Re: Psych Evaluation with Dr. Drooker-Addendum

[Guest guest]

None of my ordeal involved Dr.Drooker. I missed that part of your

post the first time...sorry. I guess I must have really needed to

vent about this still You know, old dog, and refusing to let go

of the chewed shoe syndrome

Colleen - Iowa

> > I am going to be having a psych evaluation with Dr. Drooker at

Mt.

> > Sinai. What kinds of questions will he ask me? Are there certain

> > answers that he is looking for? Any feedback would be helpful.

> > Thank you for your help.

> >

[Guest guest]

Dear wehrco: I have made a special study of the MM PI

re WLS and it ain't predictive. We have one lap

surgeon out here who's a student of Dr. Gagner, one of

the best lap guys (Mt. Sinai in NYC). Her name is Emma

. My sense is that anyone of these surgeons

who relies on the MMPI is practicing voodoo medicine

and is a quack. There is absolutely nothing wrong with

having healthy scepticisms about pain, medicos,

surgeries, doctors, medications, etc. My

recommendation is that any physician using a shrink

test to evaluate whether or not you are going to take

your meds and not eat too much should be avoided like

the plague. Here is my sole correspondence with Emma

over email wherein she shows exactly what

kind of a person she is and it ain't something that

anyone would like to encounter. Incidentally, with

, you can only contact her through answering

machine. There is no one to answer your questions or

arrange appointments with. This is followed up by

mailings and no info as to what you are in for. It's a

black box encounter. Anyway, we get into. First, there

is my enquiry, then her followup, then my answers to

her followup between lines. lcp

PS. There is a meanness in all of this, because

fatties are more vulnerable than many other groups to

attacks on them and their psyche, based on the

misconception that overeating is a form of insanity.

This is not true.

PPS. If you think about it, the shrink and the surgeon

that wasted your time and money should be sued for

discriminating against you for a mental illness. This

is not legal under the Americans for Disability Act as

far as I can figure out. This is made worse because I

don't think you are nuts. I think the nuts are on the

other side, making big bucks discriminating against

fat people with attitude. Please go by that surgeon's

office and show off your new physique. Then sue. You

have been humiliated and ripped off for nothing. The

world won't change unless people like you force them

to grow up. Sue'em.

If you think about it, the psychiatrist or

psychologist should be in the equation here as a

resource for you, the patient. You should not be in

his or her office in order to cover the buns of the

surgeon or for insurance company purposes. They should

be there to help you. To reassure you, to explain

things, to furnish medication if needed, not to tell

you that you do not have a healthy attitude toward

this or that. The shrinks, too, are being abused in

this area. They are not to be gatekeepers, except in

extraordinary cases of outright pyschoses, for any

kind of surgical procedure. The ASBS has guidelines

that are in complete agreement with my recommendations

and interpretation. Only those who are visibly

psychotic deserve to be excluded from WLS.

Sincerely, A guy with attitude toward quacks.

From: Dr

Sent: Thursday, June 14, 2001 12:45 PM

Subject: Re: BPD/DS: Impatient Patient With Attitude:

IPWA

" Mr Planz,

I treat all of my patients the same, celebrities or

not. No one, not even the highly educated, extremely

motivated DS patient, gets special treatment. "

Really? That's hard believe. So you would give the

president of the United States or one of your

colleagues the benefit of your expertise if he did not

wish to go through all the hoops? The

psychology tests, the retests, the follow-up tests,

the boring and expensive interview with the dietitian,

and so on. This sort of adamantine conviction on your

part deserves recognition. Still, it does sound a

trifle over-the-edge...

In my email below, I mentioned Procrustes. Perhaps he

was a relative of yours. Procrustes was a thief and a

murderer who would capture travelers and tie them in

an iron bed. If they were longer than the bed, he

would hack off their limbs until they fit. If too

short, he would stretch them. He, too, knew the

meaning of " sticking to one's guns. " As far as I can

uncover, however, he is not the model for surgical

care in today's land of the free.

It is asking a lot to be special, and I want you to

know that even if you do not consider me or my kind

special, just fat, I consider you so. indeed, I hope

all your colleagues around the land aren't like you.

" Each surgeon has the right to design his or her

program how they want and also has the right to accept

or refuse to take on a patient in an elective

situation. "

Yes. The patient in such a situation must never be

accommodated in any way. This is known in

medicological circles as 'the modern surgeon's

imperative'. Still, it's good that I did not have a

surgeon like you when I had my heart surgery, for I

would never have passed the mental tests in spite of

being highly motivated and of above-average

intelligence. Moreover, you can and do refuse to do

laparoscopic surgeries for reasons that are outside of

ASBS guidelines, as you diddle with psychological

tests and waste your patient's time with dietitians

that are unfamiliar with the procedures you do (I

mention these things because other patients have

mentioned them). This kind of privacy-invading

medicine, it occurs to me, skirts very close to

malpractice, as you play goddess with your prospective

patients who are, in many instances, begging for your

help and approval.

This situation reminds me of that story about a new

arrival in Heaven who is talking to Saint as this

balding, middle-aged guy drives up in a brand new

dark-blue Mercedes. He is going too fast. He stops at

Heaven's gate with a screech, almost running into it,

and repeatedly honks and makes a big to-do about the

gate not opening promptly enough. Finally, the gate

opens, and he guns the Mercedes, and heads past it on

into Heaven. " Who's that?' " the new arrival queries.

He must be somebody really important. " Saint

answers, " That's just God. " Then he makes a sign

indicating that the Creator is not quite all there

with his index finger pointed toward his head. Then he

explains, " He thinks he's a surgeon this week! " Maybe

God was thinking of you, Dr. , and your

perspective on your patients when he took on that

surgeon persona.

" I am not aware of any other type of surgery where the

patient comes into the office demanding surgery, or

worse yet, via email. "

Is your office being invaded by patients demanding

surgery? If so, I suggest that you hire a guard to

keep them out. I have no intent to invade your office.

This is unequivocal on my part.

Still, Dr. Pattersnon, you imply that I am " demanding

surgery " from you. I did not demand anything from you,

ma'am. You misread the tone: It is not strident or

angry. You see, in my world demanding is demanding and

asking is asking, and the two diverge and are based

upon different mental states. There is neither urgency

or peremptory in my asking in the email query below.

Therefore, it does not qualify as demanding. I laid

down a set of facts, and then ask you a few questions.

You said, no, in so many, many ways. I guess, from

your superior perspective, asking a few questions via

email is tantamount to demanding something. With your

attitude, it's hard for me to imagine a poor patient

demanding anything from you.

I think, in fact, that you have it backwards, surgeons

command and demand, patients ask and acquiesce. I am

sure that you don't have any truly demanding patients

for long.

This, in truth, is an instance of what psychologists

and psychiatrists call " projection, " for the demanding

is all on your side. Admit it: One has to be a little

on the mental side to resort to projection from a

droll and mildly entertaining email inquiry such as

below.

Why would someone want to contact you by email and ask

a few questions? Because all that one gets when one

calls your offices are answering machines and one has

to leave messages and then one gets forms and then one

fills out the forms. This, in case you don't know, is

not the way most medicine is carried out in this

country. Well, I was a possible consumer who may have

a question or two for a real human being before I walk

the uncertain plank of your lengthy and hidden program

which is four hours away by vehicle. In truth, you

manage the relationship only on your terms and those

terms are way out of the norm. Only those, Dr.

, who are willing to put up with anything

will subject themselves to your program.

" As I am sure you are aware, I do require

psychological evaluation. "

Yes, even when the patient has already had a psych

workup, you would not be satisfied. You have already

indicated that you make no exceptions. You reinvent

the wheel with every patient. There is only one way to

do things: Emma's Way. You can't be too careful---a

neurotic might slip through your clutches and get

skinny. In the old days, surgeons just did surgeries;

they did not have to act as gatekeeper and jury, there

to make sure the patient deserves to get the

operation. One wonders if you are not doing psych

research and having the patient's insurance company

pay for your data.

" If you are interested in our program, then please

call and leave your name and addresss

on the bariatric extension. "

I am now not interested in your program. I could never

pass the psychological evaluation. Nor am I that

stupid. You see, I consider myself a consumer of

surgical services, as well as a patient. I do not want

to be a pawn in your surgical chess game. I have a

right to ask to be treated like a human being and not

a pawn. A few prospective patients can say no with

their feet.

That you accommodate no one for any reason, including

scheduling, makes you someone that needs to see a

shrink to shrink one enormous EGO.

----lcp

" Sincerely,

Emma J. , MD "

BPD/DS: Impatient Patient With Attitude: IPWI

" Dear Dr. :

I have gone through a complete physical and psych

workup for the obesity surgery with my personal

physician and psychiatrist. This included chest X-ray,

EKG, and blood workup. My internist is enthusiastic

about the surgery and has had several patients with

open RNYs. I had an-hour-long interview with the

psychiatrist. He okayed me for the surgery.

I have done a lot of research on these surgeries and

believe that you are competent to do a lap BPD/DS,

which is the preferred surgery from my perspective,

though you are not as experienced as some. I figure

that by the time a surgeon has done about 10 of these

procedures, he or she ought to be pretty adept at it.

You have exceeded this number, I'm sure. I have not

heard anything really bad about you on yahoo in the DS

group. I also feel that your professional interest in

baryatrics is a good thing.

I weigh a little over 300lbs and have a BMI of about

42. My surgery will be covered by Medicare-Medicaid,

Oregon Version, so there is no problem with

preapproval because Medicare covers obesity surgery

and the OMAP program that I have covers all Medicare

approved surgeries, picking up what Medicare Parts A&B

doesn't completely cover. I am not a death's door. I

present no extraordinary problems, except a little

post-CABG scarring at the base of the sternum from 15

years ago. In short, I am a good candidate, physically

speaking.

I am, alas, of slightly above-average intelligence. My

analytic skills are superior. I am aware that I must

have tiny meals for the first six weeks after surgery,

go light on the fats, drink or eat lots of protein,

and eschew sweets. Four ounces is a half a cup of

water. This is not a very large amount. After that

period of time, the danger of blowing open my stomach

is less. My tiny stomach will inflate to some degree

in size over the next year. Hopefully, I will be back

to a decent weight by that time. Still, I will never

be able to eat like I do now. It is imperative that I

have this lap surgery for weight and health reasons.

Perhaps being a quick study is part of the reason that

I am not interested in being part of any 'program'. I

do not need to consult a dietitian and find psychology

tests to be irrelevant in the context of having gained

the approval of my internist and a psychiatrist.

Indeed, I am a student of the use of these written

indicators, and consider them overrated and unreliable

predictors of ultimate patient compliance. As a way to

sort out candidates for a procedure, the use of the

MMPI, for example, is highly questionable and probably

a violation of the ADA. I manifest no obvious

psychoses, so I qualify under both the NHI and ASBS

guidelines, mentally speaking.

Is it, first, possible to get this surgery from you

and your clinic in a timely manner? Or do you or they

insist, like Procrustes, that all of your

non-celebrity patients be program patients and go

through a rigmarole that the two SF physicians, who've

done over 200 such surgeries, that I have contacted

don't? Are you restrained by conviction or the system

to only drawn-out program business? Or do you, in

short, want my quick-and-lean business as the ASBS

guidelines okay? What's so wrong with quick-and-lean

when appropriate?

What I would like to know, secondly, Dr. ,

assuming a qualified yes to my first set of questions,

is this. Since I have to travel Portland from

sport, OR, which is quite a lengthy trip, is it

possible to have the office visit and the surgery in

close temporal proximity? Or will I have to make a

couple of trips to the area? I have relatives in the

McMinnville area, so I can stay overnight with them.

In short, how can I arrange a lap BPD/DS from you in a

most efficient way?

Thank you, Dr. , for your prompt and helpful

response to both concerns.

All my best, curmudgeonly yours,

lcp "

--- wehrco@... wrote:

>

> None of my ordeal involved Dr.Drooker. I missed

> that part of your

> post the first time...sorry. I guess I must have

> really needed to

> vent about this still You know, old dog, and

> refusing to let go

> of the chewed shoe syndrome

> Colleen - Iowa

>

>

>

> > > I am going to be having a psych evaluation with

> Dr. Drooker at

> Mt.

> > > Sinai. What kinds of questions will he ask me?

> Are there certain

> > > answers that he is looking for? Any feedback

> would be helpful.

> > > Thank you for your help.

> > >

>

>

>

----------------------------------------------------------------------

>

[Guest guest]

Wow! I wish you would've been by my side when I made the call to the

surgeon that rejected me due to my MMPI results. I agree with

practically EVERYTHING you said below. From them being there for US,

not the other way around, to them being gatekeepers for a lifesaving

surgery. Exactly! No other lifesaving surgery involves

being 'worthy'! I just couldn't believe it! I too feel I'm a rather

intelligent person, to understand the post-op regimen, and when their

results said I was unlikely to follow the post-op regimen due to

my 'strong personality traits' I literally BLEW! I guess they only

operate on mealy-mouthed, hide-in-the-dark, fat people that wouldn't

DARE think of questioning what they were told without checking it out

for themselves first.

I too was very distrustful of their 'program' and all the jerking

around they made you go thru. In fact, that Dr. is now scheduling

initial consults today for May 2002! Wow! Why would anyone wait that

long for an initial consult, to then have to wait at least another 4-

6 mos for a surgical date. That time frame should tell some people

that they either are very inefficient, OR they waste a lot of time on

unneccesary pre-op crap!

Colleen - Iowa

DS 1-15-01

DR. BUCHWALD U of MN

-71#

> > > > I am going to be having a psych evaluation with

> > Dr. Drooker at

> > Mt.

> > > > Sinai. What kinds of questions will he ask me?

> > Are there certain

> > > > answers that he is looking for? Any feedback

> > would be helpful.

> > > > Thank you for your help.

> > > >

> >

> >

> >

> --------------------------------------------------------------------

--

> >

[Guest guest]

I agree with you. I was going to go to Portland but after finding out how many

things were required...I changed to Dr Heap and am really happy with him. He

doesnt waste anyone's time.

AJ

wehrco@... wrote:

>Wow! I wish you would've been by my side when I made the call to the

>surgeon that rejected me due to my MMPI results. I agree with

>practically EVERYTHING you said below. From them being there for US,

>not the other way around, to them being gatekeepers for a lifesaving

>surgery. Exactly! No other lifesaving surgery involves

>being 'worthy'! I just couldn't believe it! I too feel I'm a rather

>intelligent person, to understand the post-op regimen, and when their

>results said I was unlikely to follow the post-op regimen due to

>my 'strong personality traits' I literally BLEW! I guess they only

>operate on mealy-mouthed, hide-in-the-dark, fat people that wouldn't

>DARE think of questioning what they were told without checking it out

>for themselves first.

>I too was very distrustful of their 'program' and all the jerking

>around they made you go thru. In fact, that Dr. is now scheduling

>initial consults today for May 2002! Wow! Why would anyone wait that

>long for an initial consult, to then have to wait at least another 4-

>6 mos for a surgical date. That time frame should tell some people

>that they either are very inefficient, OR they waste a lot of time on

>unneccesary pre-op crap!

>Colleen - Iowa

>DS 1-15-01

>DR. BUCHWALD U of MN

>-71#

>

>

>> > > > I am going to be having a psych evaluation with

>> > Dr. Drooker at

>> > Mt.

>> > > > Sinai. What kinds of questions will he ask me?

>> > Are there certain

>> > > > answers that he is looking for? Any feedback

>> > would be helpful.

>> > > > Thank you for your help.

>> > > >

>> >

>> >

>> >

>> --------------------------------------------------------------------

>--

>> >