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Medicine is full of occasional victories, unfortunate defeats, and never feeling like it's enough. Here are five times I feel less than successful.
Today I didn't feel like I was a success in clinic. It started out on a promising note - I got there earlier to huddle with my MA to ensure we had a great start on the day. It soon turned into a day full of chronic disease visits with many emotional concerns thrown in. Each of these visits ended up going long so I never caught up. I had a walk-in patient who I saw before lunch but was complicated enough that I didn't finish with her until 45 minutes into my afternoon clinic. So it went. It made me think of all the ways that make me feel like I've been less than successful in clinic.
#1 - Running late. I hate to run late and it is usually outside of my control. However, I feel that it is unprofessional and disrespectful to my patients. When I am behind all day, it ends up being a significant distraction from patient care, as I repeatedly try to assess just how bad it is.
#2 – Truly having no idea what is going on. I usually have at least a strong hypothesis about the cause of a patient's symptoms, but every once in a while I am truly stumped. I generally use tincture of time to allow the disease process to declare itself, as long as that is a safe and reasonable option. It is never satisfying, though, to explain to a patient that we're going to wait and see.
#3 – Knowing what's going on but being unable to fix it. It is difficult to see a patient suffering and be out of options for them to try. I can offer support, encouragement, and empathy, but sometimes the patient and I are standing together at the end of medical knowledge or ability.
#4 – Not being able to complete a procedure. Whether it is difficulty placing the IUD or a skin excision that doesn't heal well, these moments cause me to question and doubt my abilities. In my attempt to do no harm, I always want to make sure that I am proceeding with both knowledge and skill.
#5 – Forgetting the little things. When I am rushed and stressed, I forget to wish my patients a good day, take the extra moment to listen to their story, and neglect to high-five the kindergartner for being brave during the exam. These little things bring me (and hopefully my patients) joy and connection. Days which are too full and busy to accommodate these items leave me feeling flat.
So that's the bad news. Now for the good. I cured at least once person today (strep throat). I made a diagnosis that is treatable and which patients often suffer with for years before receiving effective treatment. I provided reassurance. I sacrificed for the good of my patients. I had the hard talk with a long-term patient. I got my charts closed.
And that is medicine - occasional victories, unfortunate defeats, never feeling like it is quite enough, but being able to find joy in connection and relationship. Tomorrow is a new day!