Friday, August 10, 2007

The way I really felt about it

I worked 9 am to 9 pm in the ER the other day, and the day went pretty fast. Until about 7:30 pm. I got a whole two and a half hours of sleep the night before, and the last ninety minutes of this shift felt like ninety years--the way it can when you spot the light at the end of the tunnel and can't wait to get there. I ended the night with a handful of patients, one of them a 19 year old girl. She was in the ER because she hadn't been able to keep any food down in days. She had a lot of other health problems and had met her share of medical students. Like most patients who spend a lot of time in the hospital, she had learned that the medical students generally know less than she does about how it all works. So, she didn't have very high expectations once she spotted my short white coat.

We laughed and joked a bit as I took her history and did a quick physical, though. She seemed to appreciate all the little things--the things I was taught to do by the nurses I worked with in college. When I got done feeling the pulses in her feet, I wrapped them in the blanket and gave her toes a little squeeze. She looked at me with such gratitude in her eyes. Like most people who are sick, she just wanted me to look past her parts and her pathology and see her. And, that look on her face reminded me that as much as I am interested in the biology of her parts and in her pathology, I went into medicine for the chance to see her.

I checked on her several more times between 7:30 and 9, updating her and her mom on her lab results and reassuring her that this looked like it was just a nasty flu bug that knocked her on her butt. At 9 pm, as I got ready to leave, I gave report to the next medical student on duty. I told him, "She's dehydrated. Make sure the attending stays on top of her nausea. She's going to need more Zofran than what we've given her." With that, I retrieved my backpack, and, as I walked past her room, I gave her foot one last squeeze.

Her mom said, "Uh, T, we hate to keep you, but she was wondering if (insert unnamed problem here) could be causing these symptoms. She didn't want to say anything because she was embarrassed, but she said that maybe we could tell you."

"And I'm glad you did," I said. "Yeah, that could be making you sick. I'll find a more private room and we'll check it out." Checking it out meant doing a pelvic exam. No one is supposed to be excited about staying late to do a pelvic exam. Excited may not really be the word I'd use to describe how I felt about it either. But, to connect with someone, to earn her trust, to be the person she lets take care of her...I would stay late for that any night.

After the exam, she and I had a little chat about what it means to take care of yourself in a relationship. She got my little "You have to use a condom. Every time. And you can't have sex with anyone who isn't great to you" talk. I gave her foot a little squeeze, and I headed home. I should say, I floated home. I floated partly because I was too tired to feel my feet touching the ground, and partly because I was in peaceful bliss--remembering why I chose this long, sleepless career path.

Remembering it's all worth it.

15 comments:

Rich said...

Very touching post - The days blend all together but pulling little thoughts out like this to share is worth it for us readers.

Mme Benaut said...

Thank you for sharing this story, little one. This is precisely why you're going to be such a GREAT doctor. All patients need their doctors to be able to see them, not just their pathology. There are a few specialists to whom I would love to show this story, to help them reclaim their lost humanity. I hope you can get some sleep and lots of it. xxx Mme

Susanlee said...

I'm so proud of you. You're amazing.

Maria said...

You are doing great. Isn't it amazing that just a little extra time and a foot squeeze made all the difference?

And, it is the reason that you helped to get to the bottom of her illness. If more physicians would just realize that, things would go better for everyone.

I think you are going to be one of those mds who make a difference, I can smell it a mile away....

And it smells tired and worn out, but also very, very wonderful.

dive said...

T, you're a star.

Cheryl said...

That personal and caring touch is what separates the doctors from the great doctors. I'm so glad this patient had the chance to be in your care.

Alissa said...

Such a beautiful post. Thank you for sharing.

Maya said...

Be very proud of yourself T. You've proved that there really are md's out there that truly care and will look at you as a person not just a chart.

The world needs more professionals like you!

Kate Isis said...

Theres nothing like that feeling that you've made the connection. The one moment when it all just comes together and it not just a professional talking to yet another client. It doesn't happen all the time but they are the moments that get you through.
And i know what you mean about that last ninety minutes.

Robyn said...

This such a relief to hear, knowing that not everyone in the medical profession understands the importance of that personal connection. Most have my experiences with doctors and nurses, but my elderly parents have not always had just a good connection. good for you.

Dear Prudence said...

You may never know what impact you had on that young girl but bless you for taking the time to be HUMAN! We all should behave that way on a regular basis.

CS said...

Lovely, really. I like to think this is the motovation of many physicians. The technical knowledge may make her better, but the connection is what truly heals.

Proxima Blue said...

I hope this compassion will stay with you for a very long time and doesn't get lost in "I've been doing this for x amount of years and ssen it all before."

I used to work with a younger woman whose Uncle was one of our coworkers. She had contracted an STD and I was the only one she told. It was strange, but at least she had someone she could talk too. I must have invisible ink on my forehead that says "Deposit secrets here". :)

-P

Ms. Avarice said...

i thought i lefta comment, but obviously i neglected to do so. that really is such a very special memory, and it makes me happy that you're doing what you do. <3

Melanie said...

i want you to be our doctor.