kindness

As a new third year medical student, I find myself often feeling clueless, incompetent, and something of a burden to my nurses, residents, and attending physicians because of my ignorance.  This is exacerbated by comparison to the other medical students who have already rotated through their core rotations (medicine, OB-GYN, and surgery). 

But I finally have realized that what I can offer - my time.  Everyone else is very busy.  But it is clear that patients when they are suffering want to know that you hear them, that you care.  Everyone wants to feel loved and heard, but both of those things take time.

The irony of the hospital system is that the very reason that many of us came into medicine - the chance to heal and care about people - is the very thing denied to physicians because of documentation and lack of time.  There is simply too much to do.

But I see now - those kids in the red shirts volunteering in the ER - they are the ones who have time to hear the stories of the patients, to comfort them, and to care about them.  I, as the superfluous medical student, have time to take a thorough history, go through a long physical exam, and hear about not just the medical facts but also the grandchildren, the patient's fears about illness, and the long list of herbs and vitamins the patient is taking. I am the one who has the time to hear the homeless man talk about his former life as a theater actor and the famous actors that he worked with.  I am the one who has time to apologize to the patient that the ER is busy and that trauma came in, knocking there 7/10 pain to the list below exsanguination (bleeding out).  I am the one who has the time to hear questions, to answer them, and to explain in laymen's terms what is happening to the patient.

Part of me really enjoys the drama of human life unfolding, the privilege of hearing so many people's stories.  In a strange way, it is not suffering that bothers me as much as the lack of reaction from the people around me.

I know it is not possible to experience or feel every patient's pain, not when you are seeing fifty patients a day, but please at least verbally acknowledge that it exists.  That drug seeker who claimed to be in a sickle cell crisis?  Well, she was addicted, and she had body lice.  She was suffering too, but in a different way.

The cowboy ER physician I had seen - the old school physician who did not believe in writing notes - told me, "Care for the patient the first minute, then fake it for two minutes after that while you think through the diagnosis.  Nobody ever sues me because they think I care."

The absolute saddest part about the hospital is that many physicians have been shaped into body mechanics, but what patients want is to feel cared for and comforted in their distress.  What we give them is excellent technical medicine (hopefully!); what they want is our compassion.

Unfortunately, compassion is often in the shortest supply.  As a medical student, I cannot really offer them knowledge, but I can offer them my time.  Unlike the residents, I only worked three shifts a week, with plenty of time to be happy and recover in between.  Unlike the residents, I have some mental space, for now, for the people who come into the ED.

... and the cynical part of me wants to tell people, "If you go into the hospital, really try to be pleasant to the staff if possible, because if you are swearing at people or being mean to the staff, people aren't going to go above and beyond for you.  It's already hard enough getting the bare minimum done."