I am currently doing my family medicine rotation. It has been rough, and I’m only a week in. It is really long hours, sometimes 12 hours a day with driving. Most days I only get to see my baby for a few minutes in the morning as I get her ready for daycare, and then again when I pick her up. I am lucky if I even get back to pick her up on time. She goes to bed at 6 so she is very fussy and ready for bed the second I get home.
Plus, she still wakes up every 2 hours, like clockwork, to eat during the night. Even if I go to bed early, around 9 most nights, the quality of sleep I get is just really terrible. I won’t bore you to tears with my problems, but this rotation is just a lot. In many ways, I am just trying to keep my head above water. I try to remind myself that it’s only a 4 week rotation, but my next rotation is Internal Medicine at the VA, which is probably going to be even worse.
Anyways, today was a really long day. It was stressful emotionally, physically, and intellectually. I had two patients cry during my interview – one had recently lost his spouse of nearly 50 years and another was in a very abusive marriage and struggling with depression and a lot of other things. I had a hard time knowing what to do with these patients. They don’t really teach you how to deal with this in medical school.
Needless to say, they were tough exams. The patient with depression was actually there for some manipulation treatments on her neck, but during my history she started to dive pretty deep into her emotional issues. After about 20 minutes of listening to her and giving her some support and advice, I left the room. I presented the patient to my attending, mentioning how distressed she was. He asked me what I found on her physical exam, to which I told him that I hadn’t done any. He scoffed and said, “Why are you even here?”
I was a little hurt by his remark at the time. I tried to explain that I hadn’t gotten to a physical exam because of the emotional distress she was in, but he didn’t care. He looked at me like I was a complete idiot and went into the room. He apologized to the patient for the stupidity of his medical student and made me perform a thorough physical exam on her neck with some OMT treatments. He referred her to a psychiatrist and sent her on her way.
His words stuck with me the rest of the day. By the time I got home I was starving, I had a headache, and my feet hurt from standing the entire day. Anika started crying as soon as I walked in the door, so I fed her and put her to bed, sad that I didn’t get to spend time with her at all today. And I just couldn’t stop thinking of what he said to me. “Why are you even here?”
I know I’m not a doctor yet. I know that my preceptor is a wonderful physician, but I make no apologies for what I did today. I don’t have to agree with his style of medicine, and he doesn’t have to agree with mine. I have to do things his way because it is his office, and I am working with his patients. But that patient was suffering. Really suffering. Maybe she did need OMT, but more than anything she needed someone to talk to. And I provided that to her. I was only sorry I couldn’t do more.
I sacrifice a lot to do what I am doing, and I wouldn’t do it if I didn’t really believe I could make a difference. I might not know all the right drugs and treatments to prescribe, but I know how to listen. I know when patients just need to talk, and I don’t need a medical degree to help them. I would do the same thing over again tomorrow, and the next day, and the next.
My answer to his question would be too long to explain to him between patients, but I will explain it now. I am here because I love to help people. What I have learned in a few short months in rotations is that people want to connect with people – especially when they are in pain, especially when they are sick. They want someone to listen to them, to empathize with them. They want someone to hold their hand and tell them that everything is going to be okay. Drugs, manipulation – that all comes second. First and foremost, doctors are called upon to be at the bedside of the patient. Just sitting, waiting, comforting. And that is why I am here.
my first patient 
You left me with tears, em. This was beautiful. You were Jesus to that woman today
Wow. What a thoughtless thing for him to say. I hope you are feeling a little better. We all have doctors say things like that to us, but that doesn’t mean it hurts less. I’m so sorry for your tough day. For what it’s worth, I think your focus on her emotional state was good. Do you get the weekends off? Because it sounds like you need some TLC – and rest!
I read this this morning and have been thinking about it ever since. Firstly because that doctor sounds like an insensitive nob and there’s really no call for doctors to treat medical students like that. It happens all the time, it’s horrible and it’s not really acceptable. We’re still human beings! I walked out of a clinic last year because the consultant was being a patronising bastard, but that’s not really possible when you’re running the clinic!
I am do proud to have you in the family!!! I am sure your parents are bursting their buttons with pride too
This is absolutely beautiful. You have such a caring heart, and believe me patients do appreciate it. As someone who has spent a lot of time in and out of doctor’s offices, I know that a doctor that listens and truly cares even if they can’t figure out what is biologically wrong is much more helpful and impactful in the long run. Don’t give up!
I can totally relate to this as unfortunately more or less the same thing happened to be last week. I am just really at the beginning of my medical school journey and had to find a patient to practice history taking and examination. My patient clearly wanted to discuss her situation and end of life plans rather than anything else. She then left the room for a little to have coffee with a friend as it was her birthday. When I came back to check on her, she was asleep and I was not going to wake her up….That did not go down too well with the consultant 😦
And secondly, because you clearly had thought very hard about why you were there and were making sacrifices to do so. It sounds as though you did the right thing in listening to the patient, and I think you’ll be a very good doctor because of it. Keep it up. I like reading your stories 🙂
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I have a wise staff physician on my service who told me once that I should always consider all feedback, but to remember that some of it is golden and some of it is garbage, that part of learning is to learn to discern the garbage from the gold. Sometimes people say crappy stuff that stings and it sticks with you. But, often, it is just that, crappy stuff. You were being compassionate and loving and that is the main part of medicine. Sometimes an exam has to be deferred because we are all human.