“The good physician treats the disease; the great physician treats the patient who has the disease”
I was 37 weeks pregnant with my son when I started bleeding. I had finished a long day in the ER and was home with my husband, who was putting together the crib. I went to the bathroom and saw blood in the toilet. At first, I honestly wasn’t sure what to do. There was no pain, and everything else had been going well that day. But I quickly realized that bleeding while pregnant, especially this far along, wasn’t normal.
I called my doctor and we were instructed to go to the hospital. We thought we would be going home after a few hours, but the baby continued to have a very high heart rate and an ultrasound didn’t tell us much so we were told I needed to stay the night on monitors.
There was no room in labor and delivery, so we were stuck in a small back closet area. My husband was in what appeared to be an uncomfortable chair. Fortunately, I didn’t continue to bleed, but JP’s heart rate remained above 200 during the night. In the morning, we were counseled by the maternal fetal medicine physicians (the high risk OBGYNs) and I was transferred in an ambulance to the main hospital which had a level IV NICU. The doctor informed me I was not going home without a baby. This was unexpected, as I hadn’t even packed a bag! I also had over 10 shifts left until I was ‘supposed’ to deliver, so I felt totally unprepared.
Over the next few days, I had a different doctor every 24 hours and a different nurse every 12. We were in the hospital for a total of 5 days. This was the first time I really felt what it was like to be a patient. It didn’t matter that I was a doctor, and had been on a OB rotation during medical school, I still didn’t really know what was happening. I began to feel and understand the fear, frustration, and helplessness so common for patients in the hospital. I was scared. Things were said outside the room, decisions and conversations were had without my input, and I really hated how many different people were involved in my care. I also recognized that I didn’t appreciate when my nurses and doctors talked to me as though I was just a number, a presentation– ‘37 y/o G3P0 female here with bleeding and fetal tachycardia.’
I felt alone and without an advocate.
Initially, we tried to have JP vaginally, but I did not progress. After about 48 hours of pitocin, balloon dilators, and hoping that things would move along, unfortunately they did not.
The doctor that came on next was the one I will always remember. She sat on my bed. She told me that she knew it had been hard to be there, and that she thought it was time to make a decision about having a C-Section. She shared her thoughts on timing, we discussed anesthesia methods and she listened to my concerns. She saw me as a person, and I could feel for the first time since I arrived in the hospital that I had someone caring for ME, looking out for ME. She promised me ‘We will get this baby out while I am on shift. We have 24 hours to do it.”
I realized that in my own life, I have definitely come to the hospital to just work my 8 hours, to care for patients, but in a much more sterilized way. Sometimes life gets the best of me, and in those moments I struggle with hearing my patients, trying to do the best and what is right for them, and making sure compassion enters each of my interactions.
As a patient, it finally clicked. I realized sitting in a hospital bed that my patients invariably know where my head is at based on how I treat them, whether I sit, whether I look them in the eye, whether I talk to them in layman’s terms, whether they felt I was listening.
I recently read a book that put all of these thoughts I was having into words, In Shock, by Rana Awdish, a female physician who herself has had multiple harrowing experiences as a patient. She currently works in critical care, and with her writing has been changing the conversation about how we as physicians care for our patients.
After my experience, and reading this book, I came to the conclusion that I need to make it a point to do better. We as physicians need to do better. This last week #Doctorsaredickheads was trending on Twitter. It was very interesting to see patients describe their terrible experiences, but also fascinating to see physicians responding. There was a lot of anger over the fact this was trending, physicians defending themselves and our profession, rejecting the words, rejecting the notion that this phrase, albiet crass, could apply to any one of us at any given time.
I think the real lesson is that we as physicians are people too. We have bad days, and misbehaving children, and health scares, and working too much or too long. Sometimes we let our lives dictate how we show up to work. Sometimes that means we aren’t as compassionate as we should be, we don’t listen as much as we want to, and we don’t honor the sacredness of our profession. There are times when I am certain we are all ‘dickheads.’
I learned so much from being a patient. I’ll tell my full story at a later date, but since my experience, it has forever changed the way I come to work. I know that every family can tell if I am mentally there or not. They know if I am there to take care of their child, or if I am just punching the clock. Every family in the emergency department needs and wants to be heard, and navigating the system can be really challenging. Sometimes the only option a family has is to come to the ER, because it feels as if no one else is listening. It is my responsibility to then become the one that does listen.
Prior to every shift I make a true and concerted effort to leave my ego at the door. The work that I do is not about me, it is about trying to make sure that each of my patients get exactly what they need. Sometimes that is complicated care, sometimes it is to listen and create a plan to move forward.
I want every family to know that it is my job to take care of their child, so I will do my best to do that very thing. I also have learned that often, a parent knows way more than I do, and it always helps me to listen and to take their perspective into serious consideration.
I understand why we as a profession get the reputation we do, but don’t think it is because we don’t care, it is because we are still just people, with our own challenges and lives and families. Sometimes the things outside of our control affect us more than we would like them to. Sometimes we forget how to be compassionate and to put our patients first.
Do you have a story, of how you changed the way you practice based on an experience? Or as a patient you felt by the way a physician treated you? I’d love to hear it.