Towards the end of a busy clinic afternoon, I felt my phone buzz with a page in my jacket pocket. It is rare to receive pages on our phones in the middle of the day because we usually get messages through the EMR or direct calls to the office. I called back the number to the sound of an exasperated ER doctor who had been trying to reach the PCP of a patient in the ER for an acute pain crisis. The ER doctor expressed how they could not admit the patient due to full capacity, that the pain medicine specialty had stopped rounding at the hospital, and the most they could do was give her enough pain medicine to feel well enough for discharge. The most important thing she could do was to arrange a follow-up for the patient, and even that was hard. She sighed as she talked about the two hours and several different people she had to speak with before she was finally connected to me. Unfortunately, I was the wrong doctor, and this was not my patient, but I knew I could easily pass on a message to that doctor’s nurse. I listened, and we bonded. One of my best moments in medicine was sharing trauma with a stranger. Although these days, it feels more like being a fellow soldier in arms. I think we both felt good just knowing we were not alone.
I have been feeling more alone lately. Overcrowded clinics, angry patients, insurance red tape, long hours at the clinic, overwhelming paperwork, and administrative pressures such as RVUs and quality metrics have made life even more difficult. Dealing with sicker patients than I am accustomed to, as well as balancing life outside of work, continues to wear me down. I reflected on one of the things the ER doctor said to me during her frustrated phone call: “I promise I became a doctor to help people.” This resonated with me. Recently, I read my personal statement for residency, and it had so much hope and idealism. That person dreamed of helping the underserved, providing comfort for patients at their worst times, and giving a voice to those needing an advocate. That young soon-to-be MD did not know how crushing the real world would be. Residency beat and broke her to the point that she stopped caring for herself. Her first year as an attending was such a steep learning curve, and then a once-in-a-generation global pandemic hit. A system on the brink completely broke and left her broken. Trying her best, yet still falling short of doing the things she pledged to do all those years ago. Now, the only comforting thing to help me get through the next day is knowing that someone else is also telling themselves, “I promise I became a doctor to help people.”
LaBianca Wright is an internal medicine physician.