“Doc, I didn’t take the medication you gave me. I read something that said it would destroy my liver.” Sigh. These conversations are far too common…and they make me wonder: what are they thinking? Do they really think I prescribed the drug with the evil intent of destroying their liver? Do they think I …
I am normal.
OK, aside from that llama thing.
I have good days and bad. Some days I am content, connected, focused, and motivated. On those days I enjoy my job, I enjoy the people I’m with, I am willing to be inconvenienced by interruptions.
On other days…not so much. I wake up grumpy and (despite multiple cups of coffee) continue it through the day. I keep score of all the ways in which life has conspired to make the day difficult. Too many red lights. Too windy. Clearly terrible things going on. I am not patient with people, and am distracted by little things.
Like I said: I am normal. I do my best to not let these things stand in the way of the care I give, and I try to hide my emotions from my patients. It’s a necessary part of the job. But there are still days I’m better at it than others.
Being a doctor involves hearing a person\’s narrative and working to direct it in the best direction possible. There are some people for whom I have become a significant part of their narrative, and others whose narrative I know better than anyone else. It\’s a bond that doesn\’t happen anywhere else.
It\’s been two years since I first started my new practice. I have successfully avoided driving my business into the ground because I am a dumb-ass doctor. Don\’t get me wrong: I am not a dumb-ass when it comes to being a doctor. I am pretty comfortable on that, but the future will hold many opportunities to change that verdict. No, I am talking about being a dumb-ass running the business because I am a doctor.
I think there is something in us that makes us want to make heroes. This is part of the attraction of sport and other entertainment. We want to see people doing things that are amazing, superhuman, and heroic. As a child, I imagined me hitting the home run in the bottom of the 9th inning, or hitting the basket with no time left on the clock. I imagined the adulation and praise of my skill from the adoring masses. I dreamed of being a hero.
I had a very great yesterday.
I saw three patients who had recent diagnoses of cancer. Yeah, those two statements seem to contradict. They don\’t. Each person I saw gave me a clear view of how the practice I\’ve been building over the past 18 months is making a difference. A big, big difference.
As a clinician, I fantasize about being the heroic detective who notices those obscure facts that others would miss, coming up with the life saving diagnosis when all others had failed. This, unfortunately, is not how it usually works when dealing with real human patients, and my desire to find a single diagnosis to explain what is going on can actually distract me from finding the answers my patients need.
I\’ve heard many doctors refer to themselves as \”healers,\” as if we have some special power to bring about healing in our patients. This idea confers some sort of a higher status and originates, to some, from a \”higher calling\” to a more noble life. Again, this is a logical step, in that we have opportunities on a regular basis to help and even save the lives of people. It\’s natural to believe that somehow the healing power comes from our touch, or even from our knowledge.
It doesn\’t. I am not a healer.
Dr. Rob:
Long-time reader, first time writer! I want to know why it is that my doctor makes me pay to get my own medical records. It seems like since they are my records, they should be free to me! Can you explain this to me?
– Lucy in Texas
Thanks, Lucy, for asking such an astute question that is near and dear to my heart.
There is, in fact, a simple answer as to why doctors don\’t want you to lay hands on their medical records, Lucy. It\’s the same reason you don\’t want your son\’s underwear after his first semester in college (known to have broken autoclaves): they stink.
Why do they stink? It\’s complicated. The best way to see this answer is to look into the past. Way back.
\”I\’m kind of stumped here,\” I confessed to her, going through my list of possible causes. Together we discussed the possible options of diagnostic testing and treatment. While we talked, she continued showing a glimmer of fear in her eyes. It wasn\’t that she thought she\’d die from this, and I don\’t even believe it was a fear that I couldn\’t help her; it was a fear I would tell her the grass was not green. Maybe her reality isn\’t real. Maybe she is crazy.
Doctor and patient. Insecurity meets insecurity. Weak helping weak.
Humans.
