*More* Reasons I Have White Coat Hypertension

In an earlier post, I confessed that doctors make me so nervous that it raises my blood pressure. And it doesn't just stem from the principles from that post.

I also already noted that I have a number of formative memories from frequent trips to the ER growing up. But there was another formative medical experience in more recent history: my three trips to the psych ward (Three trips, two episodes; one of the visits they just sedated me and sent me home, so it got worse and I ended up having to go to a different hospital via ambulance a little less than a day later).

I feel the need to state that the two episodes were only months apart and that I've not had to go back in almost a year. I am lucky to have a good personal medical team.

Also, I know I just did a medical post (and am probably going to do a few more). I just had surgery. It's on my mind. Sue me.

Pictured: We're going deeper Leo!

1: They Mean Well

Becoming a doctor is a noble goal. You want to make helping people your profession. And the side effect of this motivation is that doctors truly think that they are helping with everything they do. For better or worse.

The most dangerous kind of doctor (or really any person)? Someone who believes they are doing the right thing and that they know better than the people their decisions affect.

2: Hospital Roulette

I have a personal medical team that really gets me. And because of that, there is a relationship of trust there. Honestly, I wish everyone could say that about their medical team. But I digress.

Once you're in a hospital, all of that familiarity and understanding goes out the window. It's a grab bag of motivations and experience.

Don't get me wrong, there are some great ones in there. True gems. That includes those involved in the *rougher* aspects of my care (like the people who had to restrain me to keep me from jumping out a moving ambulance). I wasn't a fan at the time, but I was (pretty obviously) not in my right mind and it was needed.

But as with any group, you are dealing with a blend of ego and experience levels. This includes brand new doctors, people who are in it because they like to feel superior, those who are predisposed to jump to a wrong conclusion, those who value rules over well-being, etc.

In short, there are great people and doctors in hospitals. They are diamonds in the rough. The rough is also particularly coarse.

Pictured: The stakes are your life. No pressure.

Thankfully, it can be pretty easy to see through people on this. On my first trip to the psych ward, the doctors brought in two psychiatrists - one was training under the other. The senior psychiatrist was dressed to the nines; he looked like he could have walked out of a TV show. They took themselves a little *too* seriously. (I did get to bruise his ego by being much more responsive to the very friendly trainee instead of him, which was fun. He was wearing scrubs, by the way.)

Another great example of this was my first time visiting someone else in the psych ward. At the time, our friend needed to check themselves in. Their significant other was not supportive, to say the least. The entire friend group (including myself) was concerned given our friend's fragile mental state.

I get to the hospital to visit them. Because I was working that day, I was there at the tail end of visiting hours. On my way in, I pass the significant other on the way out. I get past security and get to the actual ward. They inform me that their policy is one visitor per day. And they just had their one visitor (guess who).

I understand policies are in place for a reason. But sometimes there need to be exceptions. I explained the context to the nurse who was there. She said she had to get her supervisor. The supervisor said I had to call a number. I call the number and need to be on hold to talk to someone. Then I need to be transferred. All while watching the window to talk to my friend disappear before my eyes.

I finally get to a person who can grant an exception. I explained what was going on. Nope.

Thankfully, the nurse that I explained things to recognized the situation. Though I didn't technically get into the ward, she *could* let me talk through a door to her. A shining example of one of the aforementioned gems.

Once you check in to a hospital, it's time to start placing your bets. May luck be your lady tonight.

3: Social Hierarchy is a Bitch

It is well documented that people can slip a bit too much into their roles and, in the process, dehumanize perceived subordinates/patients/prisoners (see, e.g. the Stanford prison experiment, the Milgram experiment).

I referenced the Rosenhan experiment in my prior post. It's particularly applicable here. Here's a quick summary (though, if this sounds at all interesting to you, consider reading the Wiki or full study; it's fascinating).

A group of professors faked their way into a psych ward by pretending they had mild auditory hallucinations. Said hallucinations were crafted to suggest an existential crisis rather than illness. Once they got in, they went to acting perfectly normal and told the doctors that they were no longer experiencing the hallucinations. All but one of them were diagnosed with schizophrenia (the other one got a manic-depressive psychosis diagnosis instead), they all had to "admit" to the doctors that they had chronic mental illness, and all had to agree to take antipsychotic medication.

All without the doctors witnessing a thing. Horrifying, right?

Pictured: Well, I forget if they were all professors per se, but they were all "associates" of the professor who came up with the experiment (who was one of the pseudopatients in the study as well).

There's also a peculiarly interesting wrinkle. (In full disclosure, I remember this from a lecture and can't find something to cite here.)

By the nature of their job, at least some of the professors were actually qualified to analyze the other patients around them. In the course of the experiment, one of them noticed something troubling. A misdiagnosis (a.k.a. a patient not getting the care they need). They brought it up to the doctors. Instead of making any changes, the doctors added "delusions of grandeur" to the professor's chart and upped their meds.

Let me repeat that. The professor had the right answer. It was a medically appropriate call. But, because the doctors wouldn't actually listen, it was ignored.

One of my personal hells (and I suspect it's not unique to me) hinges around being misunderstood and locked away as a result. I'm not sure what's worse: Being thrown away into a room of isolation where you can scream (and no one will hear you) or the being dragged there while offering an ignored yet genuine explanation.

A hospital is the most probable place that will happen to you. In fact, I can guarantee you that it happens to people on a daily basis. A seclusion room is the right answer except when it isn't. Then it very much is not. Then it is that exact hell.

There have thankfully been reform movements in the right direction on this. But take it from someone who was on the front lines not too long ago: It's nowhere close to there yet.

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My high blood pressure making more sense?