My 10-year-old Honda has been acting weird lately, like an old, weathered man whose body is starting to fail.
The symptoms that I’ve noticed include: morning gas pedal stiffness (it’s hard to get going when I first start the car), irregular rhythm of the engine (it revs itself like a punk kid at the red light), and spastic jerky movements (it switches gears with big spasms). Some abnormal markers on diagnostic tests also showed up (engine warning light, and a “tcs” light which is a mystic acronym jargon that only the specialists will understand).
I suspect that this constellation of symptoms can actually be attributed to a single cause, or at least commonly occur together as a “sticky gas pedal syndrome”. Like any patient under the age of 60 with a new health concern, I googled the symptoms and found that many others have the same problem. Some suggest that it’s an issue with the throttle able, and offered a website where one can buy a new one, replace it for under $10, and avoid hundreds of dollars of dealership diagnostic and repair fees.
But like a scared patient without a courage to take his health into his own hands, nor any ability to judge the accuracy of such information and advise, I rushed to the Honda dealer as fast I could.
The check in process included an agent asking to see my insurance paper, taking down my contact info, asking me some questions regarding the symptoms my car has, and getting me to wait an hour while the doctors, I mean the technicians do diagnostic tests to figure out the diagnosis. Then I will be called, the diagnosis and treatment options will be explained, I will be confused but too timid to ask questions, and say to them “whatever you think is best, doc.”
The parallelism is striking.
There is a paramount imbalance of knowledge. They know every part of my car, and I barely know how to open its hood. They know how much things cost, which parts last longer, which parts you can get from any repair shop for a fraction of the price they charge. I know nothing. In an hour they can tell me: your engine is toast, you should sell it for parts and buy another, or they can tell me: just the cable getting worn out, it will be $200 total. The most I can do is seek a second opinion with another repair shop, and go through the process again.
In this position, I can only trust that they are legit and at least fair about charging me extra for being the official Honda dealer. They can ask for $200 or $1000, either way I will probably have to pay up. They can be nice and explain things to me, or they can be too busy to slow down. They can do unnecessary tests and cost me a fortune, or they can be judicious and use their experience and judgement.
And I’m just getting my car fixed!
Imagine how scared an powerless you will feel in a big hospital with countless doctors in authoritative white coats rushing about, patients screaming in agony or puking their guts out around you, and never ending ringing of the phone, beeping of unknown medical devices, and calling code-blues overhead, waiting for your loved one to be seen and cared for. The wait, which can be hours, is felt to be even longer because you don’t know how much longer it will be. You don’t know if you can go to the bathroom because you may miss the doctor, you don’t know if it’s safe for your loved one to take a sip of water, and you may not even have an idea what’s wrong with your loved one and if he or she will get better (there is no selling the parts and getting a new car here).
What we as health care professionals can do, is at least be mindful of what our patients and their families are going through. For us, it could be the fifth time being woken up to see someone in the emerge with vague abdominal pain, or yet another patient who doesn’t speak English which makes our job difficult, but for them, we can be their first contact with the medical team after hours of waiting for this very real crisis. It’s easy to forget that and lose patience when the worried family press us for that morphine we said we’d give an hour ago, because it’s up to the nurses to fill our orders. We can say: “talk to your nurse”, or “let me see what I can do for you” and find out what’s holding things up, and perhaps start the IV that the nurse is too busy to get around to do.
Also, we should keep the patients in the loop as much as possible. Update them on what’s going on, what the short term and long term plans are, when they can expect which things to happen, and to check for questions often. Sometimes it seems like our job is to check lab results, check vitals, talk to patients about their pain, bowel, and appetite, and write a progress note. But when I update the patient on an improving lab result that they have been worried about, that could be enough to improve their pain, bowel, appetite, and their day could go so much better.
The hour of diagnostics is up, and they found a dirty throttle body, cleaned it at no cost, and just charged me the diagnostic fee of $75. I’m impressed by their time management, which is more than I can say for many doctors. Of course, patients are not cars, and we can’t always be expected to predict how much time a patient will take as we could for cars. But there are many lessons that we can learn from a good car dealership nevertheless.