Today my clinic patient lost his wallet, including his cash, government ID, and his credit cards. He drove more than 130 miles to the clinic. Still, somehow, he sat in front of me in the exam chair as patient as ever through all my history questions. When I asked about his day as I was washing my hands just prior to the exam, he told me his wallet story. I could feel my heart instantly sink – as if down the drain in front of me. Another story of a patient who has traversed so many obstacles to get to me. Many weeks to get an appointment. Driving from rural and suburb areas to see a specialist. Putting words to symptoms that are difficult to describe.
Unfortunately, these obstacles are likely the tip of the iceberg for this one patient. The obstacles my patients endure are so numerous, and I often forget how privileged I am as a provider. I cannot begin to understand all the complexities and hoops that my patients must jump through to come to an appointment: to obtain medications, to plan for surgeries, to elicit help from family and friends post-op, to financially afford treatment, etc. I feel simply honored to be given the opportunity to serve. I held back tears for the rest of the appointment, simply stunned in humility. I vowed right then that my patients deserved my absolute best. I cannot donate my own privilege, education, financial security, or support system, but I can use every ounce of it to pour my empathy and knowledge into their care.
We are so absorbed in our profession that our brains don’t often reflect on our patients’ social barriers. In fact, we’ve outsourced this task to social workers and case managers. In a way, it’s made our day more efficient and helped us focus on the medicine. Appointment times have gotten shorter and shorter. Reimbursement and the bottom lines have become more of a priority in the age of expensive treatments, long hospital stays, and a broken healthcare system. However, our profession is at risk of alienating patients and distancing the “power-holding” physicians from the “compliant” patient. These stories of hardships are the ways to inject empathy into a frankly naïve group of physicians, myself included. It’s a way to break the “Us vs. them” wall that erupts when patients or providers share their stories. I need to work on this. We need to work on this.
I can’t thank my patient today enough for putting my life into perspective. I hope to continue developing enlightening relationships with my patients and reminding myself to acknowledge the challenges they endure. We need to acknowledge the power walls and biases our patients traverse in order to provide the best care. Sending well wishes to my patient from today, and I pray he finds his wallet.
Deeyar Itayem is an otolaryngology resident.
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