What is a doctor? Technically speaking, a doctor is a person that dedicates his or her knowledge and skills to the prevention and treatment of diseases, while maintaining and even enhancing human health.
The majority of physicians enter into the profession of medicine because they are committed to helping others. It is this mission-driven spirit and dedication that makes us grateful for the opportunity each to care for others during a moment when they need it the most. The trust that patients place in their physicians is humbling. Every day is a new opportunity to learn, to grow and the increasing ability to diagnose and treat is inspirational.
The process of becoming a physician is not easy. It takes an extraordinary amount of hard work and a sense of dedication that is unique to the profession. Becoming a physician has long been lauded as an honor. As experts in biology, physiology, health, wellness and so many other subjects, some might view a physician as a human encyclopedia. However, referring to a physician as a walking, talking encyclopedia brings to mind the idea that most patients romanticize physicians in such a way as to be almost robotic.
Unfortunately, doctors are in fact not robots and are as human as the patients they treat. It is hard to imagine with the long hours and the plethora of medical knowledge needed to competently perform the job well on a daily basis that a physician would ever deviate from the challenging schedules they maneuver on a daily basis with aplomb. However, there are moments in which each physician finds him or herself with the reality that they are no longer in the role of a physician, but the tables have turned, and they are faced with the reality of becoming a patient.
Recently, I found myself in that very position. I was now playing the part of being a patient versus my regular role as a resident anesthesiologist. Fortunately, my role as patient presented in a more organized and orderly fashion. However, regardless of the non-emergent nature of my scheduled surgery, it still placed me in the position of feeling powerless. I could control the date, location, and surgeon, but I still felt that so much was out of my hands.
On the morning of my procedure, I found that knowing the process that would occur put me at a slight advantage, however looking around at the other patients gathering in the waiting area with their loved ones the anxiety was palpable. From the patient’s perspective, their procedure is hopefully a once in a lifetime event — one that could help alleviate all of their pain or cure their disease permanently. It is a day that could be the beginning or the end of much of their health issues. Yet as an anesthesiologist, it is seen as another day at work. That does not diminish the importance of each patient, but it distances us from the very real feelings each patient is experiencing because of their specific case.
Lying in bed waiting for my IV to be placed, it was hard not wear the hat of an anesthesiologist. I wanted to point out where I thought I had the best vein for a stellar IV. I did not initially share that I was an anesthesiologist. However, it quickly became evident that I had a background in medicine, and my role as patient reverted back to that of a physician. No, I did not have to hang my own drugs or fill out my own preoperative check sheet, but I was addressed differently. This shift in dynamic made me realize how difficult it is when a doctor becomes a patient.
There are few studies that have explored the challenges that arise when the doctor becomes the patient. It is important to understand the inherent challenges faced when treating physicians. One quantitative study that focused on how physicians provide care to physician-patients examined some issues that arose, such as maintaining professional boundaries and adhering to guidelines. It concluded that further investigation was needed.
With the inevitability of the physician becoming a patient, this is a perspective we as physicians should all consider. As physicians who treat patients, we are afraid of making a life-changing mistake. This fear arises from the ingrained core principle of our profession: Primum non nocere or “first do no harm.” It is a principle applied to all patients and one that is exponentially increased as two physicians come together, especially when one of them is a patient.
As physicians, we are every patient we treat, and every patient represents a human life that should be valued and protected with the utmost of respect. It is my hope that as physicians, we may always protect our most valued and lauded asset — our ability to care. May we always remember that our patients and their families have placed their most precious gift in our hands, and may we always respect the frailty of our humanness.
Lucy Guevara is an anesthesia resident.
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