Physician, Keel Thyself

There’s something vindicating about outliving your doctor. It gives you pause, certainly, to consider the fragility of life, as someone’s death always does. But in a perverse way, when the person advising you on your health keels over from a big, greasy heart attack, it means you win. All those lectures about diet and exercise are instantly nullified. What the hell does a dead guy know?

Not that Dr. Rivers was a bad guy. He was a jovial, back-slapping sort, quick to cut through the malarkey and give it to you straight about your urinary tract infection or your six weeks to live. Granted, he was also a right-wing gun nut, always going on about shopping at gun shows and deer hunting, so I did secretly wish for him a gun-cleaning disfigurement of some kind. But you know, nothing life-threatening. A missing thumb would’ve been fine.

It’s just that, even with both thumbs, the guy was in terrible shape. Not just overweight, but a chain-smoker, constantly wheezing and dripping sweat. He huffed around the office, beet red throughout his balding head, his clipboard slippery from his wet fingers. I deferred to his medical expertise regardless, but let’s face it, a doctor who appears to need immediate hospitalization does not instill confidence. I mean, you wouldn’t buy smoke detectors from a guy engulfed in flames, would you? I had my misgivings about the wobbly doctor, but I kept returning to his office at the insistence of my mother. Having worked for years at the local hospital, where she acquired all the inside dope on county physicians, my mother assured me that Dr. Rivers was one of the few in family practice not currently under investigation for child molestation or back alley facelifts. So I continued to let him heave and sweat all over me while he searched for bowel obstructions.

Dr. Rivers and I served as two opposing forces during my visits: the hypocrite and the hypochondriac. Sensing that my real trouble was uncontrollable anxiety, and not, as I insisted, full-blown cancer of the lyme disease, the moist doctor dispensed topical creams at random and told me to sleep it off. Dr. Rivers would, however, between slugs of Mountain Dew, lecture me on the importance of a healthy diet and exercise routine to reduce anxiety-induced stomach ailments, emphasizing his point with a six-minute coughing spasm. This was the stand-off. Doctors, as we all know, consider any patient’s attempt at self-diagnosis a personal attack. Whereas I, as a hypochondriac, don’t feel I’m getting my money’s worth if my innumerable symptoms are not acknowledged. At these prices, I feel I should be getting a real diagnosis of some kind. Restless Leg or Shaken Baby or something.

Why couldn’t Dr. Rivers have been more like my vet? Dr. Milvey of the Heartstrong Veterinary Clinic looked and behaved like a man in training for a vital space mission. He scrutinized the x-rays of Pepper’s kidneys with a humorless intensity, rattling off treatment options like Adam West trying to decode the Riddler’s latest jewelry heist. The rock-jawed seriousness of his delivery convinced me of my crucial role in the dog’s recovery, and that Pepper might live to scamper again if only we ACTED AT ONCE. I always left feeling that I had a new purpose to my life. Dr. Milvey and I were on the Winning Team, joined together in our fight against hook worm and fungal infections.

 None of that with my people doctor, who cheerfully poo-pooed my self-diagnosed brain legions, never suggesting we run tests or x-rays or rush me over to ICU before the coma set in. He’d simply pat me on the back in a manly fashion and send me back to Reception with a sopping handprint on my shirt to dole out a $20 co-pay for nothing. I’d wander away, feeling I’d once again been duped into believing I was a well man when I knew damn well I could go into convulsions at any time – and all because I was taking medical advice from a man oozing deep-fried fat from his pores.

But the next thing I knew, Dr. Rivers sat down one night and had himself a croak. He had one last private session of Pall Malls and perspiration before his heaving heart finally gave out. And on hearing the news, I instantly knew that I had been right about everything. Obviously, a doctor too clueless to have foreseen his own bacon-induced death had no business telling me my hysterical blindness was all in my head. My confidence in my own illness renewed, I frisked myself for fresh lumps, consulted the AMA Family Medical Guide ( a wonderful guide to step-by-step diagnosis of symptoms that often concludes with the warning, “Consult a physician now! Do not delay!”), and went out in search of a new general practitioner who would validate my terminal condition.

The physicians I’ve seen in the years since the death of Dr. Feelbad have been a mixed bag. Some, like Dr. Parham, met my every gripe about dull pains or skin rashes with what appeared to be genuine alarm. They were happy to run up enormous lab fees in search of my serious ailments and wrote prescriptions for a wide assortment of ointments, inhalers and suppositories I didn’t necessarily need.  But others, like Dr. Shore, seemed deeply offended by my suggestions that I didn’t feel well.

“I can run tests if you want,” Dr. Shore would say. “But I can tell there’s nothing wrong with you just by looking at you.”

I suppose this could’ve been intended to soothe my worry. But when Dr. Shore admitted to me that the prescription she had just written was for a placebo, I sensed hostility in her treatment methods. Undeterred, I asked her if any studies had shown which placebo was the most effective.

What these doctors all had in common, however, were their robust, healthy glow and trim physiques. In fact, my current physician, Dr. Sanders, is a young lady who appears to be about 17 years old, petite, freckled and impossibly vivacious and cute. I’m terrified I’m going to develop a crotch rash or anal warts that I’ll have to expose to her. But whether catering to my health anxieties or brutally rejecting them, none of these doctors would do so while sweating feverishly and gasping for breath. And noticing this, I’ve started to realize why I miss Dr. Rivers.

A hypochondriac, you see, can never completely trust a healthy person. He needs some indication that the physician he’s dealing with knows about illness first hand. Because only a sick person knows that sickness is sometimes real, and not just wishful thinking. And what I recall in Dr. River’s approach that really spoke to me was when he would match my health complaints with his own.

“Acid reflux? Oh, man, I know what you’re talking about there. Mine keeps me up all night. Listen, that’s no stomach cancer. Just double up on your Xantac and forget about it.”

It often made me feel angry and dissatisfied that I wasn’t being diagnosed with something more exotic and fabulous, or being treated to elaborate procedures by guys in radiation suits. Because what the hypochondriac needs, ultimately, is a genuine condition to distract his focus from the imaginary ones. A left arm lost to a band saw, verifiable with a mere glance at the infected stump, can be a godsend to the patient ordinarily worried about bird flu.

But though my worst fears were often dismissed, Dr. Rivers himself, swollen with carbs and raging blood pressure, remained living proof that real illness still existed. His enlarged heart and emphysema were not the products of runaway anxiety, not the ravings of a discombobulated hypochondriac, but were very real, very serious physical maladies that eventually exploded in his chest and sent him to his sweaty death.

 So there’s hope.