I am the job

This year, I had the chance to take Christmas off, and I was happy to take a nice long weekend, but I find that I can't stop thinking about patient care items. One of the strange things about being on vacation is that it's not so much a vacation from a location as much as it is a vacation from the profession. No more decisions, I just want to relax. But I realize now that I've done something quite dangerous: I have become the job.

Even in my regular life, it shows. I don't do much outside the medical world. I eat out sometimes. I go to coffee shops. But most of my time is spent simply waiting to get back to being a doctor. Outside of the white coat, I'm not sure who I am.

So, I need to find myself a little and start enjoying life, now that I've got some time to do just that. But how do you go about getting a life? I'm really not sure. If it takes more effort than going to Starbucks, I might be in trouble.

Every now and then...

I think one of the things that I feared the most about being a doctor was crying. I was very afraid that my patients would cry. I myself am a pretty emotional guy, and I would probably cry too, so I was eager to keep an emotional distance. But one attending I worked with bucked that notion. Why shouldn't I cry? Am I made of stone? Compassion is a noble thing, not to be hidden or suppressed.

And since then, I have tried to be compassionate to the emotional wellbeing of my patients. Call it biopsychosocial if you like. I try to make sure my patients know that it is my job to care for them, not their disease. And most of the time, this is okay, but every now and then, it can be tough.

I had one patient, a very nice lady with fibromyalgia and IBS. I know the data as well as anyone else. Chances are she has a background of abuse or other psychological trauma. But I'm patient and I wait for her to feel comfortable with me. After several months, it comes out one afternoon. She had recently been mugged, and it gave her flashbacks to when she was a little girl, and she was physically and sexually abused by her father. I don't know about you, but it's hard to sit in a room with a woman who is telling you her deepest secrets of being abused and raped and not shed a tear.

We sat in the office crying, both of us, and it was tough, but every now and then, it is good to be reminded that there is more to patient care than titration of meds and diagnostic testing: that seeing her that day and letting her share the deepest secret of her life probably did her more good than all the meds I'd written.