I don't wear My hospital insignia on my badge holder, that ubiquitous piece of plastic that medical folks use to display their allegiance - sports teams, hospitals, folk art IV bottle tops. I wear her hospital.
I spotted it today as I looked at my watch.
Overdue for an appointment with a resident – the prognosis of an
unprompted "Dr. Z, do you have a minute to talk" is at least 30
minutes in my office, with a 50% chance of cathartic emotional breakdown.
And so I looked back at the cracked, abused plastic of the rolling
stool in the half-lit, curtained room.
Thought about the 3 "I'm sorry"s my patient had already laid
on me during our brief discussion of their disabling, unfair and very chronic
condition.
Text to the Resident: My own "I'm sorry". A plea to
catch up before I go home.
Mentally move two projects from "2-4:30 PM" to
"after bedtime".
The diagnosis that hangs over both of us in that room is one
dear to my heart. One I witnessed not as
a physician but as a friend – holding a hand and watching as symptoms derailed
plans. I remember her "I'm
sorry"s as well – she also was great at simultaneously cracking jokes/apologizing
to her medical team, trying to lighten the somber tone in her own cramped ER
rooms.
And there it was, the catharsis. The moment I plunked down, dropped the doctor
demeanor and agreed.
This Sucks. Capital S.
The fear, the resentment of everyone living a
"normal" life and hitting the socially accepted milestones that seem
less attainable with every ER visit. An admission of anger – the natural
progression of pain, left to mature in an environment of alienation and
frustration. Followed by of course,
"I'm sorry"
I don't talk about
this stuff to people.
And there it is. This
patient doesn't need a House MD. Doesn't
need the TV version of the outlandishly attractive and intelligent doctor
coming in with The Answer That Will Magically Solve All Their Problems. (Spoiler Alert: those are few and far between
in the real world. We have, at best partial
solutions, and long recoveries achieved through hard work done by dedicated
people)
They needed someone safe, and quiet. A dimly lit room to air out what's been
festering inside, what they're terrified is going to make them into a "Difficult
Patient". Ironic that one of our
patient's greatest fears is that they will get Labeled as "Demanding"
or "Seeking" by the system that is supposed to help them. Knowing that my system is broken, that I'm not
going to un-fracture their care I can only sit and hold a hand and try to make
them feel Heard.
And because the mark of a good Doctor is to shuck off
emotional trauma like we ditch isolation gowns and gloves as we come out of rooms,
me sprinting back up to my office, wondering if I have the energy left to
navigate catharsis #2.