Dr. Gary Joshua Mishkin, MD

I have a rare condition called hereditary angioedema. Many physicians may not know about it unless they have had a patient with it, or unless they are in a certain specialty that deals with it. It is swelling not caused by histamine, but bradykinen problems. It is a strange, traveling edema that usually starts on the left side of my face, then goes down slowly through the throat and GI tract. When I worked as an RN in a small hospital in St. Helena, CA, of which that is the hospital name, I was unfairly discriminated against when I went to the ER for throat swelling. I was hoping one of the good doctors would be on call, but I got Dr. Mishkin instead. Yes, I will use his name. Because I have had this condition since I was six years old, I was trying to explain the history and the fact that my mother also had it. I know as an RN, most doctors want to know the history of a patient. This one, however, said it was exacerbation of asthma, but I was only wheezing when the fluid got to… the trachael area of my throat. I was not wheezing when it started, two hours before I came to the ER, or after the fluid passed down past the larygeal area. IV steroids did not work, antihistamines did not work. They don’t work with this medical problem. I really tried to give this doctor a good history when I could talk. It was obvious he didn’t know about it, which did surprise me some as he is an ER physician. He also didn’t have a flexible laryngeal scope. When this fluid got down to mid sternal area, it really was painful. I asked for some pain medication but he deliberately withheld it as he thought I was drug seeking. I wasn’t drug seeking and asked for plain Tylenol. I still didn’t get it. I went out to find him as it has been 1-1/2 hours since I had asked for pain relief. I was assertive because I know he was with-holding pain medication. I know as an RN that is against the Joint Commission standards and policies. Apparently he didn’t like me standing up for myself. No doctors believed my condition during that hospitalization, or consulted with an ENT as they know about it. It is okay with me, in fact refreshing, when a doctor says, “I don’t know but will find someone who does.” This doctor was very hostile. When someone is misdiagnosed, they don’t have the right kind of treatment. My problem is, them not even believing anything I said about this. I have gone to ER’s in other states where I lived and had never received this kind of an attitude problem. I was so surprised. I didn’t get anything for pain for 3-4 hours after I was admitted to a medical floor. I felt so bad I cannot explain it in words and was so angry about this documentation from him as he took his anger out in my medical records. He just thought I would not get them. I wrote the hospital administration about this situation, the medical director as well. Since I didn’t trust this hospital as I had worked there in dealing with this effectively, I also wrote the Joint Commission of Hospitals in Chicago. I had three medical errors made,one in the ER, and two from the hospitalist who admitted me. A nice lady who went to Johns Hopkins, but was neglectful and used medical records from a year before to write orders, which were all different than now. She ordered a medication that was also documented in my allergies. These two errors are so basic that no one should ever make them. I couldn’t get any sleep because I didn’t want anymore medical errors made. Since medical records are electronic, I knew I would not be able to take what the ER doctor said out. Physicians can amend records,if they want to, at least in California. Another ER physician who is a good doctor, also wrote his own value judgements, questioning if I ever took meth. I said never, only marijuana in the 70’s a few times when everyone else smoked. He questioned this so much and did a drug screen, when I was in the ER for chest pain. I am glad he did because it was all negative. I called the California Medical Board and talked with a lady there. She told me that it is illegal to write lies about a patient in medical records. I knew it was, but what could I do about it? She said just talk with him. I knew I would not do that but reported it in written form to administration. This whole situation hurt me so much for a long time. Most doctors I have had through the years have been pretty good and fairly easy to talk with. It is a good thing for people to get medical records of ER visits and sometimes hospitalists who don’t know you. All you have to do is go to medical records, sign a form, and they will give them to you. It is your right. Now I live in New Mexico and feel a lot better about the ER doctors I have had here as they are very professional.

I have a rare condition called hereditary angioedema. Many physicians may not know about it unless they have had a patient with it, or unless they are in a certain specialty that deals with it. It is swelling not caused by histamine, but bradykinen problems. It is a strange, traveling edema that usually starts on the left side of my face, then goes down slowly through the throat and GI tract. When I worked as an RN in a small hospital in St. Helena, CA, of which that is the hospital name, I was unfairly discriminated against when I went to the ER for throat swelling. I was hoping one of the good doctors would be on call, but I got Dr. Mishkin instead. Yes, I will use his name. Because I have had this condition since I was six years old, I was trying to explain the history and the fact that my mother also had it. I know as an RN, most doctors want to know the history of a patient. This one, however, said it was exacerbation of asthma, but I was only wheezing when the fluid got to… the trachael area of my throat. I was not wheezing when it started, two hours before I came to the ER, or after the fluid passed down past the larygeal area. IV steroids did not work, antihistamines did not work. They don’t work with this medical problem. I really tried to give this doctor a good history when I could talk. It was obvious he didn’t know about it, which did surprise me some as he is an ER physician. He also didn’t have a flexible laryngeal scope. When this fluid got down to mid sternal area, it really was painful. I asked for some pain medication but he deliberately withheld it as he thought I was drug seeking. I wasn’t drug seeking and asked for plain Tylenol. I still didn’t get it. I went out to find him as it has been 1-1/2 hours since I had asked for pain relief. I was assertive because I know he was with-holding pain medication. I know as an RN that is against the Joint Commission standards and policies. Apparently he didn’t like me standing up for myself. No doctors believed my condition during that hospitalization, or consulted with an ENT as they know about it. It is okay with me, in fact refreshing, when a doctor says, “I don’t know but will find someone who does.” This doctor was very hostile. When someone is misdiagnosed, they don’t have the right kind of treatment. My problem is, them not even believing anything I said about this. I have gone to ER’s in other states where I lived and had never received this kind of an attitude problem. I was so surprised. I didn’t get anything for pain for 3-4 hours after I was admitted to a medical floor. I felt so bad I cannot explain it in words and was so angry about this documentation from him as he took his anger out in my medical records. He just thought I would not get them. I wrote the hospital administration about this situation, the medical director as well. Since I didn’t trust this hospital as I had worked there in dealing with this effectively, I also wrote the Joint Commission of Hospitals in Chicago. I had three medical errors made,one in the ER, and two from the hospitalist who admitted me. A nice lady who went to Johns Hopkins, but was neglectful and used medical records from a year before to write orders, which were all different than now. She ordered a medication that was also documented in my allergies. These two errors are so basic that no one should ever make them. I couldn’t get any sleep because I didn’t want anymore medical errors made. Since medical records are electronic, I knew I would not be able to take what the ER doctor said out. Physicians can amend records,if they want to, at least in California. Another ER physician who is a good doctor, also wrote his own value judgements, questioning if I ever took meth. I said never, only marijuana in the 70’s a few times when everyone else smoked. He questioned this so much and did a drug screen, when I was in the ER for chest pain. I am glad he did because it was all negative. I called the California Medical Board and talked with a lady there. She told me that it is illegal to write lies about a patient in medical records. I knew it was, but what could I do about it? She said just talk with him. I knew I would not do that but reported it in written form to administration. This whole situation hurt me so much for a long time. Most doctors I have had through the years have been pretty good and fairly easy to talk with. It is a good thing for people to get medical records of ER visits and sometimes hospitalists who don’t know you. All you have to do is go to medical records, sign a form, and they will give them to you. It is your right. Now I live in New Mexico and feel a lot better about the ER doctors I have had here as they are very professional.