People like to think the worst about doctors: we don’t listen, we don’t care, we only want your money. But, the truth is we do care and that is why most of us answered the calling to become doctors. That is why the burn out rate for doctors is so high.
Patients hate to wait in the waiting room for too long. But, truth is I sometimes need to take a break to cry because I just told a patient they have cancer. Of course, I can’t show that face to patients because I need to put on my strong one to give them hope, even though it tears me up inside.
When you think we aren’t listening, it might because we are processing how to tell you something. Telling a patient they have a bad disease is never an easy thing. But, through our experience, we know that diagnosis is going to alter your life. You may have walked into my exam room smiling and thinking of your next vacation, but walk out crying and planning your visit to the oncologist. While I try to answer your questions and give you hope, I secretly hate the doctor inside who just destroyed part of your world.
Seeing disease after disease, hurt after hurt, it is hard not to be affected. Some of us grow hard calluses on our exterior in order to survive our daily existence. Others of us become infused with cynicism. It is not because we no longer care; rather, it is merely a survival mechanism because we care too much.
You may walk out of our office and think we didn’t hear you. But, you don’t see us at night when we can’t sleep because we are worried about you. Did we do the right thing? Is there something we could have done better? What are the best next steps? Did I forget to send that prescription? Night after night these questions call to us, drawing out the doctor hidden inside to take account of all our doctorly actions.
You may think we are not available enough when you call at the end of the day for an appointment and we ask you to come the following morning. But, you never sat with us at the dinner table, where almost every meal is interrupted with calls from patients or pharmacies. You never sat with us on Christmas morning when our kids open gifts while we are taking calls from the emergency room. The doctor inside never truly rests, even though we sometimes feel we cannot take another step.
The doctor inside wonders if you will listen to the advice just shared, or will you go and do your own thing. And if you decide not to listen, is it because of your own reasons. or the fact that the inner doctor failed?
The doctor inside cries often and fears much. We are never satisfied with bad outcomes or medicines that don’t work. The doctor inside always claims the blame, no matter the actual cause.
Copyright secured by Digiprove © 2018 Linda Girgis, MD, FAAFP
Very well written. Reading this post I began to well up with tears. I can’t begin to tell you how many sleepless nights I’ve had worried about patients and whether I did the right thing. I think of the times I’ve tried to calm a patient from worry when my insides were screaming out in fear and empathy for them. There is no other profession like ours. I pray that at the end of my career, I made a positive impact in the lives of all my patients.
You have made a positive impact. You may not always see the results, but they are there. Thanks for your kind words!
Dr. Linda
When Studs Terckel wrote his best selling book Working, probably in the 1970’s, his preface noted an intentional exclusion of doctors among the many vignettes of people in all sorts of livelihoods. The paragraph that explained this decision, his and not his editor’s, relied on what we both seem to think is a false belief that people are already exposed to doctors at work either as patients, families of patients, or TV viewers who watched Dr. Kildare or Marcus Welby or real medical news of innovative transplants, CT scans or dialysis. Probably a misjudgment in an otherwise memorable effort on his part.
While the terrific essay captures the reality of the doctor in the absence of the patients, the experience of the patients coming to the office or being seen in the hospital includes a lot more than the doctor that they see. It is the office staff. It is the trip to the lab or xray where the doctor knows the result but they don’t. It is the copays and it is the pharmacy handing them a page of threatening side effects and wondering why the doctor only mentioned two annoying but harmless ones. For good or ill, we are the mascot for all that, the one person in the cast of thousands who can always be identified and usually contacted.
Linda,
Spot on!
The doctor inside is human.
The doctor inside is tough—and in the same instant vulnerable.
The doctor inside cares deeply about each patient.
The doctor inside believes you, as a patient, will share the responsibility to take care of yourself—it is not “only the doctor’s job.”
The doctor Inside work effortlessly to bring awareness among medical institutions and insurers (and government) that we need to treat our students and doctors with dignity and compassion—not as disposable revenue generators.