I’m irritated with this Salem doctor, and pleased with this Eugene doctor

There’s a lot I could say about the prostate surgery (TURP) I had two months ago at the PeaceHealth Riverbend hospital in Springfield. But in this blog post I’m going to try to follow my adage, “The only people who want to hear about an old man’s prostate surgery are other old men, or the man’s closest family and friends.”

So my goal here is to mainly talk about a bigger issue, one that almost everyone who interacts with doctors faces at some point: how is it that some M.D.s are so uncaring toward patients, while other M.D.s are so caring?

I don’t have an answer to that question. I was first exposed to it when my first job after graduate school was as a research associate in the Family Practice Department at the OHSU Medical School in Portland way back when. Part of my job was patient satisfaction surveys to give residents feedback on how they were coming across to their patients.

The four years I spent hanging out with both experienced family doctors and residents in training disabused me of any thoughts that physicians are anything other than human beings just like everybody else — with strengths and weaknesses, pluses and minuses, talents and flaws. (You can watch The Pitt on HBO and see this play out in every episode.)

Now, at the age of 77, in no way do I expect perfection from a doctor. But I do expect that I’ll be listened to, that my concerns will be taken seriously, that I’ll be given good reasons for either a treatment decision or a decision not to treat.

And when that expectation isn’t close to being met, I feel justified in complaining. And when that expectation is met to a high degree, I feel justified in complimenting. Which is what I’m doing in this blog post, complaining about one doctor and praising another doctor. I’ll start with the complaint.

In 2017 I had a serious urinary retention episode. If you’re up to it, I shared the details in a piece I wrote for 180 Medical, “Facing catheter-related depression.”  A urinary catheter is a plastic tube that is inserted in the urethra that allows urine to flow out of the bladder when someone isn’t able to pee sufficiently on their own due to an injury or some other cause.

I don’t know what caused my bladder to go on strike, so to speak, the smooth muscle becoming atonic (lacking the ability to push urine out of the bladder). After I failed a bladder function test in 2017 at Willamette Urology here in Salem, I was told that I needed to use a urinary catheter five times a day. After seeing a different urologist initially who seemed uncaring, at my request I was switched to Dr. Bradley Warner. (Willamette Urology now is Salem Health Urology, being no longer an independent medical practice.)

I was told by Dr. Warner that I’d have to use a urinary catheter for the rest of my life, because smooth bladder muscle doesn’t recover like regular muscle does. That was disturbing, but as the years passed I grew accustomed to my disability, trying to view it as somewhat akin to wearing glasses, an aid to seeing. Except I was using a catheter as an aid to peeing.

Eventually, though, I found that I could pee better on my own, after initially being utterly unable to get out even a drop. So much so, in April 2025 I sent a message to Dr. Warner via Salem Health’s MyChart that referenced a type of bladder surgery someone had told me about, saying in part:

Naturally that got me to thinking about my own situation. Over the years I’ve been able to urinate on my own more easily and reliably, though I still need to self-catheterize. So I’m wondering about a couple of things: (1) Do you think repairing my pouch/diverticulum would help my bladder function? (2) If this is a possibility, would updated bladder function/urodynamics testing be called for, since it has been about seven years since my initial testing?

I got a response from Dr. Warner’s nurse that said:

Hi Mr. Hines, I heard back from Dr. Warner. He said: Your previous urodynamic study in 2017 exhibited no significant bladder contraction. I do not feel this surgery would benefit you. If you would like another opinion then you can pursue this with urology groups in Portland or Eugene. Let us know if this is something you want to pursue further.

That response surprised me. To put it more bluntly, it pissed me off.

I understood that bladder or prostate surgery isn’t any use if there is no bladder contraction able to push urine out of the bladder. However, I’d told Dr. Warner that I could pee on my own now more easily and reliably, so obviously I had considerable bladder function now. Yet Warner referenced a failed bladder function test from eight years ago and wasn’t interested in conducting a current test.

So I asked for a referral. I’d had a second opinion in 2017 from a Portland area urologist, so I figured it made sense to try a Eugene urologist. Which led to me seeing Dr. Brenton Sherwood at the Oregon Urology Institute.

Wow. What a wonderful change. At my first appointment, Dr. Sherwood listened to me in a marvelously unhurried, calm, compassionate fashion. I shared the results of my own personal bladder function test where I stopped using a catheter for most of the day to see how much I could pee on my own. Sherwood agreed that it made sense to do some “real” testing of my bladder function, which involved several follow-up appointments.

At one appointment I was given the urodynamics test that Dr. Warner refused to do. After my bladder was filled up with water, I was able to pee much of it on my own, which Dr. Sherwood said was encouraging. So much so, on January 26 I had prostate surgery, the TURP procedure, performed by Dr. Sherwood.

He told me in a follow-up appointment that while doing the surgery, the camera revealed that my prostate was obstructing flow of urine from the bladder to a greater degree than was apparent from previous testing. Which was good news to me, because I’d been told by other urologists, “Brian, you don’t have a prostate problem, you have a bladder problem.”

Here’s my happy ending: after some post-surgery ups and downs, which is typical with the TURP procedure, now I don’t have to use a urinary catheter at all. I’m basically peeing the way I was before 2017 — needing to find a bathroom, or a tree (we live in the country), every couple of hours. You know, like lots of older men. I just wake up once during the night. I use an iPhone app called proudP to measure the strength and amount of a urination in a toilet bowl. The app listens to the sound.

Today the app gave me a report of how I compare to other men about my age who use proudP. My most recent urination was powerful enough to get an OK from the app. The previous seven urinations showed that at the age of 77, I’m in the top 30% among men in their 70s. So basically I’m peeing on my own like a normal 70 something guy now. Or at least guys who use the proudP app for one reason or another.

I’m exceedingly grateful to Dr. Sherwood for listening to me so well and so compassionately, then giving me a shot at the prostate surgery that I’d been dreaming of for many years. I’m also exceedingly irritated at Dr. Warner for disregarding me even after I’d told him that my bladder function had improved considerably.

I’m a strong believer in science and modern medicine. But I’m also a strong believer in doctors looking at every patient through a fresh eye. Probably Dr. Warner hadn’t encountered many men, if any, whose bladder function had improved so much after their bladder had become dysfunctional. But I’d told him that mine had. Warner didn’t care. He didn’t listen.

Thankfully, I found a urologist who did care. And did listen. My life is much better because of Dr. Sherwood. Who, I want to point out, never had any bad thing to say about Dr. Warner. Or indeed, any sort of thing, because I was the only one who would bring up Dr. Warner in a non-complimentary way.