What Having a Hysterectomy Taught Me About Crohn’s Disease Part 6 - Consultants Have Very Big, But Very Fragile, Egos

I’ve almost lost count of the number of consultants I’ve seen over the years. Some have been good, most have been pretty mediocre. One was a total bastard extremely unprofessional.

Every one of them has had a very big ego. Some of them even have a bit of a God-complex.

I guess that comes with the constant academic butt-kissing success that comes with achieving that level within their field. But I also find that their egos can be very fragile. Bless.

In my experience, most of them don’t take well to being questioned. “Why do you think that’s the best option for me?”, I ask. “Because it is”, is what they say. “But that’s not answering my question . . .” and around and around we go.

They don’t like it when you point out inconsistencies. “Why are you still taking that much Prednisolone?”, the consultant asked me yesterday. “Because when I was here three weeks ago, you told me to stay on this dose until I next saw you.” “ No, I didn’t”. “Um, that’s what’s printed on the box from pharmacy. Do you want me to show you?” The consultant quickly changes the subject.

They get very offended when you question or disagree with their clinical decisions. Very. In fact, it’s like you have personally smote them, leaving them with a nasty scar. Some of them get so offended that it is a like toddler going to have a pout in the corner who then glares back at you with this expression that says “See how you made me feel, you big meanie? You should feel guilty for making me feel like this!”

They get especially offended when you start quoting research from scientific journals at them. Most especially when you quote from a paper that they wrote . . . .

In fact, they really don’t seem to like you doing your own research at all. “Where did you get that information?” the consultant asks. “NICE Guidance and the British Medical Journal.” “You don’t need to read that”. Um, yes I do. It’s called being an informed and empowered patient. Ironically, NICE's chairman just released a statement on this - http://www.bbc.co.uk/news/uk-25890572

And then there is their reaction when you ask for a second opinion or admit that you use complimentary medicine. That goes beyond being offended, and moves into them feeling that you are undermining them. On a personal level. Evilly.

Few will ever admit that they are wrong or be humble enough to admit that they don’t know everything.

Surgeons, on the other hand, are a different breed of consultant. They still have big egos, sometimes even bigger than other consultants. But ultimately, surgeons are really just frustrated plumbers/mechanics/electricians/carpenters. They want to open the lid have a look, fix it, close the lid, and send you on your (hopefully) merry way.

I find them a lot easier to deal with. In fact, they are rather like dealing with tradesmen. My non-committal meeting with the surgeon yesterday felt like I was negotiating with my gardener. He explained just about everything without me asking, fully admitting the limitations of what he can do. The surgeon who did my hysterectomy and one of my diagnostic laps was rather the same. Not people you go to for sympathy, but people who will tell it like it is from their perspective. Fair play really.

I find negotiating my way around consultant’s egos probably the most frustrating part of being a patient. I have no patience for people who need their egos stroked at the best of times, and have even less patience for it when my health is on the line. In my line of work, there is no room for that. If you ever get the point that your head is so inflated that you think you know everything and don’t question your practise, you need to leave the profession.

As the surgeon said yesterday, “Ultimately, you know your body better than I do”. Damn straight.