Every year I make a resolution list of patients that I find challenging. I truly believe that it is impossible to be a good physician if you don’t like people in general. (Side note- when the residents I work with start to get aggravated on rounds I make them say something nice about the patient before we walk into a room, and "he has nice hair" doesn’t count. You would hate me if I were your attending.) In spite of my efforts, some people just push my buttons, and that is what "the list" is for. The list usually contains about 5-10 patients, usually older, anxious, demanding women. By the end of the year I am usually able to find something endearing about around half of the patients. And then there are those that make the list year after year.
Last Friday I saw a patient for a physical. We talked for a bit before she mentioned the name of her mother. It’s very common for me to be the doctor of friends and neighbors and parents of patients, but she caught me off guard. Her mother has been on my "list" for several years now. My staff visibly rolls their eyes when talking to her on the phone, and I cringe when I see her name on my schedule. I find her endlessly challenging, which is why I made a whole resolution to like her.
After her daughter mentioned her name I volunteered that I was her doctor. Without missing a beat her daughter replied that she knew that I was her doctor, and went on to say that she wished I had known her mother before she developed her chronic illness. She told me that her mother had been more full of life than anyone she had known and she felt lucky every day that her mother’s doctor could see the woman that she had once been, instead of the woman she had become. She said, "I’m so grateful that my mother has a doctor that cares about her the way that I do."
To which I thought, oh shit.
Sometimes I get karmic kicks in the ass. Seeing this woman’s daughter, and seeing how much she was loved was enough to move her off the list. I’ll be able to see her clearer now, but there will always be people on the list. I hate that I don’t have the ability to instantly see the good in everyone. I hate that I have to work so hard at it.
My job is often physically demanding. I don’t lift heavy boxes, but I stand for eight to twelve hours a day and soemtimes work thirty-six hours with no effective sleep. But the emotional toll is much harder. I work very hard to care. It’s hard to hear what people mean rather than what they say. It’s hard to want to fix people that can’t always be fixed. And it’s hard to lose the people I have come to care so much about.
I chose my path. I doubt I would quit medicine if we had a windfall of money that allowed us to pay off my school loans and pay our bills. But I have bad days, and sometimes-bad weeks. I am again amazed by the kindness of people. I am so very grateful for the emails and comments people have sent me this past week. I’m taking a short break from this journal for a while. Writing here feels like one more thing that I’m not doing well at right now. I started for fun, but it’s turned into a chore. Hopefully after a few weeks I’ll feel recharged.
If not, I hope 2007 brings all happiness and health.
