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Jul 14, 2009

Care of the Patient

A person’s life is shaped by innumerable experiences and interactions. Sometimes, it is not readily apparent when this influence is taking place; the implication is only evident later, and it is only in retrospect that we can appreciate the moment that changed our way of thinking. Other times, you know right away. Right there, in the moment itself, you feel the change happen and you see your course in life a little more clearly.

I can tell you, without any doubt, that my recent illness changed the way I will treat patients. I will not go into the specifics of my situation here, but I will tell you that it was an embarrassingly negative experience. Every time I think about it, I am appalled by the mistakes that were made, by the astoundingly poor communication both to me and between various professionals, and by the complete disregard for my well-being.

Not all parts were bad: the Emergency Department staff that took care of me was exemplary and saw to my needs quickly and appropriately. Even when I was mind numbingly drugged on pain medication, I remember feeling such an overwhelming gratitude for his presence. He included me in decisions, respected my wishes, and was diligent about caring for my pain. This is how I want to treat my patients. This is how I want my patients to feel about their health care.

The parts that were bad, though, were horrible. The anesthesiologist, when I asked how I would be sedated, said, “You’re a medical student. You should know that” and never answered my question. The surgeon did not write appropriate pain control for after the procedure, and could not be bothered to correct the error until I was discharged. The nurse, who recognized my pain, was too afraid of the surgeon to call and ask for pain control for me. As a result of these actions, I went into a procedure not knowing what would happen and awoke in significantly more pain than I had started with, pain that was never controlled while I was hospitalized.

I don’t know if it was made any better or worse by my being in the medical profession, but the fact remains that everyone I came in contact with knew that I am a medical student. And they treated me like that anyway. I was left to suffer – and I do not use that word lightly – by my colleagues, my peers. This was the best they could offer a fellow professional.

Let me make this vow here, now, publicly: I will never allow this to happen to my patients. Never.

I certainly will make mistakes. I will prescribe the wrong medication. I will choose a therapy that will make someone worse. I will make the wrong decision and awful things will result. These are things that I will try to avoid, but ultimately cannot help. However, under my control still remains the commitment that I made and continue to make to patient care, “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”

It is because of this very experience that I can declare this so strongly and so specifically. This may mean more work for me, more tedious double-checking or longer rounds, even more time away from my family while I care for someone else’s. But it is never acceptable to knowingly allow someone else to suffer, even if it is an inconvenience or an annoyance to me or my family. Never.

In telling my story to my friend John, he shook his head and said, “Katie, I hate that you had to go through this. But we can learn from this. We can do better. We have to do better than that.” He told me about an article written in 1927 by Francis Peabody, from which the following quote is taken.

“… For the secret of the care of the patient is in caring for the patient.”

We’ve been trying since the beginning of modern medicine to get this right, but we are not there yet, not anywhere close. We can and we will do better. We will.

4 Readers rock!:

XE said...

Oh Katie. I'm going to print out this post and keep it on my wall forever.

I am so sorry that you had such an unfortunate experience, there's really no excuse for that whatsoever. I'm glad that you're able to learn from it though, and that others can learn simultaneously (I feel stronger about patient care after just reading this!) You really are going to be an amazing doctor.

Thanks for the comment by the way, it was really super kind and helpful.

Long Family Chronicles said...

Wow, what an experience!! Katie, you are going to make an excellent doctor!! I have shared those same feelings while working aside various physcians. The ones that have always stood out to me are the ones that put the patients care ahead of their own selfish wants and desires! I think some physicians forget the primary reason they went into medicine -- or I can only hope it just wasn't for the $$! I encourage you to write up your compliants and send it to the medical director of the hospital. It really will make an impact ... even if only they get a slap on the hand... maybe they won't treat another patient that way again!

Alykat said...

Katie, I totally agree. When I had surgery last summer, the nursing staff before the procedure was GREAT- sweet and caring and made me feel so at ease. But I had the same issue with the doctors- rude and degrading. I woke up screaming in pain and was given NOTHING- I repeat- NOTHING for it until the nurse huffed, "FINE" and handed me a pill. The whole time I was waking up, they were complaining that it had taken me so long and they wanted to go home. Ignoring me when I said I was not quite ready to try to get up, they literally dumped me into a wheelchair and out the door. I will say that this experience has made me more compassionate with pets and their owners, and hopefully will transfer when I have patients as a psychologist one day.
I hate that you went through all of that, but I hate it more that this seems to be a common theme at hospitals. One thing is for sure though- YOU WILL BE A GREAT DOCTOR!

KT said...

Are you sure you dont want to be a veterinarian?? J/K the human medicine field is in GREAT need of people like you. People who remember that they are treating other people, not just a disease, and that compassion and caring mean more to most than hitting the nail on the head every single time!
So sorry you had to go through that - i can only somewhat imagine having had a kidney infection before and i thought that was bad...
Trust you to find the positive in a horrible experience!