Heaviness.

Speaking of my so-called cranky patient... he left today.  Spent a good 45 minutes discussing rehab with him - reassuring him, applauding him, scolding him.  The best of both worlds, I tried.  His poor nurse, though....  his constant gripes, complaints - at least I could escape from it.

On  my drive home I received a phone call on my cell phone.  An unknown number, I answered it.  It was my 55 y/o female patient upon whom I did a routine pap on...  and it revealed trich.  She has been married 20+ years.  

It was one of the most difficult phone calls I have had.

I am praying for her tonight.

The difficult patient.

I have my difficult patient - much more obvious in the in-patient setting versus the out-pt.  He is whiny, he is cranky.  He is on a mega-dose of narcotics.  He doesn't move out of bed.  He belches every time I walk in the room.  He always, always, ALWAYS complains.

I try.  I try to be removed, to be impartial...  objective.

It is beyond difficult.  Sometimes it's damn near impossible.  How to get over that?!

Perfect Enough?

I may be in the wrong profession.  At first glance, that initial statement doesn't make much sense - I like the science of medicine, I like the human aspect of medicine, I like the versatility of medicine.

But what I don't like is that ever-pervasive feeling of wanting/needing to be the Perfect Doctor.

How can one even comprehend this? Is it rationalizing feelings of always wanting to do better, always wanting to learn - or am I just too insecure to be in this field?  I nit-pick, I overanalyze.  I wake up early in the morning with these thoughts in my head...  I dream about it.

Am I just trying to better myself, or do I just not believe in myself?  And if the latter is the case - is it really me or is it just my thoughts?

I wanna hold your hand...

I had an interesting encounter the other day.  Was assigned to tag along with a patient who was to undergo his first ect treatment....  things were delayed (shocking!), and it left me with a lot of time to, well, just chat with the patient.  He was in his 70's, admitted to the psych ward for a suicide attempt.  He was also a former physician.  So we chatted for a while (I love non-floors months), about his life, his family...  he, in turn, asking questions about my own.  I could feel his anxiety - it really was palpable -  which only increased as the minutes passed.  In the end - right before he was going to be wheeled to another room - he asked me to hold his hand.  For comfort, he said, to feel human.  

So I held his hand.  He in his gurney, me standing awkwardly aside of him.  30 year old resident doctor holding the hand of a 75 year old [retired] doctor.  An anxious resident holding the hand of a depressed doctor.

Interrupted by a nurse that walked in, I quickly dropped his hand, almost relieved to have an escape.  It was then I realized just how embarrassed I was.

It's interesting... I have grown to be the type of resident that is touchy in the frequent-pats-on-back way.  And I suppose I have given the occasional hug.  I realized, though, that they are always on my time; it is always me - as The Doctor - offering the compassionate touch.  It was surprisingly difficult to be on the other end of the spectrum, with the ball not in my court.

I thought a lot about the scenario later that day.  Glad to have been there for someone.  Humbled, really.  So why was crossing that boundary - that professional boundary - so hard for me?  

I think a lot of it has to do not just with boundaries, as there wasn't much that was crossed that day... but more so with identifying.  I could identify with this physician/patient - I know what it's like to be sad, depressed, anxious.  I get it.  But perhaps at that point, I didn't want to get it. I didn't want to empathize, I didn't want to be reminded of my own struggles in life?

Onward.