A choice pickle

Russell Baker

June 30, 1993|By Russell Baker

LIKE everybody else in America, I want the right to choose my own doctor. What I'd like from the government, however, is some good advice on how to do it.

When I was fresh out of school it was easy. Having attended college with several people who went on to medical school, I simply phoned one or two and asked them which doctors to take my troubles to and which ones to avoid. Being young, therefore gossipy and indifferent to the discipline of the medical lodge, they told me.

Life separated us. After 10 years practicing in the Texas Panhandle and points west, old school pals were no longer much help when you had to choose a doctor in New York. Moreover, they were succumbing to the mystic code of the medicine men.

The fractious intern who had once warned you not to let a certain surgeon work on your appendix because incisions left him too confused to tell kidneys from the islets of Langerhans was becoming suspiciously discreet. After allowing that Mengele was a disgrace to the profession, he never spoke ill of another doctor.

As a matter of fact, how often do you hear a patient speak ill of his doctor? When my old medical-school pals became too gray and calcified to divulge the straight dope on which doctors to choose and not choose, I turned to friends and colleagues who were sick a lot.

Would they recommend their own doctors? They would, and they did. And with what glowing praise! Listening to these frequently treated patients, you would have thought we were in a golden age of competence.

These people, always ready to denounce their fellow workers and colleagues as too incompetent to pour bilge water out of a boot, were almost universally awed by the high quality of their own doctors. Since none of them knew any more medicine than you can learn by subscribing to the Reader's Digest, I was puzzled about the enthusiasm with which they recommended their doctors.

Surely incompetence must be distributed in the medical profession at much the same rate as among other workers -- carpenters, say, or journalists. Statistics would demand it, wouldn't they?

The medical field might even have a higher percentage of incompetents than most because of all the money and time it takes to become a doctor. When you've made an investment that big, discovering that you're not very good at your job isn't likely to make you throw it all up and try a new line of work.

Yet, when trying to choose a doctor from among those treating your friends, it seemed you couldn't go wrong picking one at random. All apparently were in a class with Welch, Osler, Halsted and Kelly.

Gradually I realized that the friends dispensing this praise all had one thing in common: They were alive. Being habitues of doctors' offices, I reasoned, they worry excessively about being told their time is up.

Something about going to the doctor promotes this particular worry. It is why I never go near a doctor's office until it's obvious I have only a few minutes left to live. At these times, blessedly, I don't have to grapple with the insuperable problem of deciding whether the doctor is competent enough for me to choose him as my own. For pronouncing me officially dead, any boob will do.

Leaving a doctor's office alive always makes my day. I assume my friends who can't get enough of doctors' offices come to believe it is medical genius that keeps them available to sunlight and bill collectors.

The truth, I fear, is that most of their doctors are only moderately competent while two or three may be highly dangerous bunglers, like those about whom my medical-school pals of long ago used to tell hilariously hair-raising tales.

These hair raisings no longer seem hilarious, now that I have to exercise that great American right to choose my own doctor without anyone reliable to guide me. Come to think of it, why did I ever think those old medical-school pals were reliable?

If one had settled nearby I would probably choose to make him my own doctor and make threats against Hillary Clinton if she tried to stop me. Yet, for all I know he could well be that nightmare imagined by the comedian George Carlin: the statistically inevitable worst doctor in the world, with whom somebody has an appointment tomorrow morning.

Russell Baker is a columnist for the New York Times.

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