Thanks for listening

Last year as I struggled though the process of coping with cancer and wondering what my life might actually end up being like as it was shaken like a snow globe I though so much about how much I missed working. I am sure there were a good number o my readers who thought I was just crazy to be thinking about work. There were many different reasons I am sure people questioned why I would want to be back at work. Many times I sort of wondered myself. Why would I want to be back dealing with the hassles of work when I was potentially at the end of life? Why when I had time to be with my family didn’t I just enjoy it? Why would I want to worry about other people when I should have been worried about myself? Yet, those who supported and followed me knew that all those thoughts could easily be flipped around to reasons why I would want to be back at work. At the end of life the only thing that really matters is did you help or influence others. Worrying about others makes one worry less about oneself. Finally my family had other things to do than just watch me struggle.

Now that I find myself back into the fray of providing medical care I have to admit I am a bit longing for the mellower pace of the sick life. I assure you I wouldn’t trade the hectic nature of my days for the ugliness of being sick but there was a mellowness to the moments I felt okay and wasn’t worried (not really that often for the year and a half) which I actually think fondly of. Yet, I am glad to be back at it. There is a feeling of being part of something when you work that you don’t ever get from recreating or languishing around. I will admit that my one fear of returning to work in my chosen field was would my experience as a patient help or hinder my being a doctor. I can honestly say I think it has done both. I clearly have a better understanding of some of the sensations and feelings people explain to me. But the dark side is becoming more clear.

The negative of being a physician, who went through and continues to deal, with a significant health issue is that we run into so many patients who just don’t care about themselves. Obviously this is unto itself a health issue which needs to be addressed but so often can not be in the given time patients and docs are together. So many physicians know this and either struggle with how to fix it and get burned out or just let it slide. Some of us find ways to rally patients to really want to participate but even then we face so many more pitches than home runs it is tough to keep swinging. Right here at the end of my time away from practice I met this amazing group of patients who really do care about their health, more over about those with similar issues. I was inspired really. I thought why can’t everyone be in this clan. I even thought heading back to work maybe I was just deaf to what patients were trying to tell me.

So I listened. I am lucky that I really could take a good deal of time with patients in my setting. Far more than the average 5 minute visit so many people have become accustomed to. I had patients this week I spent 45 minutes with just listening. I would love to say that I helped them, that they felt listened to, that some sound connection was made on the road to better health. Yet, I will admit that I don’t feel that way. Today, as I sit listening to a patient tell me how she was not a drug abuser and that she only went to doctors when she really needed it and that I was just “some doc” who didn’t know her I just cringed. I had been with her for 30 minutes today alone. I had seen her the 5 previous days and never for less than 10 minutes, more than any doctor she had seen in her life probably. I recounted to her the worries she talked about through the week and how she had made tough but good decisions to not just listen to her desires about walking out on her treatments in exchange for dealing with these other issues (which will still be there when she does leave). I listened to her tell me I would never understand, and I nodded and agreed. I did this all behind my N95 mask, my gown and gloves to protect her from anything I may have, or other patients from what she had but mostly to protect myself because my labs are worse than hers. I did this while I fought of the nausea of my meds and the little virus my kids gave me because I need to touch their skin to know I am still in their lives.

I can say I kept my calm, I didn’t dive into telling her she was wrong and that I did know what she was dealing with. I didn’t mention me at all. I just sat and let her vent at me. I encouraged her to keep making good decisions and that my team would be there to help her if she needed us to but that we could only just help, we couldn’t run the race for her. After a half hour she did calm enough to let me say these few things, to check and make sure physically she was stable. I left to spend another 10 minutes getting her note for the day put together and orders set in motion. Maybe she felt like I helped her, I don’t really care. I tried. The nurse who overheard a good portion of it told me I was great, but she is on my team so she is biased. The dark side of my experience is screaming at me to tell this patient that she doesn’t know a god dam thing and that her self inflicted problems are nothing compared to the shit I wallowed through and continue to try and rinse off.

Yet, tonight as I sat down to think for a second, to see if I had something to write about I checked my Twitter. I was mentioned in a tweet in reference to one line of my MedX speech, “we are all an N of 1”. I had told the patient today that, I don’t know if she understood. I tell lots of people that. Maybe the fact that someone listened to it or maybe the fact that the patient today is just that, her own story, that I am still so  happy to be doing what I do. Yeah, I missed work last year. I am glad I am alive. I am even more thrilled to be back to work even if there is a dark side to my experience because it is just one more challenge that I can overcome. One more area to try and shed some light on. Thanks for listening.

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