Farewell to the medical tyranny

February 14, 2023 admin Comments 0 Comment

Life can be quite surreal sometimes and life can be stranger than fiction.

A few weeks ago I sent a strongly-worded letter to my doctor who I have not seen in over 2 years in which I basically made some pretty serious allegations of misconduct and in competency

YOU CAN READ THE LETTER HERE

Having time on my hands I sometimes lapse into daydreams thinking of all the possibilities. Sometimes, I think “that was pretty paranoid” but have discovered on more than one occasion, reality can indeed be stranger than fiction.

I had had the ludicrous scenario arise in my head that the doctor would just ignore the tenor and content of the letter and see it as some sort of “cry for help” and try to offer some form of medical assistance whereas I was looking for clarity on whether they were just incapable of reaching some sort of diagnosis and denying it by falling back on a medical dogma that says if the tests don’t come up with anything it’s all just in the patient’s head.

My reveries were provoked by a call from the medical centre booking me in for an extended appointment albeit in at least 40 days time.

That was it until my partner, Pam received a phone call from Dr. McCabe saying he had referred me for blood tests, so broad ( a total of 21 tests that range from liver and kidney function, inflammation markers, vitamin and mineral levels to God knows what else, that it looks to me like he is on a fishing trip.

I got to talk to McCabe later in the afternoon in which he said he had a “hypothesis” based on his belated perusal (7 years too late) of my medical records. By the end of the conversation I don’t mind it got it a bit heated on my side towards the end.

I just don’t like lies and falsity.

In the midst of writing this I received an email with a letter from Dr. McCabe.

Dear Mr Westenra

You wrote to me on 25 January outlining your concerns about a number of symptoms you were experiencing and the lack of a unifying diagnosis to explain them. I got the sense that you were frustrated by this and sought a way forward.

I spent 3 hours on Waitangi weekend reviewing your notes in great detail and invited you to a consultation to discuss things further. I requested blood tests ahead of that consultation. You contacted the practice on 13^t^h February and were angry and hostile to the reception staff over the phone. You advised that you weren’t prepared to do the tests without having an explanation as to why they were requested, and that I speak to you about why I had ordered them first.

I rang you on the same day and you informed me that I was incompetent. You weren’t willing to listen to me when I explained what could be going on to explain your symptoms and the rationale for the tests. You then informed me that you would be recording our impending consultation as evidence.

While you have the right to record your consultation, I feel it would change the dynamics of the consultation. I also feel that the anger and hostility you have directed at me, as well as your concerns about my incompetence, has irretrievably damaged the Doctor-Patient relationship. For there to be a good outcome there needs to be mutual trust between the Patient and Doctor, and it does not exist in our case. I would not feel comfortable being your doctor in future.

I had hoped that the one hour consultation I had put aside to discuss your complaints, and possible diagnosis and further management, would help you. Ultimately, it is important that you get an accurate diagnosis for your long term symptoms. Having reviewed your notes going back to 1998. I think you may have Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome or more colloquially as “Tapanui Flu”. However I would have also have liked to refer you to a specialist geriatrician to further elucidate the diagnosis.

Because of the hostility I experienced in our telephone call I suggest you see another doctor in the Connolly Street Medical Centre. They would be able to refer you as they saw fit to clarify the diagnosis. Alternatively, there is Dr Rob Maunsell who practices medicine from an anthroposophic viewpoint. He is based in Masterton but has clinics in Lower Hutt at the Aurora Health Clinic at 37 Pretoria Street. You can text 027 443 1490 to make an appointment. His clinic is called “Fresh Start Health Services” and he may be a more congenial doctor for you.

Please let me know what you decide.

Dr Hugh McCabe

I have put everything aside to write a response

***

Dear Dr. McCabe,

I am responding to your letter paragraph-by paragraph so I don’t cherrypick and you don’t misconstrue what I write.

As I tried to tell you yesterday I wrote to you about nothing of the sort. I mentioned a few symptoms by way of introduction and then I laid out what for me are serious allegations of malpractice.

There is nothing vague or confusing about my letter. My conclusion:

It is common to ask what I would want from any negotiations. For me it has gone beyond any forlorn hope of a positive clinical outcome. Rather, I would be looking for some honesty from you and an acknowledgment of two possible situations.

Either you are not sufficiently qualified to treat chronic conditions such as autoimmune diseases or chronic fatigue that go across several body systems, in which case you should have referred me to someone (if, indeed, they exist),

A second scenario is one whereby you follow a dogma that I believe is taught in medical schools (you can tell me if this is an urban myth), that if a condition is not self-limiting and if commonly-prescribed medical tests fail to come up with anything, it is regarded as psychosomatic – in the patient’s head – something I believe is called somatisation symptom disorder.

It takes a certain type of person to misconstrue this as: getting “the sense that you were frustrated by this and sought a way forward.”

I spent 3 hours on Waitangi weekend reviewing your notes in great detail and invited you to a consultation to discuss things further.

Nobody asked you to spend your weekend reviewing my notes although, of course you are welcome to so.

I requested blood tests ahead of that consultation.

You were not entitled to do so without discussion and my informed consent – I was not informed, and I did not give my consent.

This is the second time this has happened in my life, both at your practice. I was summoned for an appointment in the absence of Dr. Kusel. I was rung a second time, told he wanted to discuss my blood results.

Of course, it was nothing of the sort: he wanted to lure me in to discuss the general aspects of my case.

I find this sort of practice unconscionable

You contacted the practice on 13^th February and were angry and hostile to the reception staff over the phone. You advised that you weren’t prepared to do the tests without having an explanation as to why they were requested, and that I speak to you about why I had ordered them first.

I was angry at having blood tests ordered without my say-so.

I have not been to see you for TWO YEARS – you might care, in a moment of reflection, to ask why that may be.

You then informed me that you would be recording our impending consultation as evidence.

I announced I would be recording the session when you announced you would bringing a “chaperone” with you.

While you have the right to record your consultation, I feel it would change the dynamics of the consultation.

You are right about that. I said it in response to you and because, in your words you have misconstrued and misrepresented everything that I have said or witten. I have little faith that anything you write up in your “contemperaneous” notes would be an accurate.

also feel that the anger and hostility you have directed at me, as well as your concerns about my incompetence, has irretrievably damaged the Doctor-Patient relationship.

Had I not been so triggered by what you are saying I would never have accused you of “incompetence”. Such strongly- held feelings are not directed at you by at the System, which I despise.

For there to be a good outcome there needs to be mutual trust between the Patient and Doctor, and it does not exist in our case. I would not feel comfortable being your doctor in future.

I’ve certainly lost any trust in you and the System you represent, and that is reinforced by every interaction with you.

See below for my response.

I had hoped that the one hour consultation I had put aside to discuss your complaints, and possible diagnosis and further management, would help you.

MY intention was never to discuss my ‘complaints” but to discuss my letter.

It was never MY intention to raise my medical situation. The time for that has passed.

Ultimately, it is important that you get an accurate diagnosis for your long term symptoms.

That’s YOU, not me saying that.

Having reviewed your notes going back to 1998. I think you may have Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome or more colloquially as “Tapanui Flu”. However I would have also have liked to refer you to a specialist geriatrician to further elucidate the diagnosis.

I am unsure what you are trying to say.

When I was practising a decade or so ago, ME and attending conditions the entirety of the general medical community was in active denial that such a thing even existed. See my comments about “somatisation symptom disorder” at the end of the letter.

It was practically my bread-and-butter.

Until you start dealing with the causes of ME, such as environmental toxins or latent viruses ( where the myalgic Encephalomyelitis comes from). Without having an understanding of these things you don’t have a hope in hell of treating it.

As you have come to this so late in the piece my guess is that I know more about the condition than you do.

If you think I am going to a GERIATRICIAN about this then you don’t know me very well.

There is no way that I am going to look for another GP, as I pointed out in my letter.

First, that as a patient I have the right to raise serious areas of concern without threat of reprisal.

The second I can illustrate with an anecdote about Mullah Nasruddin, who was discovered sweating while he ate one hot chili after another. When asked why he was doing this he said: “I am looking for a sweet one”.

I have a sinking feeling that the subtlety of my second point might be too subtle. Basically, I am saying is that I have no hope in finding another doctor. They are all far too busy and I suspect the ones I might have gone to have been mandated out of their practice by a corrupt Medical Council.

For what it is worth I will NEVER go to Mr. Rob Maunsell – that would be a giant leap backwards, even from the status quo. I went to see Dr. Crawford, not for his anthroposophical medicine but for his knowledge, his caring and for his respect and willingness to consult.

Please let me know what you decide.

I have not been to see you as a GP for the reasons I set out in my letter for the past 2 years.

Those 2 years, the covid “pandemic” notwithstanding, have been quite peaceful.

By contrast, every interaction with this medical centre has come with high degrees of stress and frustration.

The only reason I agreed to a consultation with you was to discuss the contents of my letter and to get an honest answer to my questions.

I can see that I am never going to get any honest response that is not self-serving. However, from our phone conversation yesterday I have as clear an answer as I am likely to get.

So, my response is:

I see no need to alter the status quo of the past two years. I shall not bother you further if you do not bother me.

By the same token, I will remain on your books as a purely formal matter.

The policy introduced in the early 2000’s that requires me to register with a medical centre with no right to seek out the doctor best able to help me, still sticks in my craw and os responsible for many evils.

To ensure you get the message I shall repeat it:

I see no need to alter the status quo of the past two years. I shall not bother you further if you do not bother me.

By the same token, I will remain on your books as a purely formal matter.

Because you have misconstrued, or igored the entirety of my previous letter I am resending an annotated version to you.

Best wishes,

Robin Westenra Dip. Ac, BA

****

I sent an annotated version of my original letter as well

To:Dr H. McCabe,

Over the summer period, the health condition I have had over the period I came to you with took a rapid turn for the worse. During that time I caught covid-19 (the second time I have had ‘flu’ in 15 years). I recovered from it relatively quickly but have had an aggravation of symptoms I have had for some years, so they cannot possibly be construed as “long covid” because they pre-existed.

These are the same symptoms I have reported since I first consulted you, but with an intensity that often keeps me bed bound for much of the day. They include:

Extreme and constant exhaustion
Nausea
Dizziness on standing
Chest pain that is quite distinct from gastric reflux
Loss of memory and loss of cognitive function, as identified by Wellington Hospital
Periodic shortness of breath

This was an introduction and IN NO WAY a “call for help”. I was summing up the symptoms that have never been addressed.

For years I have brought an account of these symptoms to you without once having had a discussion of what could be going on, or questions asked which would allow for a differential diagnosis to then decide what physical tests should be done.

This is the essence

I wish to explain why I have never returned for a consultation in the last 2 years and it is clearly NOT because I had no health issues that needed your attention.

I came after seeing your junior doctor because I had started getting burning feet and altered sensation. I raised the findings of tests for homocysteine that I had done and paid for myself because your locum had refused them. I pointed out that low levels of homocysteine could be linked to serious conditions such as higher risk of strokes or kidney disease. He suggested a consultation with you.

You have an unfortunate, and in my mind ego-driven tendency to lecture or feed back to me things that I already know or told you

When I explained my symptoms of tingling, burning feet you asked, as I recall, no questions about these or any other symptoms but tested my reflexes, which may or may not have had relevance in a diagnosis or may have provided something to put in my notes.

This was fobbing me off. I recently went to my podiatrist and got more sense from her in a few minutes than I got from you.

I recall that no questions were asked or any explanation offered as to what might be behind this. Instead, your main interest appeared to be to ask me and my partner Pam what our intention with regard to “vaccination” was, despite the fact that Pam is not your patient.

This irritated me greatly.

From that moment I decided to forgo any further consultations as a fruitless exercise. Two years later I still have the exact same symptoms.

The last time I was referred to anyone was in 2016 when I was referred by W.C to the neurology department at Wellington Hospital where I received important tests of my physical and cognitive function. I later received a diagnosis of a condition called called Parkinson’s Plus.

I have throughout rather expected that it is good practice to discuss the condition, recent tests etc but that has never happened. This is largely to provide some context to the situation and perhaps relieve some anxiety

However, I recall no reference to any of this but rather, “what can I do for you today?”, all delivered with an uncomfortable feeling of being fobbed off and not taken seriously, despite diagnoses of sarcoidosis and Parkinsons. No questions, no referrals – nothing but endless generic tests that without a clinical context mean nothing if a serious diagnosis and treatment plan is what is in mind.

Why should I think this attitude is ever going to change?

One person who did want to talk about my blood tests was Dr. Forsey who wanted to discuss my blood tests despite having no knowledge of my clinical history, apart from the notes in front of her. The last thing she had done on a previous visit was to suggest an online survey that I am sure was designed to demonstrate that I was clinically-depressed.

You may recall that she wrote in her contemporaneous notes that I was abusive and threatened her with my stick, when the truth was nothing like that and I was being nothing more than emphatic although I did use the “f-word”, directed not at all at her but the suggestion of the use of an antihistamine as sleeping medicine. I am sure that the use of mistruths to justify one’s actions is not an example of high professionalism.

Remember this?

You will not be aware of another incident because I have never mentioned it.

For a while, I had consultations with Dr. Kusel.while Dr. Crawfprd was away. He was, indeed most thorough in his consultation and told me that the basis of my condition was obesity and assured me my symptoms would improve 50 % if only I lost weight. On a subsequent visit he was adamant I had sleep apneoa, something I found risible.

At the same stage the question of my clinical notes from Dr. C’s previous practice going missing in transit and the failure of anyone to try and track them down came up. In response to Dr. Kusel’s irritation – “how dare you accuse our receptionist” – my own anger must have shown itself by my saying I was contemplating taking a complaint to the Health and Disability Commissioner. His response I still recall as if it was yesterday: he said – “what can I do to induce you not to take that course of action?” and offered me a free treatment.

I declined the kind offer, went out to pay and while I was paying my bill Dr. K rushed out to say he had a special fund.

This time I accepted his bribe.

This is an extremely serious accusation and something that should have been subject to disciplinary action. Yet you have chosen to ignore it.

Right at the beginning of my illness I was fortunate to have a doctor who realised the seriousness of an acute flare up of oedema and referred me immediately to hospital. An exceptional doctor in A & E asked me many questions and did not give up until he had reached an interim diagnosis of sarcoidosis.

I am capable of gratitude where it is warranted

Other more mediocre doctors would have overlooked the seriousness of the situation and come to the conclusion that I was either suffering from depression (Dr. Forsey) or from sleep apnoea (Dr.Kusel).

That is in fact what has been allowed to develop into a serious, chronic illness. I hold this practice (with the possible exception of Dr. Crawford, who tried his best), at least in part responsible for the situation I am in.

At no stage has anyone gone beyond the most routine of tests or taken my situation seriously. The tests (such as routine blood tests) appear to me to be nothing more than expensive ways of throwing me off the scent and to demonstrate that nothing serious was amiss.

Take particular notice of this. Quite how you take this to be a “cry for help” is totally beyond me!

I have a suspicion that you are going to regard me as a troublemaker and “suggest” I find another practitioner.

I have two answers to this.

First, that as a patient I have the right to raise serious areas of concern without threat of reprisal.

I have an appointment with you later this month. However, my health is too delicate to risk sitting in a waiting room, exposed to other very sick people so

I hope you can find a way to accommodate this.

I look forward to a frank and honest discussion addressing what I have raised in this letter.

Thank you for your attention.

Yours sincerely,

Robin Westenra, Dip. Ac

I think I have served him with divorce papers. Now, hopefully, I can be at peace from that directions

HERE is a previous interaction

WHAT THE HELL HAS HAPPENED TO OUR HEALTH SYSTEM

A short time ago I booked in for a session with a new doctor at the Manuka Health Centre where I used to work as an acupuncturist for ten years until 2011 until I shifted to a new doctor at a different centre. With Dr. William Crawford in Canada for the last 2 years and unlikely to come back any time soon my time at the Connolly Street Medical Centre was pretty disastrous as detailed fully elsewhere. Intuition told me not to transfer my files back until I had spoken to the new doctor on the basis of the principle “if things look as if they cannot get worse they usually do”.

Nothing much has changed in the last year