Hitting a Nerve

Staying in my lane


 

In one of my favorite fall rituals, I fired up my hot tub. In Phoenix the months for relaxing in one are limited, so I try to enjoy it when I can.

It’s a routine I know well. Remove the coverings it’s been hiding under for the 8-month Phoenix summer. Clean out the dust, dead bugs, leaves. Connect the pipes and hoses, tighten the clamps, and begin filling it with water. A pinch of water softener, a dash of chlorine, plug in the motor, and stir.

Dr. Allan M. Block, a neurologist in Scottsdale, Ariz.

Dr. Allan M. Block

After a few minutes of running, however, I noticed water starting to come out from under the motor unit. That ain’t good. I checked the fittings to make sure everything was in place and tight. They were. So the problem was somewhere inside the motor.

I unplugged the hot tub and went to my computer. Using the ever-popular Google, I looked at diagrams of motor plumbing and wiring, then watched several DIY videos on YouTube.

After about an hour of this I got some screwdrivers, went back out to the hot tub, stared at it for a few minutes ... then I realized I was out of my league and called a repair service.

Part of life is accepting what you can and can’t do.

I’m a neurologist. I hope I’m a decent one. But I’m not a hot tub mechanic anymore than I am a neurosurgeon. Or, as Bones McCoy would have said, “Dammit, Jim, I’m a doctor, not a spa repairman.” Either way, I was out of my league and I knew it. My taking the motor apart – while certainly feasible – was more likely to make things worse.

Unfortunately, not everyone feels the same way. Although I spent quite a few years learning to be a neurologist, it’s amazing how many people feel that, after a similar time on Google, they’re qualified to diagnose and treat neurological (or any medical) conditions. They know what they have, what tests need to be done, and which medications should be prescribed. They only need me to rubber stamp their plan, since their insurance won’t take orders from them. (They often won’t take orders from me, either, but that’s another matter).

While occasionally they’re correct, most of the time I have to politely explain why I disagree with them, or why other possibilities have to be considered and treated. No one is forcing them to follow my plan, but if they aren’t happy with it, they’ll have to find another neurologist. I have to go with my education and experience over theirs. I mean, this is my job. I’ve been doing it for more than 25 years.

I’m sure if the hot tub mechanic showed up and I told him where and how to fix the problem he’d wonder what my qualifications were. I may be right, but I may be crazy (or at least wrong).

Unlike medicine, there’s nothing to keep me from trying to fix the hot tub myself, except my own awareness that I have no practical idea how to do so.

I try my best not to practice outside of my field. Google isn’t going to make me a cardiologist any more than it will let me fix hot tubs.

I’m all for knowledge, but it also has its limits. Why some patients think the Internet is a good substitute for 9 years of education and 25 years of ongoing experience, I have no idea.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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