It’s Tuesday around 9 a.m., and I, a pediatric ear, nose, and throat surgeon on my third or fourth patient at a satellite clinic an hour away from home when the abdominal pain started. It feels as if someone is repeatedly stabbing a knife, and twisting it around, right below my breastbone.
I barely got through that encounter, then moved to the next patient. It will stop, it has to. There were 14 patients on my schedule this morning, and 12 in the afternoon.
The pain made it clear I was not in charge today. In between the stabbing pain, I managed to get through each appointment. Our staff suggested that I go home.
“No, it will go away.”
I took 4 Tums, chugged Mylanta, and Pepto-Bismol without success. In between the 10:15 a.m. chronic cough and the 10:30 a.m. hearing problems, I am barely able to stand. There were five more patients for the morning, two were late and supposed to be here an hour ago.
At 11:15 a.m., I apologized to this mother, excused myself, and stumbled to the treatment room, onto the exam chair while fumbling for the recline button. The staff insisted that I cancel rest of the clinic, I reluctantly agreed with a plan: “Please offer them rescheduling this Thursday at the hospital with me, or here again next Tuesday, or this Friday with Dr. K (my partner).”
Once the pain stops, I can drive an hour back home and rest. Except, it didn’t. At one point, I started sobbing like a child. I don’t know what to do. I declined offers for someone to drive me home. I laid there helpless, a feeling I don’t recognize, while everyone discussed the best emergency room to take me to.
“No, I don’t want to go to an ER. I will just wait a long time, and then get a big bill, and they won’t know what’s wrong.” I protested with conviction. This pain has been a surprise and unwelcomed guest randomly for over 20 years, and my prior scopes and biopsies have always been normal. I am 5’ 5″, 122 lbs., and “healthy” as defined by life insurance policy standards. By the way, doctors can’t see pain.
You see, I am a doctor. I know the issues and challenges in the health care system. I know some doctors are great, good, and others not so good. How can I be a patient in an unfamiliar hospital, without knowing their quality and safety record, level of expertise, and their standard of care? Of course, I am skeptical. know that medical errors are the number two cause of death in America, yet this was the best option today.
As I was being driven to a local emergency room, I made my plans clear. I was not going to just sit around and wait indefinitely, and if I needed surgery, we need to transfer me back to our metropolitan and more reputable hospital. Calls would have to be made to find out who is the best surgeon that can cut me open.
While waiting in the ER, my companion shushed me repeatedly as I threatened to leave. Doctors can’t be patients, not well at least. Finally, I was brought back into a room.
The ER physician, nurses, and staff were kind to me. While waiting in the ER room, my phone would chime every few minutes. The rest of the division had heard I was ill; something must be terribly wrong for their chief to cancel. In between texts of, “You OK?” were also texts and emails about “crisis” and problems requiring responses. Even on a gurney, I was solving problems. I did notify my husband but reassured him I was fine.
The pain subsided about the time IV was started and fluids given, basic blood work drawn, and some IV Pepcid. As I laid under 3 blankets, staring at passing fluorescent ceiling lights while being wheeled into the CT scanner, I was glad we canceled the afternoon.
The CT was normal. No rupture of an abdominal/aortic aneurysm, nor any of the laundry list of differential diagnoses I made for myself. I “wasted” everyone’s time, not to mention so many patients and families have been inconvenienced.
The pain has to be stress related. I am human, and I feel fragile. Yes, doctors need to take better care of themselves. I have already been through high degree of burnout, and give presentations on this topic. Yet, day in and day out, I simply do not live what I preach consistently. My urine is usually dark, I still rarely eat three meals a day, and blocking out my schedule to get my annual check up is done begrudgingly. There isn’t ever, a good time for me to think about me. Doctors were never trained or raised to think about recovery, or that it’s OK for us to be sick.
I tell my colleagues, “Better you, better everyone else.” Yet, day to day, there is not a single minute to spare whether I am in clinic or the operating room. This is how I have been trained to live and the behaviors society and others have reinforced in the world of health care.
To everyone who reads this, please, ask your doctor(s) how they are doing, if they are taking care of themselves, not working too hard or too much, if they have had water and/or food that day. I can tell you that to most physicians, their hospital administration everywhere is likely not asking those questions as the emphasis continues to be on productivity and the business of medicine. Our spouses have stopped asking years ago as they know we won’t change, and our lack of prioritizing ourselves have likely caused those who love us and live with us to give up. We don’t call in sick, we don’t cancel surgeries, and we don’t exercise or eat regularly. Yes, I know we can, and no one is stopping us, theoretically. There are too many patients and too few of us, and everyone wants more from us.
It’s been three weeks now, the sharp pain hasn’t come back, and after about one week I felt like myself again. I did get that big bill, and I didn’t get any answers except at least I knew I don’t have a tumor. Not reassuring, but enough for me to move forward to another day in the career that I love and am passionate about, no matter the trade-offs.
Julie Wei is a pediatric otolaryngologist.
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