Confrontation

I’ve been doing a lot of research in the last few days on artery blockages, bypass surgery, and this treadmill stress test that ultimately indicated that my dad needed an angiogram to identify his artery blockages. I’ve spoken with both his surgeon and his anesthesiologist at length to learn more (both of whom were incredibly patient, listened, and answered all my questions thoroughly), and I’ve also discussed this with others who are familiar with coronary artery bypass surgeries because they know people close to them who have had them. What I have found is that as common as bypass surgeries are, treadmill stress tests are just as common, if not more common, and are done regularly on people who are at high risk of heart disease, as indicated by family history. The American Heart Association recommends this as the #1 test for anyone with a history of heart disease in the family. It’s not a secret, and I don’t need to be a doctor to know this. It’s all available online for anyone to see and learn. They are done on people as young as their 20s and 30s who have indicated a family history of heart problems. Even Chris is one of these people, as he had this test done two years ago.

So you can imagine how angry I got after thinking about this whole chain of events. Why did my uncle have to tell my dad to ask his primary care doctor for the stress test — after his own stress test, which showed my uncle had a blockage? Why did my dad’s doctor not proactively recommend it to my dad, knowing my dad has heart issues already as well as high blood pressure and a family history of heart disease? Every person before my dad on that side of the family has died of a heart attack. My dad is very honest and open about discussing these issues and has made this all very clear to his primary care doctor. I posed this question to my dad’s surgeon, who paused and said, “That’s a very good question — one for your dad’s primary care doctor to answer.”

I scheduled some time with my dad’s primary care doctor to chat tonight. Needless to say, the conversation did not go so well. When he called me back, he was very curt and seemed confused as to why his patient’s daughter would be calling him. yet when I spoke with the other two doctors, they completely empathized and understood immediately why I would call — because I’m a concerned daughter. I explained to him my thoughts, and when I asked him point blank why he never recommended this specific test to my dad and had to wait until my dad asked HIM if he could do it, that was when the drama began.

He immediately started interrupting me, claiming I had “misinformation” and “misinterpreted” what I was reading and what I heard from the other two doctors. He said my dad exhibited no chest pains or tightness. To this, I insisted that this test is supposed to be preventive, not reactive — it certainly can (and should) be done reactively, but I thought the whole point of having a primary care doctor is to prevent problems, not just treat them after you are already ill? He insisted he was right and I was wrong, that I didn’t have the proper training to understand any of this. It was a lot of condescension, with him constantly raising his voice at me. Not one to be outdone, I made sure he knew I was not going to back down and just raised my voice even louder. And I told him to stop interrupting me. Here’s a hint: if I tell you that I’m not done speaking, it means you should probably shut up and let me speak. That doesn’t happen often, but when it does, I mean it. It became quite a shouting match in the end. I told him, I guess we’ll need to agree to disagree here. He laughed and said, “There’s nothing to disagree about. This is all very clear.” A few more back and forths, and I said, “This is going nowhere. This conversation is now over.” And I hung up.

While he was rude, condescending, and everything opposite of calm and empathetic, the worst part was when he actually told me that “family history” of any disease, whether it’s heart disease or cancer, is defined NOT by the family members before you such as your father, your grandfather, etc., but by those in your current generation, so your brother, sister, cousins, etc. I’d never heard anything more ludicrous in my life. “So you’re going to tell me that just because my father’s father and my great grandfather both died of heart attacks that this indicates nothing about my father’s risk for getting heart disease or a heart attack?” I asked him in complete shock.  He said yes — that’s how “family history” is defined by those in the medical profession. Oh, and I think he completely forgot my dad told him that his older brother died from a massive heart attack at age 65. That was over 14 years ago.

There’s a reason why the American Breast Cancer Foundation advocates that women whose mothers or grandmothers have had breast cancer should get tested earlier — because that’s how family history is defined – by anyone in your blood line. The same goes for anyone else.

I’m deeply dismayed at the fact that there are doctors like this who exist and can still practice medicine. Clearly, being proactive is not a valued or strong suit here. And this man, Richard Tang, is supposed to be the director of the Phase Clinic for Prevention of Heart Attack and Stroke at Kaiser in San Francisco.

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