“Hey Doc!” I heard the patient say as I blazed by Bed A.
Bed A is the ‘door’ bed. My patient was in Bed B, the ‘window’ bed. I had just met him; it was a new inpatient consult. For all the rules and regulations surrounding patient confidentiality, the curtains between beds do little to protect privacy since inevitably there will be audible conversations about symptoms, diagnosis, and management between patients and the doctors, nurses, or family who visit them.
The residents had already seen the patient in Bed B and were reviewing his case in detail with me between OR cases. I looked at my watch, contemplated typical OR turnover time for a moment, and decided we had enough time to get the consult done.
When I got to Bed B, I introduced myself to the patient and sat at the edge of his bed. I explained that I had already reviewed his story, lab data, and imaging and confirmed these facts. I stood briefly to perform my physical exam before beginning to scrawl on an index card. I simplistically portrayed the complex anatomic relationships between the liver, the gallbladder, and the pancreas and the series of tubes (the biliary tree) that connect these organs. I described how stones form when the balance of three ingredients (bile salts, lecithin, and cholesterol) in the viscous fluid (bile) made by the liver, and stored in the gallbladder, gets off kilter and how those stones can then cause blockages at various points along that biliary tree. I showed the patient where his problem was and used hash marks to explain the operation and what would be removed.
Before getting my patient’s signature on the consent form, I made sure any questions were answered and asked if he wanted me to call a family member to summarize the details. He said no and signed.
Conversations like this take time. Whether it is the 4 patients per 15 minute block in clinic or the patient who I am rushing to see between OR cases, I invariably feel pressed for time when talking to patients. But I do what I have to do, often skipping meals or holding in bodily functions while incorporating a brisk walking speed to keep up with competing demands, none of which seem to incentivize having thoughtful and thorough conversations with patients and/or their families.
After telling the patient in Bed B that I would see him in the pre-op holding area the following day, I upped my walking pace so I could run back down to the OR to my next patient. I had already taken too long and was anticipating the reprimand of the OR board. And that’s when I heard the patient in Bed A.
“Ugh” I thought to myself, “I really don’t have the time to find this guy’s nurse for his pain meds or to figure out how to keep his IV from beeping…”
But how could I not stop? He was addressing me directly so I paused and turned to him from the threshold to the room.
“Hey Doc! It ain’t none of my business or anything but I just wanted to say that there would be a lot less fear in healthcare if all doctors explained things the way you do.”
I was humbled by this man’s feedback. I hoped my residents were listening, both to the man in Bed A and to what had just transpired before Bed B.
I find it very irritating when students or residents peel away or talk among themselves, as if they are sick of hearing what I have to say, while I am having conversations with our patients. To me, modeling doctor-patient communication is my greatest gift to them as a teacher and a mentor. I want them to listen, to observe, to understand that every encounter is a chance to learn.
As we hustled back to the OR, I turned to the residents and proudly said “For as much pride as we surgeons take in doing the perfect operation or nailing a difficult diagnosis, what happened back there might have been the highlight of my career.”
6 thoughts on “Hey Doc!”
Reblogged this on Healing Through Connection and commented:
By my friend, a trauma surgeon. She makes me proud of our profession.
Thanks, Heena. These are, indeed, the highlights of a day/career/calling. Strong work, friend.
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Hi Heena, I’m a blogger friend of Cathy’s and I can totally see why she reblogged this. I’m not in the medical profession, but find the “humanity” part so fascinating, the common thread that connects us all. Your story reminds me of times I myself have been a tad exasperated & impatient with someone, jumping to a conclusion, only to be pleasantly surprised by a compliment or some other kind gesture. Thanks for sharing, and I agree with the patient in Bed A that it sounds like you do a great job connecting with patients.
This is really true and also, if a doctor could take a moment to explain how to avoid a condition like this that will lead to surgery in the first place. Thank you for sharing what it is like to stand in your shoes. It is unfortunate that there is so much pressure timewise. This hurts everyone, it seems like.
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As a caregiver for my husband the kind, patient and informative interactions with the medical team were important to both of us.