It was a typical Friday night, the trauma bay was full, patients lined up in hallway beds 1-6, and we were 50 deep in the waiting room. Within the hour of starting my shift, I had a chest pain in room 4, pregnant vaginal bleeder in 6, old lady with belly pain in the neighboring room, and a colostomy malfunction in room 13. These descriptions were exactly how I attempted to remember them. I had systematically hit all the right questions for each patient, put in the necessary orders, images were obtained, charts were being typed up, attending physician notified and agreed with all my plans. Feeling like I had things under control, I called over to the nurse, “Hey can you please check on the vaginal bleeder to see how she’s doing?” The nurse stared at me blankly and responded,
“You know she has a name, right?”
I was immediately taken aback. To me, she was Room 6, 35 yo female G3 P 0111, newly pregnant with a few days of spotting, mild abdominal cramping, no rebound or guarding, rule out ectopic and confirm a live IUP. My face immediately became flushed and warm, my voice stuttered, unsure how to respond. I had been so consumed with everything else, I honestly hadn’t even glanced at her name. Like a good resident, I had checked on her a couple times to ensure her abdominal cramping had resolved, given her ice water, and updated her on the wait time for her ultrasound. Once those items were marked off my checklist, I routinely went on my way. The nurse proceeded to ask me, “Did you know she and her husband have been trying for a year? That she’s had a prior miscarriage and is worried it might happen again?” My face now beet red, my heart thumping out of my chest, embarrassed from the unintentional reprimand.
I walked back in, this time more aware; noticing more than just the vital signs. In front of me stood a woman, not much older than me, clearly worried. Lips pressed together nervously, hands clutched tightly, eyes wide in anticipation of bad news. This was someone seeking reassurance, not just lab values and test results. She was more than just vaginal bleeding in room 6.
As busy physicians, we get caught up with our endless tasks and algorithms that we often fall prey to practicing cookbook medicine. We mechanically run codes, fly through procedures effortlessly, and transition from room to room, chugging through the never ending ED tracking list. With the practice of medicine becoming so methodical, we forget that on a daily basis, we meet patients that are having the worst day of their life. They divulge to us private details not even their best friends and families are aware of. We forget that we are the privileged few that patients trust with their secrets and stories, and what a humbling honor that is
“To most physicians, my illness is a routine incident in their rounds, while for me it’s the crisis of my life. I would feel better if I had a doctor who at least perceived this incongruity” – Anatole Broyard
This challenges those of us in the medical field to remember what it feels like to be on the other end of the stethoscope — to remember that there is a person and not just a pathogen infecting a host. Let us remember the importance of rekindling and keeping alive the desire of service to mankind with which many of us had gone into the medical profession. Caring doctors are better doctors. They practice safer medicine, earn more trust from patients, and get them engaged in their healthcare, leading to better outcomes. In changing our practice of medicine, it could change our own perspective too – perhaps this is a step towards figuring out the antidote to physician burnout.
An excerpt from Broyard’s “The patient examines the doctor,”
Not every patient can be saved, but his illness may be eased by the way the doctor responds to him- and in responding…the doctor may save himself…It may be necessary to give up some of his authority in exchange for his humanity, but this is not a bad bargain. In learning to talk to his patients, the doctor may talk himself back into loving his work. He has little to lose and everything to gain by letting the sick man into his heart.
Thank you to my room 6, future mom of 2, fellow foodie, wife of her high school sweetheart. Thank you for reminding me that when I chose to go into medicine, I made the commitment to connect with each patient, to be their advocate, to bring compassion to those who are vulnerable and scared in their most intimate moments. Thank you for reminding me that the girl in room 6 has a name.