Today I woke up in a dark dark mood. It colored my world grey and dreary. It was a cloudy day outside, but the black cloud followed me indoors, relentless. One of the veteran doctors at the practice had broken his hip the previous weekend. Being an "Attending" he couldn't possbly have easy nice patients like a 4 month old well child check. Nope, he's got the 65 year old patient with multiple chronic illnesses, something wrong in each geographical location of the body. The same type of patient every 15 minutes, I should add. And I was assigned to him, or at least, his patients.
I mustered what energy I could dredge up and tried to be cordial enough to the first patient. Soon after that visit, my patience already began to wear thin, through no fault of the first patient at all. But then followed a trail of patients all belonging to the one category: Uncontrolled diabetes, uncontrolled hypertension, multiple somatic complaints of either joint pain or stomach pain (take your pick) and childish petulance, poor compliance with medication, and very bitchy attitudes. To top it off, each and every patient had repulsive feet, with nails long disfigured and discolored by fungal infection. But since each patient had DM, I dutifully did the monofilament test on each and every patient, expertly hiding my disgust behind a smooth mask of pure professionalism.
Don't get me wrong. I have a very high tolerance of blood and gore and all things nasty about the human body. I am not fazed too easily. It only behooves me to have to be so intimate with certain people who I find, from a purely personality standpoint, utterly annoying. So their fungus infected toes notwithstanding, it's more their personalities that were rubbing me wrong all day long.
Inside I wondered to myself. Did I really want to go into geriatrics? What happened to my bleeding heart for the elderly? For that matter, what happened to my overall enthusiasm for family medicine? Two weeks ago, I was crowing about the possibility of having found my field! Yikes, is that what I was in for, for the rest of my working life?? Picking up the feet of obese annoying patients with realy gross feet, as I do my best to maintain my empathy? I'm only a junior medical student and already, I feel jadedness creeping in.
Sometimes I want to tell these jabbering patients to shut up for a little and to listen and then I fantasize that I would say, "Patient, please, stop talking. Stop whining. Stop acting like a child. Help US help YOU. Take your medication, educate yourselves better on your illnesses and stop being your own worst enemy. Exercise! Eat right! Stop acting like you're entitled to some miracle medical intervention when you aren't picking up your end of the bargain. Take charge of your own life, grow up. Because you're headed in a bad place and you really have no one to blame but yourself, though you'd LIKE to think you had absolutely nothing to do with it."
Anyway, what a spiel huh? I know I know, as a doctor, I ought to develop more compassion and empathy, please trust me when I say this, I do realize and I'm still trying very hard to maintain it. But to quote a line from Grey's Anatomy, today I'm having a real bad case of the "dark and twisties" and my twisty thoughts have led me down this path.
Okay, now that's it's off my chest, maybe I can wake up tomorrow with a more rosy-colored lens.
