Sock It To Me

Call me crazy. Call me old. Call me a dinosaur. I don’t care.

I feel that after all my years of education and training and experience that I deserve a little respect from my patients. There. I said it. I will wait for the collective gasp from all of you. Okay, may we move on now?

I have seen the gamut of suffering souls in the emergency departments of South Carolina in the past week or two. Short ones, tall ones, fat ones, skinny ones, depressed ones, manic ones, drugged  ones, inebriated ones. Psychotic ones, aggressive ones, agitated ones, quiet ones. Hands uplifted to Heaven and eyes downcast toward the floor. The sweet words of a child and the foul-mouthed derogatory rantings of a narcissistic drug addict.

What makes me keep doing this? What makes me go back to seeing patients, sixteen-hour-Monday after sixteen-hour-Monday? Sixteen hours is a long shift. You can process a lot of pain in sixteen hours. You can become an angst-absorbing sponge in two-thirds of a day.

Well, there’s the satisfaction of helping people. There’s the feeling that maybe I can pick up on something that somebody else missed. There’s that blessed feeling of taking away medications instead of adding just one more drug because we really don’t know what’s going on here anyway so why don’t we just snow him and see what happens.

And then, there’s that one sweet patient, that one who has just done something heinous, something awful, something that nobody would have expected. That patient, who because of the ravages of time and illness has been robbed of intellect and reasoning and normal cognitive processing. The patient who still maintains, deep down in the depths of their tormented soul, that part of themselves that is civil and decent and human enough to extend common courtesies to the doctor who is trying to help them.

“May I continue, Doctor?” (Note the capital “D”. It’s there. Make no mistake.)

“I’m sorry, Doctor, but I don’t usually look like this. They gave me some medicine, and I was asleep and they woke me up to come talk to you. I’m sorry for my appearance…”

“I’m sorry, Doctor, but this is important. May I start back at the beginning? Do you have time for me to tell you about this?”

Okay, okay, my false sense of importance and the need to harvest respect from the fields of misery is not exactly what this post is about, is it? You read me. You know how I think. You knew I was setting you up way back there at I don’t care.

It’s not about the respect I get from my patients. Not really. It’s nice, yes, to have someone treat me nicely and call me Doctor with an audible capital D. It’s nice to have one’s education and experience acknowledged once in a while. It’s nice to score a diagnostic coup. All those things are nice.

The most important thing I learned in my sixteen hour work day yesterday was that even in the midst of terrible suffering, a story is a story.

Even when a blood alcohol level is four times legal, I’m sorry can come through loud and clear.

Even when someone is cursing me for everything but making the sun come up in the morning, pain comes through loud and clear as pain.

I’m having a long, hard day.

You’re having maybe the very worst day of your entire life. One that brought you to the emergency department of a hospital. One that has you talking to me, trying to make sense of it all.

I don’t need your respect.

I need your trust.

I can take it.

Let’s work this through. Together.

Sock it to me.

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7 thoughts on “Sock It To Me

  1. It’s interesting (and informative) to me, to get this sort of thing from a doctor’s point of view, so thanks.
    A short (true) story: When I moved here to Wales and signed on with a new doctor I had so many things I needed to see him about that when he asked me what was the problem, I said “I don’t want to waste your time with everything” and I only told him a bit of what was wrong. I’m good at reading body language and I was quite shocked at very startled – and hurt – reaction which, translated, said “don’t you trust me?” The trouble was, I didn’t follow through on my interpretation and it was months later that I did start trusting him. And yes – he was right. At that time, I didn’t trust him. He was new to me, I was new to him.

    I suppose the thing is, when we see a physician, we’re concentrating more on our pain and fragility than we are on how the doctor might be able to help us.

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  2. I agree with all of your points. The trust that patients and their families put in me is a gift and we can’t move forward without it.

    I put in my years, too. Seven years of grad school followed by a two year post-doc. I am not in a hospital and I live in a relatively informal part of the country. I’m fine with being called, Elizabeth, Dr. Elizabeth, or Dr. MacKenzie.

    You know what sets my teeth on edge? Being called Ms./Mrs. MacKenzie. There, I’ve said it, too! It wouldn’t bother me so much but there are so many folks who have no idea what kind of training goes into being a licensed psychologist.

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  3. Thanks, Greg. And I don’t mind being title-less as in “Elizabeth”. But when people use a title, I wish they’d use the right one! Oh well, they are still getting down the difference between psychiatry and psychology.

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