Bad Patient Day

Out sick - yet again - earlier this week (as an aside, my immune system is shot in this new job/setting/frequent acutes). Back today, only to be sort of, well, bummed by my patients.

Message from a wife of a 25 year old who said that he was abusing the anxiolytics I prescribed him (as a bridge along with his SSRI initiation).

Sixty-some year old female patient who gave one of our nursing staff "attitude" when asking about an Rx to be mailed - and to close her conversation, my patient stated "bang bang" and hung up the phone.

Narcotics. Everywhere today. I am becoming more and more aware of this narcotic issue and I HATE it. Everything is dumped on family medicine - want more meds? Not me, go to your family doc.

Now I am getting a medication agreement on everyone. Hello, I'm your new doctor, please sign this agreement. Me - who delayed getting her DEA until the last possible moment because I despised that so-called privilege... am now becoming more and more paranoid about narcotics. Is it me, as the new doc, just a ton of patients doctor-shopping, oh she's so nice! Patients I trusted.

Who knows. Tonight I'm both disappointed and annoyed. Too much of my energy is spent on trying to determine who is legitimately in pain and who is drug-seeking. Did I really go into medicine for this?!

TGIF

End of day. I am tired - it's Friday, it's been a long week, and well, I'm beat.

End of day. New patient. Best foot forward! Garner up energy! Pull together The Charm!

I am tired.

Mom with daughter. Cute mom, very engaging, very caring, worried about her adolescent daughter - grades slipping, increased irritability.

There were times I wanted to pat the patient's mother on the back and say, don't worry - you don't know how much you are doing by just being concerned. Your daughter is a teenager. Just be there. Support here. Like you already are doing.

Of course in between my engaging laughter and empathetic nods shared with my new patient, I had flashes - or rather, glimpses - of almost sheer terror - who am I to tell this mother what to do? Guide her on her daughter's adolescent angst? Tell her everything was going to be okay?

Yet I try - and that's all I can do, right, is try? You learn medicine is so cut-and-dry, evidence-based, methodical.... There are guidelines for everything. Yet it's the art of medicine that I am trying to cultivate and trying to allow myself to feel.

Everything is going to be okay.