The medical assistant swabbed my nose and my throat multiple times. Pricked my finger too. Then, the phlebotomist (or vampire?) drew bottles and bottles of my blood. Along with the physical discomfort, there was emotional discomfort too. What would the test results show? If they were all negative, would I be satisfied without having an answer?
Being a patient can be extremely vulnerable. Not only do you often divulge to a perfect stranger the details of your health, but also you make the choice to relinquish control and be comfortable with uncertainty. You put your trust in a physician to order the correct tests, and you allow yourself to be poked and prodded by (often) another stranger. You wait for the results for hours to days and are prescribed medications that could potentially have side effects.
In a hospital setting, you become even more vulnerable under that hospital gown with tubes, drains, Foley catheters, and IV’s inserted. Often, in an academic setting, a large team consisting of an attending, resident, interns, and medical students come into your room multiple times a day asking questions and examining you. The longer you stay in the hospital; you run the risk of obtaining a hospital-acquired infection too. And we wonder why our patient’s blood pressure and heart rate remained elevated during their hospital stay.
In my personal life, I can say that I’ve always been generally healthy and not taken any medications other than vitamins or the occasional antibiotic (mainly as a child). So when I prescribe something as simple as Zofran, I have no idea how that feels. I don’t think that it makes me any less empathetic towards my patients, but I haven’t had the experience of taking 1 to even 10 pills a day. Other than receiving tubes in my ears at the age of 5, I’ve been fortunate not to ever wear a hospital gown. I’ve merely had annual physicals with good report cards to show each year.
So when I began to have recurrent fevers, this process of being a patient was not familiar to me. I had finished a stretch of working many nights, and I was repeatedly told that my immune system was probably just down from the stress of the schedule. When your trustworthy doctor doesn’t know the answers either, it increases your own discomfort. And if you are in the medical field and have the knowledge of all the possibilities, it doesn’t ease your stress. But then you remember that you are the patient, not the one driving the ship.
As a physician, I’ve worked together with my patients to create a plan to maintain their health or guide them in treating an acute or chronic illness. However, I’m the one to order imaging and labs, and I’m the first one to receive those results while my patients are anxiously waiting. I have completed years of education and training to determine the correct tests to order for my patients, so I feel confident most days as a doctor, but as a patient, I had little to no training.
During my experience as patient, I learned how difficult it is to not know what is wrong with you. As physicians, we need to spend more time giving realistic expectations to patients about when they will receive results. Next time, I will think twice before waiting another 30 minutes to return a call to a patient about results. We need to provide additional comfort to our patients when we do not have the answers and share our own vulnerability and limitations in these situations. We need to listen more carefully to their detailed stories because the history generally provides the answer. And when we do not know the answer, we need to exhaust all of our resources and even turn to our colleagues to ask for help. While I did not enjoy being a patient, I’m fortunate that I had this experience in vulnerability to become a more humble, open-minded, and proactive physician.
Farrell Tobolowsky is an internal medicine resident.
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