On being a 'good' patient

Thank you all for your supportive comments about my difficulties with Dr Abrupt - his ears must have been burning over the weekend!

Hekateris mentioned that she had had similar problems at another UK clinic, but didn't say whether she was being treated as a private or an NHS (National Health Service - i.e. state funded) patient. We are paying to have private treatment in an NHS clinic, which I think may go at least some way to explaining Dr Abrupt's attitude. I don't want this to turn into a lengthy post about the shortcomings of the NHS, so will only say that there is huge pressure on resources, and the impetus seems to be to get people in and out as quickly as possible. We were aware of this when we chose this particular clinic, as opposed to the fancy private one fifty miles further away; we decided that it was more important to be treated in a research-led clinic, rather than somewhere that offered fluffy dressing gowns and up to date magazines in the waiting room.

This does not, however, entirely excuse Dr Abrupt's behaviour on Saturday. I left the clinic feeling profoundly infantilised. Obviously, this may say rather more about me than it does Dr Abrupt - I was, after all, brought up to be a good little girl, and not to bother the grown ups. And yet it also says something about the authority patterns that continue to subtend our dealings with our doctors: however well-informed we may be, we are still led to believe that the Doctor Knows Best. As many others have already stated far more eloquently than I ever could, one of the most difficult things about infertility is the loss of control. In our bid to have a child, we hand our bodies over to the medical profession; we obediently take the drugs they prescribe, drugs which disrupt the cycles we have so painstakingly learnt to chart (one of the most difficult things about the last few weeks has been the feeling that I no longer understand what is going on inside my own body). We are rendered not only emotionally but also physically vulnerable, as we lie on their couches with our most intimate parts exposed. One of the ways in which I have tried to claw back some control is by finding out as much as I can about my own condition. I am an academic, and I approach infertility in the same way as I do any other unfamiliar topic: I read around the subject, and then I ask what I hope are intelligent and informed questions. And that is precisely why I do not like being patronised and dismissed.

We returned to the clinic yesterday for the IUI, still prickling with resentment towards Dr Abrupt. Despite some anxieties in the car on the way over, Mr H rose to the occasion and came up with the goods, and then at 1pm sharp we were called in for the treatment itself.

The whole thing felt a little perfunctory. I thought that they might do another scan to confirm that we were all ready to go, but no-one even asked if I had done the trigger shot on Saturday evening. We were both asked to confirm our full names and dates of birth, then Dr Abrupt got busy with the speculum. The procedure itself was over really quickly, and was far less uncomfortable than a smear test. From behind the curtain, I heard the sound of Dr Abrupt removing his latex gloves. I should lie there for about five minutes, and then I could leave, he said. I then heard the door opening. 'Dr Abrupt?' I called. He stuck his head round the curtain. I took a deep breath. 'I feel that our appointment on Saturday raised more questions than it answered, and I just wanted to make sure that we would have chance to talk through some of those issues in more detail before we started another cycle of IVF.'

'If the IUI doesn't work, then of course we will arrange a longer appointment in a few weeks time to talk about what we learnt from this cycle, and to think about what we'll do differently next time. But for the time being, try and think positively.' He even managed a reassuring smile.

Obviously, he does have something resembling a bedside manner!

Five minutes later the nurse came in. If I hadn't had a period in a couple of weeks, I should probably do a home pregnancy test, she informed me. Would I not have to come into the clinic for a beta, I asked. 'Oh no,' she replied, 'that's only if you were doing IVF.' Should I start using the progesterone pessaries, I asked. She did not know, but would go and ask Dr Abrupt. She returned a few minutes later. 'Oh no,' she answered - you've guessed it - 'those are only if you're doing IVF.'

So now we wait.