds of tonometry: Non-Contact Tonometry (NCT) and Contact Tonometry. The first one, NCT, is the "puff test," and there is no contact -- it literally is a puff of air aimed at the eye. It is by far the most common of the two types of tonometry, and is widely regarded as an accurate measure of intraocular pressure. In cases where more precise measurements are needed, the Contact Tonometry is performed. As indicated, however, NCT is the preferred first-choice for routine eye exams.
posted by davidmsc at 11:32 AM on May 31, 2002


I just had an eye exam a week or so ago and they did the puff of air thing. Bleh...still, better than someone poking me in the eye. :)

And yeah, possibly the longest personal post I've ever seen on MeFi. Anyone care if I post my sonogram pictures? heh. I jest. I don't even make my friends suffer through that...more than once. :)
posted by dejah420 at 11:43 AM on May 31, 2002


I have been very upfront with the "vision professionals" I have dealt with in recent years. I fear things coming toward my eyes. I was hit in the face with a volleyball years ago, and since then, I'm very anything-near-my-eyes phobic. Consequently, tonometry freaks me right out, even the non-contact variety. I flinch, I can't stand it. It typically takes three tries for the first eye, two for the second. I try desperately not to pull away, but I do. Why? Because air coming at my eyeball at a high rate of speed is as menacing to me, mentally, as a bullet. It's stupid, but I just don't like how it feels.

If a doctor was doing contact tonometry and didn't tell me that he was going to actually touch a piece of metal to my eyeball, he'd better have on a cup, because I will reflexively react, and it won't be pretty. I don't ask much of doctors, and I do believe that most of them are fundamentally honest, but lying to me is the fastest way to lose me as a patient -- especially if you're lying about things near my eyes!

On preview: dejah, whaddaya think this is, FetusFilter?
posted by Dreama at 11:49 AM on May 31, 2002


*touches Dreama's eyeball*
posted by Kafkaesque at 12:05 PM on May 31, 2002


The first time I ever had a glaucoma test, it was of the contact variety. My eyelid reflexes were then, as now, extremely sensitive, and my eye shut on the damned instrument. :::shudder:::

Oddly enough, this did not cure me of my lid-jerk reaction to things coming at my eyeball. It takes me three tries to get eyedrops into my eye...and that's using the roll-in-from-the-side method. I did manage to wear contacts for a while, but never easily.

There is a REASON we have these protective instinctual reactions, and people who can (and do) blithely go about poking themselves in the eye make me nervous....
posted by rushmc at 12:49 PM on May 31, 2002


Heh Dreama, you made me laugh out loud. :) FetusFilter, news by and for the pregnant people. :) I can just see the posts now: Look! It's a blob, it's an arm, it's SuperBaby. :) heh.
posted by dejah420 at 1:35 PM on May 31, 2002


A warning to prospective FetusFilter sonogram viewers: Do NOT tell the mother-to-be that the blobby skull of her yet-to-be-birthed progeny "...looks exactly like Skeletor." Further, do not then imitate He-Man's voice and say "Ah, Skeletor, my old nemesis, we meet again!"

Trust me on this one.
posted by UncleFes at 1:52 PM on May 31, 2002


If a doctor was doing contact tonometry and didn't tell me that he was going to actually touch a piece of metal to my eyeball, he'd better have on a cup, because I will reflexively react

yea, and protect your neck, and your eyes, because sometimes my blind rage doesn't stop at instinct level and i want to choke people to death. ha, when i decide to use eyedrops i just drop lots of the liquid in the corner of my closed eye, haha, i don't consider eye drop bottles to be single-use, but almost ;) and when they dilate them it's horrible, i have to think of something else. and certainly not look at the bottle.
posted by rhyax at 2:16 PM on May 31, 2002


" Anyone care if I post my sonogram pictures?"

Not at all, but be forewarned that if you do I'm going to link to a video of a colonoscopy.
posted by mr_crash_davis at 2:58 PM on May 31, 2002


You guys make me laugh. :)
posted by dejah420 at 7:33 PM on May 31, 2002


Kafkaesque, you're a cruel, cruel man. ::weeping::
posted by Dreama at 8:14 PM on May 31, 2002


There are so many lies, distortions and exaggerations in the articles you link to, that I wouldn't know where to begin to refute them...

I believe it when you say you don't know where to begin to refute them...

If there are lies, point them out. Otherwise nobody's gonna take you seriously.

And I'm always willing to listen to reason.

If I hear any.
posted by fold_and_mutilate at 10:50 PM on June 13, 2002


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