On Being a Physician Patient
The last two months have not been easy. Notwithstanding the turmoil of Hurricane Ike, I have not felt well. I had symptoms that were frightening and compatible with life-threatening illness. Within the course of a few weeks, I suddenly find myself taking several prescription medications, having to manage my frequently chaotic work schedule around taking them, and having to swallow my pride and ask for help from my colleagues.
My mother thought that being a doctor would make dealing with all the medical problems that came up with my children or with herself or my father easier to deal with. But the truth is, it is that much harder. I know the differential diagnosis and I know the realities of dealing with many of treatment plans. My current ‘job’ means I see people at their absolute worst and their best—and that includes my colleagues. I know who is grumpy and who will return calls and who will do the right thing even when they’re tired and it’s 3 in the morning. Sometimes ignorance and naiveté is a good thing—and imagine the world of medicine is populated with selfless folks who never get tired or sick or hungry or need to use the bathroom or even just wish sit and be still without twenty voices in their ears needing a piece of their time.
I’ve had the honor and privilege and frightening responsibility of caring for fellow physicians and their families. None of us gets up in the morning thinking we plan to do a bad job by anyone but colleagues are just different—for they know what we know—and to be chosen by them out of all the possibilities is humbling. I can see on the faces of the three I have visited over the past two months that they have the same thoughts. And it becomes like taking care of your parents—there is a natural respect and wishing them to be powerful and smarter than you, but never needy or ill or weak.
Medical School and residency were not easy and although the official policy was equal opportunity, the faculty, residents and many male classmates were quite clear in their disapproval of females in the class. I blush easily and it was great fun for them to tease me—and I had to learn to be tough; never admit I was tired or incapable of doing whatever I was asked. That same attitude has persisted—and now it is what I expect of myself—to work harder than the guys, to always say ‘yes’ to extra work, and to never be ill or admit weakness of any sort.
Over the past few months, I have struggled to figure out what exactly is happening inside me. One month I am taking an estrogen supplement—not all that much different from birth control pills, Fosamax—which seems like a funny kind of vitamin, Methotrexate for my recently diagnosed rheumatoid arthritis—I thought of this as a long-acting Advil, and folate—-well, this made my hair pretty and shiny—and Lipitor—an antidote for all the cheese I love. So I could rationalize all of this and if I missed a day or two of the estrogen replacement or a night of the Lipitor, it wasn’t all that critical.
Now I am taking a blood pressure pill—I can’t take an antihistamine for the occasional sniffle, I must be sure I eat twice a day on a regular schedule, a challenge for the days in which a trip to the bathroom is a luxury. I’ve had fancy tests ordered, dealt with my health insurance restrictions, recitation of HIPA rules by folks who haven’t a clue about their usage and intent, sat in waiting rooms (and was embarrassed to be called in ahead of everyone else who was already waiting when I got there), read all the package inserts on my medications (something I urge patients NOT to do beyond the first two or three lines as it will scare them to death), googled my symptoms repeatedly, and tried to make sense of it all.
I’m not sure what is worst, feeling bad and not knowing what it is or thinking that your colleague thinks you are a ‘weenie’. My tests have not revealed the etiology yet, but I think that I have puzzled it out. I have one more follow-up visit for the final results but I’m fairly confidant it will be boringly normal. So now, I have admitted that I am indeed human, and all my worry and concern for all the bad things that might have been were simply an exercise in humility. I am grateful to my colleagues who have gracefully stood by me, listened to my fears, and did the right thing—including telling me to get back to business.
There is a good reason why physicians should never treat themselves or their families.