 Intuition
by Vicki Rackner MD
It all started with a few small black dots. I came home to find a delivery truck parked in the driveway, blocking my access to the garage. I parked on the street and sauntered through the garage heading towards the kitchen door. Out of the corner of my eye I saw several black dots on the garage floor that mapped to location of my parked car's engine. I had a sinking feeling. Somehow I knew that these dots meant serious business.
I told myself I was being silly. This was just like all the other times I was convinced I was facing some car disaster. Willie, my trusted mechanic at the family-run gas station was always there to offer perspective…and a solution. “No,” he tells me, “You don't need a new electrical system because your horn doesn't work. Let me replace the fuse.” I knew what Willie would say about the black dots. “Maybe they've been there for years. Keep an eye on them.” I tried to ignore the nagging irritation, as if that would make the dots disappear.
The day it was harder to shift out of second gear, I took my car into Willie. He put the car on the lift and said “It looks like you've got a leaky transmission.”
“A leaky transmission!” I moaned. “That's one of the worst things that can happen to a car, right, Willie?”
“Well,” he said in a calming voice. “Maybe and maybe not. This car requires special tools to do the diagnostic tests. Let me get you the card for a good transmission shop. They specialize in this kind of thing.”
My level of anxiety shot up. I knew I could trust Willie. I hoped that Willie was offering a link in the chain of trust, but who knows. I watched a hidden-camera news program about shady practices in auto repair shops and the victim was just like me. I was scared. I wanted Willie to take the driver's seat in managing my car trouble, like he always did.
What should I do? Go to the time and expense of costly diagnostic tests just to see how much the repair would be? Could I trust the transmission person who would profit more as the repair bill rose? Wasn't this the fox guarding the henhouse? Should I get a couple of opinions and estimates? Get a different car that better served my growing family?
Willie has a good head on his shoulders. I asked him what he thought. He told me the same thing I tell my patients. “I wish I could tell you what was wrong with the car and what the repair will entail. I can't. You need to decide how much time and money you're willing to invest in diagnosing the problem. You need to decide if it's time to get a different car. I can tell you what I know; you know which direction is the best fit for you.”
I know that he hoped I would buy a new car with an excellent performance profile. His life could be living hell if I got a temperamental sports car.
As I was going through this drama, I thought, “This is exactly what it's like to have a medical problem!” I had a hunch that something serious was happening, even in the presence of very minor symptoms – a few black dots on the garage floor that I might have missed. I delayed getting things checked until I really had an obvious problem, and then I had plenty of decisions to make.
My patient Melissa had a black dot too. She just happened to notice in on her back as she caught herself in a new angle trying on a bathing suit at the store. She knew before the biopsy report came back that this was a melanoma – one of the most deadly types of cancer there is. She had a potentially life-threatening problem whose only sign was a black dot the size of an eraser head.
And then I thought of how patients felt in my waiting room, wondering if they could really trust me. They didn't know me; they usually found their way to me through someone they did trust. There are plenty of medical horror stories out there. How would that patient know if I was the right surgeon to wield the knife in a procedure that could alter the course of their lives?
And I understood the longing to have some knowledgeable and competent person tell me exactly what to do. I would have loved Willie to say, “It sounds like you have been thinking about getting another car anyway. Maybe this is your time. And the perfect car for you to buy is...” I had seen the same longing in Dolores' eyes as she decided what operation she would get for her breast cancer – lumpectomy or mastectomy.
There was no right choice for me and different people would have approached my identical car situation differently. Gary would have done enough reading to earn a PhD in transmissions. Dana would have boldly faced her fear and rebuilt the transmission herself. When I sat down and asked, “What do I really want?” the answer was clear.
I just wanted the most direct path to safe, reliable transportation. I made a list of what's important in a car. I gathered expert opinions. Then I consulted with my ultimate expert. I asked myself what car choice was best for me.
So, too, your goal as a patient is to make the medical decisions that work best for you. You want the expert opinions of your trusted doctors. Your goal is not to become your own doctor; your goal is not to fix your own problem. Your goal is to make the choice that works best for you at that point in your life.
When it comes right down to it, that's your job description as “patient.” When will you see the doctor? What test will you undergo to come up with an accurate diagnosis? What treatment option will you chose? And finally, will you execute the plan as you and your doctor agreed?
There is a trusted resource always available when making choices. It's your intuition. That small still voice that told me those black dots on the garage floor meant something ominous. Dolores found her breast cancer one night when she did a rare breast self exam. She said, “It's as if an invisible force directed my hand to the cancer.”
Your relationship with your intuition may be like your connection with a distant relative you see at family events. You seek each other out at weddings because you enjoy each others' company. You share some amorphous quality best characterized as “blood.” Every time you see her you think, “It's so much fun spending time with her, I'm going to make an effort to deepen the relationship.” Maybe it does; usually it does not in your busy, cluttered life.
I invite you to deepen your relationship with your intuition, and here's how. Engage in conversations. Consult with your intuition when you're making choices. Instead of just going into the kitchen for a snack and standing in front of an open refrigerator, ask yourself, “What do I want to eat? For what am I hungry? Is it even food?” Take the umbrella if you get that flash, even if the sky is blue. Then thank your intuition when it serves you. Then let your conversations deepen.
What if your doctor contradicts the information your intuition gives you? You ignore your intuition at your own peril, as I saw over and over when I served as an expert in medical malpractice lawsuits. Karen, a 25-year-old mother of two testified from a wheelchair because her body was weakened by cancer. “ I was 20 when I found my breast lump. I went to my doctor and he told me I was too young to have breast cancer. I asked for a mammogram and he said no. I figured the doctor was right. After all, he's the doctor.” The doctor wrote in Karen's chart, “Patient believes she has breast cancer. Reassured. ” meaning his treatment for her breast lump was to falsely reassure her that she did not have breast cancer. Do not discount or devalue your intuition. If your doctor tells you something that does not ring true, get more information.
Your intuition, sometimes called your doctor within, serves you well. Your intuition will tell you when it's time to get help. When you want to hear the right choice for you, just turn up the volume of your small, still voice.
Copyright © Vicki Rackner MD, 2005
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