Dr. Combat vs. the Girl Scouts of America

As promised, here are the Continuing Adventures of Dr. Combat. As a side note, these adventures are not necessarily in order--that would take too much thought and organization.

Let me begin by making one thing very clear: Dr. Combat never, EVER found me funny. In fact, he never even realized I was attempting to be amusing at any point in our strange-yet-entertaining relationship. If I tried to make a joke out of something he would immediately implore me to "calm down" as if I were about to tear the room apart. My tendency to joke about things with a straight face probably didn't help, and it clearly threw him off. He, on the other hand, had an easily identifiable sense of humor. I would say that it was a mild, family-friendly humor, suitable for holidays and dinner parties. To give you an idea, one conversation went thusly:

DC: "Do you have any allergies?"
Me: "No."
DC: "Just to doctors, right?"
Me: [insert mercy chuckle here]

Not exactly my style, but I was kind nonetheless and usually at least smiled at his harmless jokes anyway. To recap: I always knew when he was joking. He never knew when I was joking.

Now with the disclaimers out of the way, on with the adventures. I first met Dr. Combat in the Labor and Delivery unit of an Army Hospital in the DC area. I had mild pre-eclempsia (gestational hypertension combined with proteinuria) with my first pregnancy and had to be monitored twice a week in L&D for the last two months before giving birth. As a Family Practice physician, Dr. Combat also worked in L&D as an OB/GYN. In his own words, he and the rest of his Family Practice compatriots were Jacks of all trades. I resisted the temptation to complete the phrase for him with the well known "and masters of none," thinking better of it. Considering his overly developed ego, it was likely better for my health that I refrained. He later proved, after also being adept as a pediatrician working in the baby nursery and elsewhere, that perhaps he was not far off the mark with his assessment. I had visions of him walking past a brain surgery in progress, popping in, and having his own go at it. Such would not have surprised me.

I had been going to L&D for about a week before Dr. Combat first showed his face in the unit there. His first remark to me was, "There's glucose in your urine." This, after a nurse knew this and did not tell me, let alone a week's worth of doctors and nurses apparently knowing this and not telling me, irked me a little bit. To top it off, he said it in such a way as to suggest that I should have known it on my own and was purposely failing to correct the problem, likely out of spite. I asked, "Well, why didn't anyone tell me that before??" Looking back, I may have sounded more upset than I actually was, especially given his reaction, which was to stare at me and, I do not exaggerate, slowly back out of the room without another word. Such was only the start of Good Times to Come. At the end of my appointment that day he commandingly instructed me about my diet, which obviously was inadequate, despite the fact that I was following the hospital's dietician's guidelines for pre-eclempsia to the letter. He told me that everything I was eating was bad and I had to do better, providing me with his own version of what my diet should consist of, which boiled down to next-to-nothing to eat for the next two months. For his wife and children's sakes I did not at that moment strangle him with his own stethescope. Instead I stomped out of L&D, forcing the Husband to remain and get the rest of the instructions from him.

To avoid a confrontation and to avoid the dreaded, telltale glucose, I did indeed follow his dietary guidelines. Again, he found glucose in my urine (too much information? too late) and proceeded to diplomatically accuse me of cheating on my new diet. And again, I spared his life. He quizzed me on everything I had eaten over the past 48 hours, only to conclude that I must have left something out.

There was only one instance in all of my visits when my urine was satisfactory to him, upon which he declared that it was beautiful; he was truly happy the rest of the appointment. The reason, of course, for all of the hubbub was that glucose can be a sign of gestational diabetes. It finally dawned on the doctor in charge of L&D to test my blood-glucose levels, which amazingly, registered perfectly. No one ever mentioned the glucose in my urine again, despite my having suggested for weeks that perhaps if my kidneys leaked protein, perhaps they could leak glucose too. But I'm not a doctor so what do I know, right? Incidentally, my hunch was correct, confirmed by Johns Hopkins, in case you were wondering.

My strict diet went on. Each and every time I came to L&D I had to be weighed, and despite not gaining weight, he always looked at me as if he dreaded the hour when he would have to make a call to the Army Corps of Engineers to get a crane just to get me out of my apartment. I had ordered Girl Scout cookies before it was discovered that I had this condition, and they were due to arrive any day. I had begun to dream about them at night, and certainly fantasize about them in my waking moments. The intensity with which I longed for them was magnified by Dr. Combat's ban on anything that tasted good in any form. I couldn't stand it any longer. Finally, at the end of one of my appointments, I confronted him with my problem, pointing out that the cookies had penetrated my subconscience and were taking over. He looked at me and said, "All right, you can have one cookie a day."

"ONE?! YOU'RE CRAZY!"

(Exasperated sigh) "OK.... two."

It was the way he said "two" that made it very, very clear to me that he was never going to three. I smiled sweetly, "Thank you Dr. Combat."

And then I went home and ate half a box each of Thin Mints and Do-si-dos. Now, don't get me wrong. I started out with the best of intentions. I won't bore you with the thought processes and rationalizations that took me from "only two cookies per day" to "only two cookies in my mouth at a time," but sufficeth to say that it happened. The next time I saw Dr. Combat I had gained an impressive four pounds, making my total weight gain to that point (for the pregnancy as a whole) 23 lbs. He read the nurse's notes wrong, and thinking that I had instead lost six lbs, he congratulated me heartily. His smile quickly disappeared when I corrected his misgivings, and he replaced it with a very Ward Cleaver-ish look of disapproval and disappointment. To make myself feel better, I whined to my midwife, who immediately declared all men incompetent and incapable of understanding the most basic of situations. We both felt better for it.

At a later appointment in which he threatened to put me on hypertension medication if my blood pressures didn't improve, never thinking for a minute that at least some of my high blood pressure was a direct result of my interactions with him, he admitted that he "learned a long time ago that [he] had to speak very quietly and calmly" to me. I chose not to be offended by his remark, choosing instead to see him as a doctor who saw a need in his patient and did his best to meet that need and help me by adjusting his own behavior in response. Even if he was off the mark a bit, his solution is still an example of what I think good doctors should be aiming for in the doctor-patient relationship, and unfortunately, something that escapes many doctors now. And I still respect him for his efforts on my behalf. Even if he couldn't tell I was only joking.

Stay tuned later for More Adventures of Doctor Combat in which he Thinks My Baby Is Ugly!