The Importance of Asking Questions

If you want to enjoy life, go adopt a dog. Seriously. There is nothing like a dog to bring joy, pleasure, love, and trust into your life. I know this well: my spouse and I rescued a coonhound—Daisy Mae—about thirteen years ago, and through her I recently learned something important that has touched my own roles— both as a therapist and as a patient.

A co-therapist

It all started when Daisy Mae got fired. She’d been going to a trainer on the days I was working out of my Boston office when out of the blue (it seemed) a call came: sorry, she wasn’t learning obedience, and the trainer had had enough.

So I had no choice but to bring her to work with me. I’ve never been one of those therapists who bring their dogs to the office, clinicians who claim their dogs are attuned to clients’ needs. But I have to say, Daisy Mae converted me—she was great as a shrink. She slept through the entire day! When awake, she enjoyed company and never disrupted the therapeutic bond. Many clients made a fuss over her and looked forward to seeing her.

Our relationship develops

Since then, Daisy Mae and I have spent all our time, pretty much twenty-four/seven, together. I am attuned to every sigh, grunt, exhale, and stretch; she sleeps on her dog bed on the floor by my side of the bed, so waking up in the middle of the night and catching a glimpse of her elicits feelings of peace, and joy, and love.

Because I am so attuned to her, I was pretty quick this past summer to notice when she started not feeling well. I kept an eye on her, and when in addition to the other symptoms she developed a terrible cough, I took her to see her veterinarian.

And then the doctor called

To my dismay, the dreaded post-visit call came: her veterinarian diagnosed lung cancer. He recommended palliative care so she could end her life comfortably. We were obviously distressed beyond words and immediately made changes in our lives to adapt to her diagnosis and situation.

Naturally, our version of palliative care was to give her everything she wanted—why not?—which revolved largely around her favorite thing: food. We fed her “people” food, we fed her every time she believed herself to be hungry, we fed her whenever we happened to be in the kitchen. Three days into her palliative care routine, we’d undone thirteen years of training—but never mind. Our beloved dog was dying and nothing was too good for her.

Except… she wasn’t actually dying. Apparently this new largesse made life too good to leave! Day after day I could swear she was getting better (and with that observation came the cold realization that we were now completely screwed, having truly created a monster). Another visit to the vet confirmed the truth: she didn’t have cancer, after all.

Of course we were thrilled. But it also made me look at the level of change that had happened in our home due to an inaccurate diagnosis. There was no going back to how it had been before: our lives had been changed irrevocably because we thought the veterinarian was right. We accepted the diagnosis of lung cancer and never thought to ask any questions about it.

Doctors are human, too

I don’t know anyone who would dispute that doctors are human; we all know they’re people with real lives and families and hobbies. But the moment they put on their white coats, we still often imbue medical personnel with superhuman powers. A doctor said, “this is what it is,” and we replied, “oh, okay, I see.” Even if it doesn’t feel right. Even when we have our doubts. We know medical school and internships and residences have honed our practitioners’ skills and knowledge, and who are we to challenge that?

It works the same in mental health. We know our therapist has helped us with many other issues, so if their current suggestions aren’t quite spot-on, well, it was probably our fault for not explaining things adequately.

See how that happens?

Daisy Mae’s life wasn’t endangered by this misdiagnosis on the part of her veterinarian—who is, by the way, a nice guy and fully competent—but her life was changed. As, naturally, was ours. We’re now living with the perfect monster we created in deciding to give her anything and everything she wanted as our version of end-of-life care.

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If you don’t ask questions, no one will

And this got me to thinking about other areas where we rely on our perceptions of infallibility in the medical field. While many patients and their families these days know to ask for a second opinion, especially around a life-threatening diagnosis or treatment plan, many others still say, “yes, doctor,” and accept an opinion as fact. And doctors don’t help. They’ve been treated as infallible for so long that some come to believe it; others, while more modest, are just accustomed to being right. All of them are far too busy keeping up with their overburdened caseloads. The end result is they’re not going to tell their patients to seek another opinion. They’re not going to reconsider their diagnosis. Unless the patient speaks up, they’re moving on.

Again, I would argue the issue extends to our own practices in the mental health field. I don’t want clients who silently imbue whatever I say to them—I’m not infallible. I may have training, experience, and distance, but at the end of the day my opinions are still just that—opinions. If something doesn’t feel right, say something about it. I would rather have questions asked instead of clients experiencing later misgivings through having been too timid or too polite to challenge me.

In my case, the mistake was a happy one: we get more time with our still-beloved and now very spoiled Daisy Mae. But remember that it could have gone another way, and ask yourself what keeps you from having a frank conversation with your health or mental-health provider if there’s anything bothering you.

It never hurts. And it could just help you take charge of your care, which is the best model for medicine and mental health alike.

Tips for self-advocacy:

• The best self-medicine involves advocating for yourself.
• Always feel comfortable asking your medical or mental-health practitioner for clarification.
• Getting a second opinion is smart self-care.
• Your providers are human and sometimes make mistakes.