After a three month break, during which time I unsuccesfully tried to schedule radiation at a facility closer to my house, it took one phone call to set in motion the most efficient medical process I’ve yet to participate in.

I don’t know if it’s like this everywhere, but the people who do the scheduling at UCSF, where I’ll be having six weeks of radiation treatment for breast cancer, are a marvel. They get you in as soon as they can, they have real live people with real live phone numbers call you, they look you in the eye most of the time when they talk to you and seem to get that you’re a person, not a sickness.

But even so, it’s quite obvious that the medical system is set up in ways that are not always good for you, the person seeking care. Here’s an example.

When I went in for my first meeting, a very nice young woman, a resident, took my “history.” Taking a patient’s history is a basic medical skill, one in which the doctor must be sure they understand who the patient is, what their current complaints are, and what their past medical issues might have been — all this with an eye to making sure they know the patient as a whole, so they don’t well… kill them by prescribing something they’re allergic to.

Given these goals, you’d think the person taking your history would ask you questions and listen to you speak. But this resident didn’t do that. Instead, she looked at me, and her notes, and told me who I am. It was a very odd experience and went something like this:

• She: You’re a 46 year old woman who didn’t feel a lump.
• Me (in my head): Why are you telling me who I am? I know who I am. You’re the person who doesn’t know who I am.
• She (glancing down at the chart): And you had first a follow up mammogram and then a biopsy.
• Me (in my head): well, duh.
• She: And… you blah, blah, blah,blah.

It was a remarkable, surreal conversation. And as it was happening I felt increasingly angry. Possibly, I am angry a lot these days because I don’t like being a patient. But what I really don’t like about being a patient was on display in this very moment. It was this: being spoken to in this way, by someone who’s suddenly so in charge of me that she can actually tell me who I am, is one way in which the medical care system takes power away from you. The ability to tell your own story is one sign that you are in control of your life. When someone else starts telling your story for you, well, that says even this most basic of things, your ownership of your history, is out of your hands.

And that is something I don’t like one bit.

I resist of course. I find myself taking the history of the resident and the doctor with whom she works in the way I wanted them to take mine. I talk about things we have in common: children, professional careers. I ask them questions about themselves, about where they’re from, what their hours are like. When I do this, I feel less and less like they are in charge of my life. I feel like it is becoming clearer to them and to me that they are in my employ. Not the other way around. I’ve hired them to give me something I need. I expect them to do a good job. But that doesn’t mean I am in their power. My history belongs to me, not to them. It is what I make of it, not what they tell me it is.