So, it looks like I’ll be going under the knife again in just four short weeks.  After years of procrastination, it’s time to face the fact that my right ankle can no longer exist in its current state.  You wouldn’t think it possible, but a crooked right ankle can affect knees, hips, shoulders, the neck, and, worst of all, the back.  My back has been hurting more and more as of late, and it all comes down to the ankle replacement on my right side that somehow, mysteriously, and possibly spontaneously (or so I’m told), became crooked.  So, to make a long story short, I now have to undergo another procedure to correct the first procedure.  It’s like Russian nesting dolls, I tell you.



Of course, with another procedure comes another doctor, and this puts me at eight doctors total.  I see enough physicians to have my own reality show.  “Dan’s Doctors” – Thursdays this Fall. Seriously, though, the fact that I’m just shy of a ten-pack of doctors who care for me, I got to thinking, “Just how many doctors have I seen over the tenure of my disease?”


I tried to add up the ones I could remember, but once I hit fifty I stopped counting, in thirty years of illness a person can see enough doctors to fill a small hospital.  Besides, I couldn’t remember half of them anyway.  Of the doctors I did remember, though, I started to recall a few of the more quirky personalities I had encountered.  Doctors are a unique breed, and I’m sure it takes a well-developed sense of humor to deal with the sadness and heartache that comes along with illness on a regular basis.  Even taking this into consideration, though, there were a handful of doctors who acted so bizarrely that their behavior could not be chalked up to a simple coping mechanism.  I covered a few of these doctors in my book, So Young: A Life Lived with Rheumatoid Arthritis, but there wasn’t enough space to talk too much about the doctors themselves.  So, now I can make up for that failing.


One of the doctors who certainly takes the cake was the world-expert on Juvenile Rheumatoid Arthritis, who we went to see when I was a young boy of thirteen or so.   This man was supposed to be the world-expect on kids with arthritis, and every doctor we saw mentioned him by name.  Of course, after hearing about him a few times, my parents found his number and convinced him to see their son, me.  Even on that first phone call, we should have known what we were walking into.  This particular doctor told us we had to come and see him at his home, because he just didn’t have time to see us at the hospital where he kept his office any time in the next six months.  So, of course, my parents agreed, and we drove up to Westchester, New York, to see this world renowned physician.


When we pulled into his driveway, I instantly felt a chill as I saw his home.  I now realize that the house was, in fact, the actual house where Norman Bates kept his vigil over the Bates Motel, waiting for unsuspecting patrons to drop their guard.  That’s how it felt as a thirteenager, anyway, and as we got out of the car, I saw the stairway that led up to the exam entrance.  I remember it clearly because it had at least one-hundred steps, and I remember thinking “who lives here, God?”  I wasn’t far off, unfortunately.


When my dad finally finished hauling me up the flight of cement stairs, all three of us asked simultaneously, “What kind of pediatric arthritis doctor puts his exam rooms at the top of a flight of fifty stairs?”  Not the kind that cares what you think, that’s who, and if it wasn’t evident enough by the fact that we had to hire a Sherpa just to summit the parking lot segment of the northern stair face, then it quickly became apparent when the doctor’s first words after examining me were, “Mr. & Mrs. Malito, I’m sorry to tell you, your son will never get better or be cured.”


MMM.  Talk about a show stopper, that’s just what the parents of every sick child wants to hear – that there’s no hope.  Of course my mom started crying and my Dad sort of laughed at the absurdity of it all, and asked the doctor if he could “be more specific.”  So, this doctor, this leading expert of all pediatric rheumatologists, went on to explain that I had a form of aggressive autoimmune arthritis that would eventually put me in a wheelchair and as of that moment, medical science was unable to prevent that from happening.  Then, without another word, he thanked us for coming and did the old “I’ll stand up first” routine, to signal us it was time to leave.


Well, we couldn’t get out of there fast enough, and by the next week we had found another doctor, a rational one who know how to talk to other human beings.  I learned a valuable lesson that day – that being the “top doctor” in a field doesn’t automatically bestow that person with a bedside manner, or even more, a personality with an ounce of empathy.  This guy was pure old school, the “take two aspirin and call me in the morning” type, and while that works fine for regular cases, chronically ill children and their parents are not often won over with curtness and professional detachment.


A know-it-all is never someone you will enjoy spending time with, for sure, but, frankly, I’ll take a know-it-all over a know-nothing-at-all, which reminds me of yet another doctor in my long history of physician relationships.  I went to see this particular guy at a time in my life when I had decided that there wasn’t any medicine that could help me better than prednisone, a steroid, and I no longer needed to trek into Manhattan to be on the cutting edge of medicine.  Biologics hadn’t been released yet, so there wasn’t anything really new on the horizon, and even if there was, I figured my guy would hear about it eventually anyway.


Unfortunately, every single time I went to see this MENSA candidate, he’d do the same thing:  suggest a treatment change or a new plan entirely, and then stop and ask me what I thought.  “That sounds fine,” you might be saying, but he wouldn’t say “what do you think about that?” no, that would be normal.  This guy would say things like “what, you don’t think it’s a good idea? Have you heard about anything else on the market?” I remember looking at him and thinking “is he asking me for real?  Isn’t he supposed to know this?”  I mean, this is why I came to a doctor in the first place, for informed advice, not for someone who would have prescribed me arsenic if I told him it was the latest wonder cure.  This guy was about two days removed from offering me a jar of leeches to rid myself of “bad humors,” I’m telling you.  How he retained a medical license I’ll never know – maybe he asked the medical board if they knew of any good test answers on the horizon.


So, after a little while I finally decided that I’d be better off drinking the blue water out of the toilet for all the medical knowhow I was getting, and I found a doctor in New York City, and never complained (much) about schlepping to Manhattan again.


So here I am, now, ready to add another doctor to my repertoire, and set out on another adventure of medical science.  I’ll keep you guys informed, as I always do, and I’ll be in touch at least one more time before I go under.  Let’s just hope this doctor doesn’t tell me I’m probably doomed before we start, or show up to the OR with an, “Ankle Reconstruction for Dummies” book under his arm.