…I finished my exam and presented to the attending. As I said the words I realized how they must sound to a third party who was not involved in the interview.
“Patient with foot pain…. history of narcotics…. abuse of morphine and prescription pills…past hospitalization for OD…. pain not radicular or easily reproducible …” Before he could respond I knew he thought John was seeking drugs. But somehow I knew differently, and I said so.
You really need to read the entire story. There are a couple very valuable lessons in this (as always EXCELLENT) essay/post by TNQD. I think any of us healthcare providers have been in this position at some point in our training: we feel that we have the patient’s “real” sympathetic story, but the more powerful person above us (resident, attending) has a more jaded viewpoint (and often rightfully so).
The lesson for the student: learn to trust your instincts and speak up, even if you get proven wrong a few times. Once you become an autonomous physician yourself, you will still need to follow your instincts sometimes in the face of statistical unlikelihood. THIS IS WHY MEDICINE IS ART + SCIENCE.
The lesson for residents/attendings/those in power over “less-experienced” learners: show appropriate respect towards the input and differential diagnoses offered by your learners. Do not be eager to squash their “naïveté” and strip off their oh-so-valuable ability to still remember that patients are PEOPLE. And when the student is right, and you were not — admit it, and learn from it.
The lesson for all human beings who come into contact with the misunderstood, the broken, the outcast, the downtrodden, the sinner, the lost, the powerless, the outwardly-ok-but-inwardly-suffering (in other words, the lesson for ALL of us who come into contact with ALL of us): As TNQD points out, Jesus said it best: “Whatsoever you do to the least of my people, you do unto Me.”
Perhaps whatsoever you do to the least of all people is the best you will ever be.
I had a patient today in the ER who’s chief complaint was that he was upset that he missed the birth of Christ.
I was briefly speechless. I mean, aren’t we all?
I gave him Haldol to keep him from ripping the curtains off their tracks and moved on to the prostitute who was wearing something too short to be called a miniskirt and too long to be called a belt, who’d been pushed off a bicycle at 4 a.m.
It’s hard to know what my job description might be.
Lost in Translation- I loved this movie!