Monday, May 3, 2010

The things doctors say...

I had a prenatal check up last week. It was just a check up for me, no ultrasound or anything like that. Because I'm going to a hospital which is the largest teaching hospital in Hong Kong, I had some student doctors in the process. It's possible to say that you don't want student doctors but I figure, they've gotta learn with someone as the patient - might as well be me! (as long as they're not cutting me open or anything like that!). One student doctor was going over my medical history with me, as a kind of "pre-consulatation". She consulted with me, then wrote down a bunch of information and then reported back to the doctor I was about to see. She was remarkably sensitive and a couple of times, when she saw I had a tear in my eye, she passed me a tissue and said "I'm sorry if my questions are causing you any pain". 

Fast forward half an hour and I had a consultation with the doctor. You would expect the doctor to be more experienced, more sensitive, more knowledgeable about the issues surrounding these kinds of pregnancies. And as a doctor, she wasn't a bad doctor - but one question she asked me completely floored me. She asked "So, you want to see your baby grow up?"

Seriously now - what kind of a question is that? And what kind of an answer am I meant to give to such a question? "No, I don't want to see her grow up" - duh. I think she was trying to ask in a different way "So, you have decided against termination?" but in a softer kind of a way but the way she worded it was completely wrong. 

In another situation, today I had to take Lana for her 18 month immunisations (a couple of weeks late, but she was sick when we were meant to do them). I quite like our family doctor. She is close to us, she is great with kids, she's pretty easy to get in to see, she's not ridiculously overpriced like most of the doctors that expats in Hong Kong see. We found her from our insurance company and when we see her, we just need to swipe our insurance card and don't need to pay anything for the consultation or for any medication that we need. I've only had one time in the past that I haven't been happy with her and that was when Lana was 10 months old and I was having breastfeeding issues. I found her to be not very knowledgeable about breastfeeding and felt like she gave me wrong medical advice in that situation. I do forgive her for it though because I understand that breastfeeding is not very popular in Hong Kong culture and so most doctors over here (apart from the expensive expat doctors) aren't that supportive or knowledgeable about it.

I thought that I would mention the issues we were having in this pregnancy just to a) prepare/inform her about it, and b) ask whether she had any experience in something so rare. I mentioned that this baby was diagnosed with skeletal dysplasia at 17 weeks and what was her first response? "And they let you continue with the pregnancy?"

Well first of all, no one can force you to terminate, no matter what the situation is. Maybe if I was unconscious and they couldn't get in touch with my family and it was either take the baby or else the baby and I would definitely die, maybe then they would be able to act without consent - but apart from those extreme situations, termination is always the choice of the parents, not the choice of the doctors. And secondly, there is currently no medical reason to believe that our child will not be able to live til she is 80 and have a normal life. Sure that chances are lower, and the other medical issues are greater. But there's nothing saying that she definitely will NOT be able to do that.

I am very aware that our decision is not the "normal decision" in this culture and this situation. I haven't asked the doctor specifically (I may do that at our next ultrasound) but I would guess that the vast majority of people here in Hong Kong would have made the decision to terminate is they were in our situation. You can read my thoughts about that here.

I guess I need to expect that people will not know how to respond to our different decision, even doctors obviously do not know how to respond to it. I wish though that there was a course that doctors had to take called "What not to say" or "How to be sensitive to your patients difficult situations" - it seems that quite a few doctors are unaware of these things. 

The first doctor with the public hospital, I probably will never see her again since every time I have a prenatal check up, I see a different doctor (although I do have one doctor who does all the ultrasounds, but he only checks on the baby - not on my blood pressure and weight and whether or not I have protein or sugar in my urine). With our family doctor, I'm not going to stop seeing her based on her insensitivity in this situation. I will even bring our daughter to her once she's born and hopefully she'll be open to learning more about our daughter's condition because despite the difference in culture, I do think she's a good doctor.


  1. Hi Nicole,

    Thanks for the update. It was amazing to read about that student doctor. I hope she keeps her sensitivity when she goes on to be a fully-fledged practitioner. Maybe they DO talk about bedside manner, etc, in medical school but I suppose they don't get examined on it or anything and it doesn't count towards your grade so it gets sacrificed!

    I was also very moved to read the reasons behind your intention to stay on with your GP. You are truly bringing glory to God in your circumstances. You have been a great witness and I have been very encouraged by your testimony and will never forget it.

    Hope Lana is 100% well now - Jamie and Jaya both caught different bugs and were sick too! See you soon xxx

  2. I must say, you are very strong and compassionate to keep this baby as I think abortion is wrong too. I'm not a bit surprised at all about the lack of sensitivity by the doctors in HK as in it is quite the same in my city too, San Francisco. Doctors have quota they have to meet so they push their patients in and out as quickly as possibly. I know, bad for the patients but good money for them. Keep praying and do as many good deeds as you possibly can so your unborn child can collect on the good karma and hopefully be born healthy. You never know when a miracle comes around.

  3. How can the doctor arranged some student doctors seeing & asking u questions without asking yr willingness & made u feel sad abt what they did?! I strongly believe you definately have the right to say "No" since you're going for an consultation but not a must to become a study case for them!

    And so disappointed that the doctors' wordings & questions are so......... -_-" Sad that most of the doctors nowadays only focus on physical curing that they can bring to their patients, but neglecting their feelings most of the time. (It made me see more clearly what a good doctor Jesus Christ is!)

    Yes, most of the people encountering your situation will probably choose to terminate the babe. They're feared by the difficulties that the child may bring to them, & this fear will always bigger than the value of this little life (esp. when the time they can't even feel the babe moving yet).

    This is not surprising though, just like many non-christians sometimes can't understand what the christians do (like sacrificing self benefits to help others, learn to love others unconfitionally). They simply not understanding why do we love this little life so much, can't understand our love to life. Of course, am not only meaning issues between non-christians & christians, but pointing out the different points of "values" that different ppl may holding.

    Support you! Sweet dream to you & babes~~ :)

  4. Oh, Nicole, Hong Kong doctors (in general) are social idiots. I'm sorry that you've had to deal with them. They don't just say stupid things to people in difficult situations like yours--they say them to all people. And I don't believe it's not because they don't know how to be more sensitive--it's because they don't feel they need to be. It's a very doctor-centric place, this city. So, basically they treat you like their property or instrument and not like a human with feelings. A lot of these OBGYNs are also very skilled at giving abortions (since HK's abortion rate is 29%--the highest in the entire world!) so on a spiritual level, they also have that cloud of death hanging over their heads---they are very hard-hearted. You've been very gracious to give them the benefit of the doubt and try to understand where they are coming from but the point is, that what they do and how they do it is not right by any international standard and if it were me, I would give them a piece of my mind--you'd be doing them a favor--wake them up out of their stupor. Sorry, it just makes me extremely angry when HK people are like this.

  5. Nic,

    Sorry to hear that the doctors were so insensitive. Thankfully, we were dealing with a Catholic Hospital so the subject of abortion never really came up with Madelyn (I don't remember them saying anything about it...they might have asked once just to confirm we weren't doing it). It always bothers me to hear of doctors who consider it a foregone conclusion, although I guess based on the numbers, many parents don't share the same respect and appreciation for any life the same as Christians do. But we never regretted, not for one instance, our decision to give Madelyn every chance at life. I have a lot of really precious memories from our time in the hospital, hearing her heart beat on the monitor, and most of all the opportunity to hold her for the few minutes that she was with us. She was God's gift to us.

    Praying for you and Bernie, and most of all for your baby, which I know is a blessing to you both!


  6. HL - hope Jamie and Jaya get well soon! Lana's much better now. At least I know that Lana didn't make them sick ;) ;)

    G - I was able to not have student doctors but I am happy for student doctors to be aware of our case and for me to help "educate" them a bit. These doctors need to learn from someone and it might as well be us. Particularly since our case is pretty rare. I'm happy for student doctors to be involved in my medical care. And it wasn't the student doctor who was insensitive, it was the supervising doctor.

    Miranda - yes I think that doctors here are socially a lot less sensitive than what I'm used to!! But I do try to be forgiving/understanding towards them. They are that way because of the society that they are in. And ultimately, I'm in their society, they're not in mine. Both times this past week I was too shocked to really respond - but I don't know if giving them a piece of my mind would change anything anyway.

    Nate - thanks, and we're thinking of you and your new bub(s?) and praying for you all!!

  7. I think doctors' lack of knowledge and insensitivity is just something you have to get used to as a parent of a LP. Though none of my doctors were as obviously rude as they were to you, I did get very discouraged with the way they treated my pregnancy. My OBGYN, though I love his care, acted as though my baby was already gone and only focused on my own health concerns. My paranatologists at the hospital asked me week after week for the first month after my 20 week ultrasound if I was sure I didn't want to terminate.

    Now we still deal with it. Children's specialists that think they can treat LP the same way, and don't bother to look into the specific needs of your child. I'm frustrated but can't live without those docs, unfortunately.

    Sounds like you've got quite a cultural battle to fight there, but know that there are plenty of parents out there just like you who chose not to terminate, regardless of the odds or outcome. Having hope, even if it hurts in the end, is never a bad thing.

    Hang in there!

  8. Doctors in the US are just as bad. Most of them have no idea what we go through, and I think they have to emotionally distance themselves from the situations- so they go too far and become calloused. I just prepared myself that when I went in I would not be understood- and then it wasn't so bad.