Steve Chanin
I came to Dr. Gutwein with chronic constipation and what I believe to be a partial abdominal obstruction. Seven years earlier, with different symptoms, I had seen a different doctor in his practice. Dr. Gutwein seemed to come into our consultation with a pre-determined diagnosis which had to have been based on notes from seven years earlier, given the fact that I had never met nor spoken to Dr. Gutwein before our appointment. In our consultation, Dr. Gutwein was argumentative and dismissive as I described my symptoms and what I perceived was happening to my body, calling me a “lousy doctor.” If he was trying to point out that I shouldn’t be diagnosing myself, he’s correct; I’m not a doctor. That’s why I came to him: to be properly diagnosed. But I’ve had IBS for over 40 years, mostly managing it quite well, and my opinions about what’s going on in my body should carry some weight in his diagnosis. Instead, he seemed more interested in hearing his own words of wisdom, interrupting me mid-sentence several times and putting me on the defensive. He was fixated on my history of depression and anxiety, something which I have never denied plays a major role in my history of IBS. He didn’t factor in that for 42 years I had variations of the same symptoms: IBS-D, with frequent bathroom visits and an ongoing sensation of having to “go.” Stress, naturally, exacerbated this. For the past two years, my symptoms have changed radically—180 degrees, in fact, to IBS-C, and an inability to go without over-the-counter help. I don’t run to the bathroom anymore; I can lazily saunter there. After a rudimentary examination (he didn’t even probe the abdominal area to check for obstructions), his diagnosis was that my condition was psychosomatic, in his words, “90% based on stress.” No recommendation for a colonoscopy or imaging, telling me he was saving me unnecessary tests. As far as I know, Dr. Gutwein is not a psychologist, and he based his assessment on 20 minutes or so of conversation, during which I was polite and calmly tried to answer his questions accurately. I pointed out that if my condition were solely stress-related, my recent symptoms would not have radically changed. But he dismissed that as well. His advice (which I could have Googled): more roughage in my diet. And, presumptuously, better mental health care. The mental health care I’m receiving is more than adequate, thank you very much. More pressing at the moment is finding a competent Gastroenterologist in my area. Frankly, the visit was a waste of my time. It would have been more honest of Dr. Gutwein, in the two weeks leading up to my appointment, to have called me and said, “based on your past history, I don’t think I can help you.” I would have been able to use that time to find a doctor who was actually interested in trying to help me.