THE SPECIAL NEEDS PATIENT (notes from a caretaker)

And it has happened yet again.

I accompany my adult son, whom I call the “walking wounded,” into his primary care doctor’s office. This son is a special needs person who seems typical enough, yet when having to converse with someone, his expressive vocabulary exhibits signs of deficits. This doctor has known my son for over nine years, through many tests and diagnoses (of which he has several, one of which is a chromosomal abnormality).

An hour later after sitting and waiting in the exam room, my son is on edge. Unfortunately, a wait time of over an hour is the norm. His head hurts and his hands are clenching and unclenching. He needs to sit in a chair instead of on the exam table. Fine. He climbs down and sits next to me. Finally his doctor walks in. The doctor looks over a paper on which I have written symptoms my son has been exhibiting for a long time. I do this to refresh the doctor’s memory, as my son’s file resembles a bible. The doctor says my son should get one of those self-driving cars so when he feels ill, he could get to where he needs to go. I think this is a rather odd joke. Turns out it’s odd–but not a joke. He’s serious. My son mumbles something under his breath. This visit is going downhill fast, and this doctor, who says he did his part of his residency in psychiatry, doesn’t see my son’s body language which is of an animal ready to bolt.

Then the doctor turns to my son and asks him what he’s feeling. Feeling? As in, confused? Angry? Tense? Headachy? Nauseous? This is too vague a question for him. I know this. My son is about to bolt out the door. I speak up. I begin to tell the doctor what our visit is about. The doctor puts up his hand and says firmly to me: “Wait. I want your son to answer. You can’t jump in like that and answer for him.”

My son, in protective mode, sits up straight and says, “My mom can answer.”

I hand my son the car keys and tell him to go outside to wait. He leaves. Doctor says, “Well, now I can’t treat him. I needed him to tell me what was wrong.”

I point to the paper. “He dictated that to me. Those are his words. It’s what he does sometimes. I’m his mother and I know when he can’t express himself to the doctor. You’ve known him for almost a decade.”

Doesn’t make a difference. The doctor defends himself; tells me to bring him back in. Right. I again repeat, “I’m his mother. I know he won’t. It all went downhill, first when we had the first appointment of the afternoon yet waited over an hour, then when you mentioned the self-driving car which to him is like a slap in the face, and now the generalized question that he would have trouble answering.” I don’t want to say anything I’ll regret, so I open the exam room door and say, “This isn’t working.”

I hear, as I walk away, “Don’t you want the prescription for (name of latest test)?”

I shake my head, more in disbelief than to just say no.

Please, doctors and nurses, please understand that there are times when a patient prefers the caretaker to answer. Perhaps the patient isn’t well enough to speak up at that time, or maybe they asked the caretaker to answer all questions. And yes we, the caretakers, do know the ten-second rule; that when the patient is asked a question, the caretaker should wait ten seconds to see if the patient responds. If not, then the caretaker speaks up. And please do not speak authoritatively to the caretaker. Nor laugh. Nor be demeaning. We put up with a lot on a daily basis.

We know you have studied and worked hard to get to where you are today, and we respect that. But please, walk a mile in our shoes before you assume. Many impressive degrees after your name doesn’t begin to shed light on a caretaker’s responsibilities. Please respect us, too.