A 6-page letter blasting a bigoted doctor who mistreated me.

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I'm assuming that I'm probably going over the top with this letter I have written blasting a doctor for insulting me with BS.

I've been suffering for years with fungal infections that my doctors refuse to treat or acknowledge. I try to tell them that Asperger people do seem to suffer from chronic fungal infections, and I have several of them that are obvious to see in an exam. But they keep informing me that I don' t have fungal infections and they refuse to treat them. They say that people don't get these kinds of fungal infections unless they have AIDS or something. This one doctor told me that I'm probably self-inflicting fungal infections. He sat there in the consultation and literally made stuff up as I sat there.

I've complained to my insurance company and I've written a letter of complaint to this doctor, it's over 6 pages long. In it, I call him an idiot, etc.

I'm assuming that this is probably not how a non-Aspie would handle this doctor, but I do have to document my objections somehow and I do want to be forceful and clear in my rejection of his "diagnosis".

Below is the letter. I can't imagine why anyone would want to read my 6-page vent, but here it is, in case someone does want to read it and offer some advice.

Much thanks in advance to any who reply...

___________________________

Dr. Mitchell Stashower
The Clinical Skin Center of Northern Virginia, PLLC
3700 Joseph Siewick Drive, Suite 404
Fairfax, Virginia 22033

Re: My Dissatisfaction With My Consultation With You

Dear Dr. Stashower:

This letter follows up my telephone conversation with your office manager regarding my dissatisfaction with my consultation with you. I am demanding a full refund of the fees you charged, including the copay to me and the payment to my insurance company, for your servivces. I am also demanding that you retract any communication that you had with my other doctors.

Your behavior and comments during the consultation were strange, prejudiced and lacked any medical or scientific focus. I found the experience to be personally degrading and, since I have a progressive medical problem that is difficult to diagnose, a distressing waste of precious time. Furthermore, given your slanderous and disparaging comments to me, I can only expect that any communication you have with my other doctors will only serve to make it more difficult for me to have productive working relationships with them.

After reviewing my appointment with you, I found it to be so insulting and lacking in any professional content that I don’t think there’s any point in maintaining a professional relationship with you in this matter. Furthermore, I’m very concerned about your spreading your prejudiced projections of your personally prejudiced and disparanging opinions about me with other doctors.

The fact that you chose to set aside my symptoms and pass up a medical focus on them during our interview, and focus on my personal affect and express your personally disparaging comments about my affect to me, was frankly unprofessional. Since I can assume that you are not trained in Asperger Syndrome, I am completely uninterested in your ignorant personal reactions to my communications disorder.

Your Claims that Anxiety Could Be Causing Me to Manifest All My Symptoms

Your comments that I appeared anxious and eccentric to the point where you believe I am self-inflicting a rectal fungal infection by damaging the skin of my rectum, and that my anxiety can be causing all my rashes, is was so off target I have to assume you’ve got some kind of personal problem with me. In fact I was not at all anxious during my appointment with you. Asperger individuals can have pressured speech and I have that trait. It’s also in general stressful for me to meet strangers, much less have a professional conversation with a stranger the first time I meet them compressed into a brief meeting. The fact that you chose to interpret my affect as manifesting some kind of pathological anxiety, reflects some kind of fantastical journey on your part, that you are projecting onto my Asperger Syndrome traits. Long ago, I had clinically significant anxiety, secondary to a post traumatic stress disorder that I have since recovered from, and during that entire time I suffered no rashes or other physical symptoms that were not transient. Your belief that I can experience anxiety and start manifesting fungal infections and rashes (like some religiously obsessed people manifest stigmata?) doesn’t relate to any conventional or experimental medical theory I can research. This aspect of my appointment with you was most offensive, and I interpret your behavior as some kind of personal problem you have with my presentation of Self and affect, and your projection of that social prejudice onto my social disability.

Dr. Stashower, I am not a candidate for emotionally or pyschologically manifested physical problems. Self inflicted injury and physically manifested rashes from mental illness are the conditions associated with repressed individuals. In fact, I am the opposite of someone who might profile as being a candidate for such disorders. I’m quite willing to engage in a challenge or conflict anytime, anywhere. In fact, I’m one of the first women to qualify as a search and rescue crewmember in the U.S. Coast Guard station featured in the movie “Perfect Storm”. My Asperger personality is probably the farthest one can get from the kind of repressed individual who experiences physical disorders associated with stress and other distresses, as this contentious letter to you might imply. As part of my Asperger features, I am incapable of lying and repression, and I do have a tendency to vent at length until any frustrations are relieved because I’m simply incapable of the unhealthy compartmentalization that so-called “normal” people practice in their daily lives. The fact that you would make that kind of assessment regarding me is simply additional projection of your own prejudices and stereotypes onto me in the journey into fantasy land that my consultation with you became. Apart from my symptoms that are fungal in nature, you should nave noted from the physical exam that I have everything from low blood pressure to youthful appearance. I also practice yoga, tai chi, and marial arts. I would rather punch a man in the face then cut myself or scratch myself to relieve resentment or anxiety due to fear of confrontation. I suggest you save your lame personal projections for the kind of emotionally repressed and sexually frustrated women you are no doubt accustomed to having around you.

I also suggest that, the next time you consult with a communications-disordered client, you show more respect and consider your statements more carefully, before wasting a medical consultation on choosing to focus on your personal reactions to their affect and social presentation. I, for one, am totally uninterested in your reactions to my affect and communications style, and only came to you for consultation regarding dermatology. I also suggest that you might want to reflect on why you chose to focus on my affect rather than the subject of the consultation, what personal issues might cause you to do so and why you imagine such comments are a useful professional work product in the area of your competency.

And you can use grown up words with me. The fact that I have Asperger Syndrome does not mean I have a 6th grade reading level or that you must use baby talk with me. I have a degree in electrical engineering from one of the top universities in the country. I do know how to interpret scientific argumentation and deploy inductive and deductive reasoning, unlike some other professionals I have encountered lately.

I gave you a full opportunity to explain your weird comments and theory to me, and asked follow up questions. However you didn’t seem to think it was necessary to elaborate on your theory and/or clarify any specifics of it. Because it’s so baseless and you couldn’t explain or defend them, I consider these remarks of yours to be mistaken and inapposite, and irrelevant to my own case.

Your Fabricated Conjecture That My Recurring Rectal Fungal Infection is Self-Inflicted

If your dismissal of all my symtoms with a flaky, vaporous idea that the pressured speech and anxious affect of my Asperger Sydrome means that I can be manifesting my rashes and other ills from my mental condition wasn’t personally ignorant and offensive enough, you also chose to share with me your theory that I can be self-inflicting the rectal fungal infection by traumatizing the skin of my rectum and then it gets infected with fungal pathogens is even more wildly speculative and flaky. If your aim in going there was to be as irrelevant and offensive as you could possibly be within the context of a brief professional consultation, you certainly succeeded.

This theory of yours is so offensive because it’s simply cooked out of thin air, as you essentially ignored all my other symptoms and fabricated this narrative in front of me with no factual basis whatsoever. For your information, I gave you all the information that you needed to begin to think about my rectal infection, if that’s where you wanted to focus. I told you that I am susceptible to fungal infections and once I get them I don’t seem to be able to get rid of them. If you bothered to pause in your offensive and baseless bout of personal disparaging “consultation” long enough to ask me, your curiosity about the origins of my rectal fungal infection could have been answered by me. Several years ago, it was the fashion to wear thong underwear, as they left no panty lines in business slacks and skirts. I wore them for a while but then developed a rectal fungal infection, which is something some news outlets reported some women were experiencing around that time due to wearing thong underwear. Consistent with the fact that I easily acquire fungal infections and then can’t get rid of them, I have had this recurring rectal fungal infection since that time. The fact that you felt comfortable completely ignoring my own factual narrative, and venturing out into fantasy land to fabricate some narrative of your own whereby I am self-inflicting rectal trauma and the fungal infection, makes me feel inclined to believe you, sir, are not only an idiot but one who feels free to dump on me with my Asperger Syndrome as if I’m mentally ret*d.

I have thought about the consultation and I find nothing that resembles a professional work product that I feel that I should have to pay for. Your opinions and comments have the quality and usefulness of something that I might expect from any menopausal, suburban Hausfrau with a high school disploma. I also feel that the your professional opinions, if they reflect in any way the comments you made to me during the consultation, are likely defamatory and can only have a damaging effect if they influence other physicians.

I am quite aware that I am having a hard time getting my doctors to take me seriously. I have always had problems getting people to take seriously things that I say, when I say things that they don’t understand or can’t follow intellectually. What I am presenting with now is uncommon and difficult to diagnose and treat (if it were not, I would have treated and cured it myself naturally as I generally do). Your fabrications, personal speculations about me, and your projections of personal disparagement onto my Asperger Syndrome communications traits, can only make it harder for me to get my doctors to take me seriously.

If for some reason you think you were confirming Dr. Soni’s diagnosis of lichen simplex chronicus, I don’t want or need your focus on the rash on my neck. I have had that rash for more than 30 years, and it’s almost wholly autoimmune in behavior without any relationship to any emotional or compulsive behavior on my part. It worsens when I take an antimicrobial, thus it worsens when I take antibiotics and the reason it was so bad when you saw me is that I was on azole antifungals at the time. The rash can be stable for years, and will only worsen or improve based on my immune system status (it improves when I have an infection, for example). I didn’t consult with Dr. Soni to diagnose the neck rash and I certainly didn’t go to you for a second opinion on it. I consulted with Dr. Soni about what I think are the progressive symptoms of my worsening collection of fungal infections, and I came to see you regarding them. Since as a client I get to pick the purpose of a visit for which I am paying. I think that both of you are focusing on an autoimmune rash and projecting your personal issues and judgments onto it, and if you wish to do that, you can do that on your own time without charging me.

For all of the above reasons, and because I found zero professional merit in anything you said to me in the consultation, I demand that you conscientiously retract any consultation notes or comments that you may have shared with my doctors, and I ask that you refund any charges you made to me (my copay) and billed to my insurance company. I also suggest that you focus more on facts in evidence and less on personality when you consult with individuals who have social disability. In the future I will be submitting a written symptom list and agenda in consultations in the hopes of heading off such wastes of my time and money.

If, after reading this letter, you stand by your opinions, I require a written note signed by you setting forth your professsional opinion, along with whatever explanation for what you feel is a defensible basis grounding your claims. I expect you to own professional responsibility for the ridiculous consultation I had with you, if you expect to claim fees for it and spread such opinions around my medical records. I, for one have no problem owning my statements, and would be happy, for example, to feature this letter and my gripe with you on my blog. I am very tempted, for example, to post this letter to you on a discussion forum for Asperger Syndrome, but I’m restraining myself.

I hope that we can resolve this matter of my complaint about your behavior, informally between us.

Sincerely,

P.S. Regarding your comment that I shouldn’t ignore the professional opinions of my doctors, I don’t believe that I have received anything resembling a believable professional opinion from anyone other than Dr. Mark Soltany yet. Only Dr. Soltany has been consistently well grounded scientifically and intellectually in his discussions with me, not relying on bad science, intellectual fallacies and factual fabrications projected onto me, and he will willingly admit when there are some symptoms he hasn’t seen in combination before so that he doesn’t know what to make of them. I admire that he’s the only doctor I’ve seen recently who is willing to admit when a subset of my symptoms don’t make sense to him, rather than simply make s**t up when he’s stumped. If what I had was easy to resolve, I’d have done so on my own already. Being able to admit when something is unfamiliar to him or when he does not have a ready answer to a problem, is the mark of a professional who knows what real opinions are and that he deals in real opinions.

You say that in general I should trust what my doctors say. I do trust but up to a certain limt. I can’t say that I have the kind of faith-based relationship with doctors that generally unhealthy and obese American women who don’t have a scientific background seem to have. I’m perfectly happy to trust in my doctors, and I have done so in the past, like when I took the Hepatitis B vaccine only to come down with Heptatitis B about a week later. I trusted them when they told me it was impossible for me to get infected from the genetically engineered vaccine, only to discover recently that there were contamination and production problems in the poorly regulated manufacture of that vaccine. I have a problem with professionals who use words like “impossible” when it comes to human-mediated systems that clearly fail on a regular basis, or who make s**t up to rationalize obscure diagnoses that have thin support in evidence. I have a problem believing in anything a professional says when they say things that are obviously false, like “only people who are immunocompromised get fungal infections in their ears” and then proceed to state an alternative diagnosis without any grounding in facts in evidence while ignoring most of my symptoms and those facts of my condition incompatible with such alternative diagnosis.

I don’t mind getting an opinion contrary to my expectations. But if a professional gives me a contrary opinion, and it appears to depend on facts not in evidece, bad science or some degree of magical thinking, and they do so without any accompanying explanations for their findings, and/or if I subsequently can’t reconcile that opinion with what I know to be factually true when I research it myself, that professional has only engaged in the professional fallacious behavior that I refer to as “making s**t up”. The fact that it seems plausible to you that I’m self-inflicting rashes, simply because you can imagine a scenario whereby it’s possible to self-inflict rectal fungal infections and that you can imagine that I’m emotionally manifesting anxiety rashes may be partly because you apparently look at my Asperger affect and social presentation and assume I’m intellectually impaired and have a dysfunctional mind-body system due to autism, doesn’t mean that your ignorant assumptions are plausible to me. If something that a professional says to me is de facto stupid, I will know it to be so, even if I might first do that professional the courtesy of investigating possible grounds for his opinon as I have done for you, before declaring it to be stupid.

Perhaps where you and I differ is in our understanding of what comprises a competent expression of a professional opinion. In my experience professional opinion, whether engineering, legal or medical, is one that is (1) expressed using grown up words with reference to relevant facts and scientific concepts or empirical phenomenon and not simply a conclusory statement communicated to me in baby talk as if I have a sixth grade reading level and am mentally ret*d, (2) doesn’t depend in some crucial way on a factor that consists of bad science and/or fabricated narratives that conflict with my own factual history as a client., and (3) are presented to me or recorded in some writtten form in some fashion for which the doctor will be responsible. A professional opinion must be sufficiently grounded so as to be explicable and defensible, otherwise, it’s just blowing smoke, and that is true whether one is a Supreme Court Justice or some doctor casting about for reasons to refuse to admit that a rash that is fungal in nature even though it’s not one of a handful of common, typical rashes for which remedies appear on drugstore shelves. Now if you are willing to put the fabricated crap that you said to me in writing, and otherwise set it forth in a defensible, grounded professional opinion, I will consider taking the opinion for you and pay for it, but I will hold you legally responsible for the outcome if I rely on your opinion and don’t investigate it further.

I have yet to hear a properly stated opinion on my fungal infections, whether that opinion comprises a defensible argument as to how fungal infection is ruled out or provides an alternative diagnosis that is reasonably well supported along with a differential diagnosis. Your opinion was probably the most offensive I’ve heard so far, although it’s not the stupidest.

A survey of the litany of bad science and false narratives that has been a critical factor in every dismissal of my fungal symptoms include (1) the medically false statement that only people who are immunocompromised get fungal infections in their ears and invasive tissue fungal infections (Fairfax Family Practice) (2) the bright idea that Dr. Soltany take a fungal culture of my ear after I had already been on a fungistat for more than a week (Dr. Soni came up with this one), (3) mental problems and personally self-injuring behavior is causing the fungal infections and rashes I do have (your factually baseless finding on consulting with me).

I have spent a considerable amount of time and money in pursuit of some professional investigation of my progressing physical issues, and I think I’m entitled to at least a few minutes of real professional discussion of my very real symptoms within the context of my own narrative and not the kind of fantastical narratives wholly fabricated by you. If you don’t know what you are seeing, you should just say you don’t know what you are seeing, instead of passing off false, defamatory and baseless conjecture that conflicts with my pateitn history and the facts of my symptoms as a professional opinion. Admitting that you don’t know what you are looking at and why it puzzles you, is a kind of professional discussion that is useful information. That is what a grownup professional does when they are hired to look at something they don’t understand, and they have a modicum of respect for the well-being and needs of their client.

I suggest you shorten it, or find someone to shorten it for you (an editor type person); NTs don't have the patience to read through letters that are so long. You said six pages... do you really think a doctor who probably listens to you for thirty seconds before spending the other nine minutes and thirty seconds lecturing you about psychosomatic illness would read six pages from you? Probably not...

I doubt you'd convince him to listen. What you should probably do is try to find a different doctor, one who will actually test you for whatever seems most logical, given your symptoms (a list which does include fungal infections...)

I don't know that AS people are more likely to get them; but I do know they're not just found in immunocompromised people. Who here hasn't gotten ringworm or athlete's foot from the school locker rooms, at least once? That's a common fungal infection not found exclusively in immunocompromised people.

Speaking of, have you tried a dermatologist? They might know more about the problem than a general practitioner.

Another note: Even if this were psychosomatic, your doctor would still have to address it. Illness caused or aggravated by the psychological state is just as real as illness caused by a virus or a malfunctioning organ or anything else. Somatization disorder is actually rather rare; but when it does pop up, it's not faking and it's not something that should be ignored. What you might get with AS, rather than somatization, is simply hypersensitivity. Something that might be a mild annoyance to an NT might be overwhelmingly obvious to you; something that might be unnoticeable to an NT might be obvious to you. I have several times mentioned to a doctor symptoms that, when identified as (usually minor) problems, were greeted with the comment, "Hmm... that should have been asymptomatic." Not when your sensory system picks up absolutely everything, it isn't. "Minor" problems can cause more distress when you have sensory integration disorder, and that means they have to be addressed, not ignored.

I hope you find a doctor who'll make a reasonable effort to figure out what's going on. Psychosomatic illness is only something you say once you've ruled out the logical physical causes.

This doctor would not be paid.

Yeah I'd stiff the old fart in a second.

Let the collectors come, I'd block them
with my PBX system --disconnected--

Thank you so much for your advice, Callista.

I was hoping you'd help me out.

You're so awesome. :flowers:

LOL. I appreciate the vote. Sometimes I have no idea if I'm getting upset for nothing.

It really helps to have some feedback.

I get obsessive and very upset over this kind of thing too, but I agree that you need to shorten the letter, to no more than one page. Figure out what main points you want to get across and address only those, briefly.

Unfortunately, I wouldn't expect him to change his mind in any way. Doctors can be extremely arrogant.

Good luck.

second this; also, he will probably think you are hysterical and then dismiss others with AS on these grounds in the future.

i think the letter is brilliant and i'm glad you posted it here, where it will be appreciated. an NT will not read this and learn anything from it. he will project it onto you. a letter he might read could go something like this:

Mr. Doctor:

As indicated during our telephone conversation I feel you have been dismissive and unprofessional in your treatment of me. I have written a letter of complaint to the Head of the Such and Such department at Yada Yada Medical Establishment, and will be meeting with your supervisor to discuss the details of my most recent appointment with you. Furthermore, should my condition(s) worsen due to the poor quality of the care you have advised, I will be consulting a lawyer in regards to a malpractice settlement.

Have a nice day.

Sincerely,
Patient

**

Always remember this: when fighting with NTs, it is worthless hitting them in the intellect. You must hit them in the wallet.

-K

This.

And it can't be a bluff either. You really do need to complain to the head of yadayada health center. And if you actually want him to refund the copay and not charge the insurance company, you will need to hire a malpractice lawyer. A letter that demands he do these things just because you say so will go nowehere except your medical records file with a note attached to not make anymore appointments with you. If you want to make any demands, you will need a lawyer to back that up.

It's very difficult to sue for malpractice. You would have to have actually suffered a significant physical injury due to the doctor's negligence, and you usually would need another doctor to say the first doctor made a mistake. (I'm not minimizing how awful your experience was, but the law doesn't care about that, unfortunately.) Hiring a lawyer, in my opinion, will only lead to more heartache (lawyers are usually even bigger a-holes than doctors) and it will prolong your attachment to the insult you received.

On the other hand, complaining to the head of the department or meeting with the doctor's superiors could be useful, but doctors tend to stick together, so I wouldn't have too high expectations..

If you want to send him a letter, do it because you want to be able to express your outrage, for your own sake, not because you expect anything to come of it.

Sometimes a letter can be useful, however. I have actually received a partial refund from a doctor by sending a complaint letter. They did a blood draw without informing me what they would be testing for (as per usual...) and then sent me the bill for the tests they performed, some of which were tests I had already had, so they refunded the fee for those tests after I complained.

You don't have to win a lawsuit; you just have to threaten one. Seriously, though, there ought to be in-between solutions for things that didn't deserve a lawsuit but still had to be addressed. I for one would love to force my doctor to actually explain how the medication works and exactly what my diagnosis means, rather than just saying, "You're sick; take this pill," and leaving before I can think of questions.

[putting on my doctor hat]

As a physician, reading your narrative, I am finding it hard to find the "thread" in your letter. I suggest that you simplify everything, and organize the letter like this:

1) A paragraph asking for the refund of fees
2) A paragraph asking for your letter to be retained in your record (I don't think that it is appropriate to ask him to retract his notes, but it is appropriate to ask that your comments be included with them).
3) A paragraph setting out a brief summary of behaviours that you consider unprofessional

You can attach a more detailed chronology of your visit with the doctor, providing more detail about unprofessional conduct, but it should not form part of the body of the letter. Failure to listen to you, failure to communicate with you respectfully are conduct issues that are worthy of complaint.

There is a significant body of text that is, frankly, irrelevant. It does not matter that you are a qualified SAR crew member. You would be entitled to respectful, professional communication regardless of your personal circumstances.

I don't think that you help your case by highlighting the disagreement with his opinion. You do not agree with his medical opinion, but that does not justify your request. It is unprofessional behaviour that justifies your request, so limit your complaint to that.

If you keep your letter concise, factual and relevant, you are more likely to get a satisfactory reply.

I have not read your letter as it is quite long and irrelevant to what I'm going to say.

I have read no papers from reputable sources indicating that people with AS are more prone to fungal infections, nor do I believe having AS is any excuse for an adult to act in a childish fashion.

If you do not like your doctor, see a different one. Pick another dermatologist and when you go in to see them, ask to be tested for a fungal infection.

It's as simple as that.

Check for typographical mistakes and use the "miniskirt" rule for the body; long enough to cover the subject, short enough to get read.

Also, sticking to the facts!, make a formal complaint to your state's medical board, the folks in charge of licensing/discipline etc.

Get a lawyer if you still want to and good luck!

You should not post the doctor's name or address in this thread. He could sue you or this website for damaging his name or keeping him from earning a living. I would just keeping going to different doctors until I found one that could get the job done. But I am on your side of this, this doctor thinks he knows it all and is real full of himself I bet he would not finish a 2 page letter written by you let alone a 6 page one.

You probably won't be helping your case by calling him an idiot and other names of that sort.

You know your way with words... Good! Agree on shortening though. Maybe take off the PS and put the few things you haven't expressed before into the body text.

It sux he didn't take you seriously. Docs when they don't understand sometimes think it must be mental. A little reading on his part and he might have understood you better. Some people are born with a specific weakness in their immune system and are very prone to fungus. My friend is, she actually has 3 different fungal infections at the same time. One of them was quite rare so the skin doc said it wasn't true. She made him test it but he tested it all wrong and doing this will get a false negative. Then she just got some steroid cream. I don't know which fungus, but some fungus starts up in the mouth and goes all the way through the gastric system. Nothing too weird about it. In the meantime if you eat sugars, maybe cut them out since a lot of fungi thrives on sugar.