Archive for tag: patients

Patients and Patience

You're not behind the desk, you're sitting in the chair next to it. Waiting. Waiting, for what seems like FOREVER for them to come look at you, examine you, swab, cut, bleed, sample, whatever you. They're taking forever. You feel wretched. Everything aches, stings, hurts. You're tired from staying up all night worrying, hurting, stressing. You only want to know what's going on and you feel like you're simply the only person on the face of the planet, and no one is able or willing to help you.

I'm trying to explain what it feels like to be sick -- to be frustrated with the status of the medical profession and confused and angry and scared. I'm trying to explain what it feels like, no matter how melodramatic it may be, to feel like someone else has control over your health, what's wrong, and if and when you'll get better. There's a feeling of being completely helpless that comes with being sick -- when there's pain, when there's no observable pattern or relatively easy diagnosis, or when it just seems to drag on forever. It's a feeling that no one seems to understand -- like being held hostage by something or someone and being powerless to do anything about it. And it doesn't go away -- that feeling -- until there's some grasp over the problem, like some answer, lab result, diagnosis, something, ANYTHING that seems to give some control over the situation.

If you, as a person, have never felt this way, count yourself lucky. But many others can't say that. Our patients likely can't say that. They come to us hoping for understanding and compassion, and the willingness and ability to find out what's wrong. I only hope that they find it.

It's hard to be the patient when you're used to being the physician. It's also hard to be a physician when you've never been a patient. William Hurt, in a 1991 movie called "The Doctor" illustrated just this. Having been an important, influential physician, he finds himself with cancer -- and realizes just how horrible of a physician (no matter how skilled) he (and some of his colleagues) could be.

People come to us in their worst conditions. They're not always in a good mood. They're not always understanding of our limitations as physicians (or students). They come to us seeking help and advice -- and of course, our expertise. Finding answers is what we're supposed to do. It's what our training is based in and what we've been working towards for our academic/professional careers.

But all of that training only provides a fraction of what our patients need from us. They need our compassion and understanding. This isn't taught in school. It comes from within, and unfortunately, it comes from experience.

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(Image source: hopeinhealingblog.wordpress.com)

For some of us, it's been sickness that has made us this way -- or abuse, or poverty, or just LIFE. For others, it's those things that are in the process of making them that way.

Be kind to each other this week, Everybody. Have a great one.

The Student Physician

Nearly two and a half years, countless exams, memorization of facts and figures, pathologies, prescription drugs, and maneuvers that scare you to death -- and you think you might actually know "something" (but not everything). And then the first patient walks through the door and you realize nothing you could've possibly done thus far could have prepared you for what you're about to experience. Welcome to being a student physician.

Throughout my various collegiate undertakings, I've felt ignorant. There was never much of a point to thinking I knew everything or even all that much because I was constantly reminded that whatever bits and pieces I've pulled together meant only a drop in the bucket toward what's out there. I hate feeling ignorant. Maybe that's why I'm constantly reading and researching -- because I know that I don't know anything.

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Ricky in Radiology Positioning class
(Special thanks to Dave Aiello and Ricky King for this picture.)

Dr. Harrison, our clinician, brought up an excellent point last week (he has LOTS of amazing pearls of wisdom). He said that the stuff that we learn the best is the stuff that we're faced with. If there's a condition that we, a family member or friend, or a patient has, we WANT to learn about it. And so we learn those things the best. But when something is sitting right in front of you, there's this overwhelming need to know it -- right now. Sometimes that learning curve can be pretty frustrating.

Questions get asked. Tell me about your family. How are you feeling? What's going on in your life right now? Can you describe this or that sensation? As the physician, you're supposed to know, not only what it is they're talking about, but also how to put all of it together to make sense of what is in front of you. It's a complex task. Then you have to take the person in front of you, and figure out how to make them better, take away the pain they're having, help them cope with what's going on in their life, and help them re-enter their space of wellness. And of course, you hope that they're working with you on this. This takes skills they don't teach in school. We can take all of the interviewing skills sessions, basic and clinical sciences, and psychology classes and still not be able to put all of these "issues" into the complex Being that sits in front of us. So, as I sit here wearing my white coat, I can honestly tell you that nothing I've done over the last two and a half years prepared me for my first patient. Not a thing. Not even remotely. Of all the things I've learned, even over my whole life, listening seems to be the most beneficial.

One of my biggest fears when starting clinic, besides being worried I wouldn't know what to do, is that I would be stuck with pure musculoskeletal cases. I know, this is chiropractic and musculoskeletal would theoretically be a big part of most chiro's practice, but I wanted the hard cases. And I'm getting them. From complex vascular issues to hormone imbalances, I've had to do research in the first week on topics that we didn't learn in any of our classes. Before any physical exams, before any orthopedic testing, just doing the history, I'm learning so much. I love learning this way. Get a topic, find out as much as you can, and then apply it.

Pick up a copy of Harrison's Internal Medicine, and also a copy of the Textbook of Natural Medicine, and Textbook of Functional Medicine. All three of these will serve you very well. Even though these three are great resources, there are some things that still require digging. I love a challenge. Good thing I'm in the right field.

Have a great week everybody!