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Sep 18, 2009

Look Forward From Today

Today was better, perhaps because of my midnight rant at you. Thanks for listening, really. Because of your gentle and intelligent comments about family med being about creating a community and working within the confines of a patient’s particular capabilities, I tried to approach the day with a little more patience and compassion.

I thought I was mostly successful, but I still struggled mightily with the lack of personal responsibility that is so rampant. However I got a big wake-up call today. My preceptor pulled me aside after one particularly long and painful patient encounter and asked if I was upset about anything. He said that my face gave me away and that I looked completely fed up with our patient. He was right, I had reached my breaking point with this person, but I was horrified that it was so evident. He assured me that the patient didn’t notice, but, to me, that was irrelevant.

No one deserves to have their problems discarded and their situation disrespected. Not from me, not from anyone.

I realized that as much as I am accepting the responsibility to care for these patients that, in effect, choose these diseases for themselves, I must also accept the challenge and requirement to be compassionate and willing to partner with them. At the same time as I look down on their choices, I am also asking these people – the same ones at which I spat so much anger yesterday – to trust me to take care of them. Now who looks the fool?

Some things I learned today include the fact that simvastatin can cause rhabdomyolysis and that a new prescription of adderall can make a kid with essential hypertension go into crisis. These little details fill my day and are what make up the vast majority of third year. These facts will come in handy here and there through my career, but I learned a lesson today that will affect my every interaction, my every decision, my every thought for the rest of my life.

It is not my place to judge these people for their past or condemn their current problems. Instead, it is my job, a job that I am working so hard to get, to look past the poor choices and see a better future for the patients who need a life course adjustment. Regardless of how many times they need to be reminded or re-educated or guided back to the path, that is my role. That is what they need from me, from us, from society. Patients need health care providers that care about them. I thought I did, but now I know that I have a lot of work to do to make that universally true.

Look forward from today, think positively, and don’t ever give up.

2 Readers rock!:

Long Family Chronicles said...

Great post Katie!!! I have actually seen a few cases of rhabdo with simvastatin/gemfibrozil... one on simvastatin alone. Rhabdo -- pretty nasty stuff huh?

Patrick said...

young healthy people can get rhabdo without simva, just with extreme exercise and dehydration. prisoners know this - they do it all the time, intentionally, so they can hang out at the Wis for a few days.