Pain and suffering together is a universal language. It is unspoken, one that a person of any age feels when they see a loved one die, or when someone sees another human being suffer when nothing more medically can be done.
I once saw a Vietnam War veteran who, within a few years of returning home, suffered from a hemorrhagic stroke. He was robbed of his ability to walk, to talk, and has been in and out of the hospital for recurrent seizures and periods of respiratory failure. On this admission, he was full code status, which meant if his heart was to stop, CPR would be performed and potentially intubation if there were any problems with breathing. If CPR were to be done, the patient would die during the process because of how traumatic CPR is to the body. His wife refused to put him on DNR/DNI (do not resuscitate/do not intubate) status despite his son’s adamant fight to remove his father’s full code status. It took many conversations between the family, the treatment team, and ethics to have everyone come to terms that the best decision in the interest of the patient was to move to DNR/DNI. A week after the change, he flatlined and passed away in the presence of his wife and son at his bedside.
Why did I choose medicine? Sure, the cliché “I want to help people” is a valid reason to become a physician. Though, to pursue a profession in medicine, you must have other motivations. For me, those reasons always come back to the patient.
Regardless if you have a sample size of a million people, no two patients are ever the same. You can see someone coming in with the common cold, to an adolescent lying prone on the exam table who has mono, to an elderly woman with COPD that has struggled to breathe because she ran out of oxygen two days ago. Every patient has their own story to tell, and I remember one of my favorite attendings telling me that “If you are able to take a good history, you can, for the most part, understand the physiology underlying the patient’s illness. And even at times, make the diagnosis right off the bat before even touching the patient. They say a picture is worth a thousand words. But, words themselves, if you listen carefully and ask the right questions, is everything that you need.” The opportunity to talk one-on-one with patients and for them to share their life stories with me is a privilege that I will never take for granted. For every story that I am told, I will remember all the patients I saw before and hope that remembering their experiences will help me with the patient sitting in front of me.
Another motivating factor is being to help patients with chronic health issues such as diabetes and heart disease. Specifically, to limit the number of medications that they take (or even get them off completely) by encouraging a regimen of eating a healthy diet and daily exercise. If you were to eat a diet low in sodium, drink water, and exercise for 30 minutes to 1 hour a day (whether it’s walking or going to the gym), you likely would no longer need blood pressure and diabetic medications.
Finally, I chose medicine because I want to be there for my patients as if they were my own family. I want to be the person to not only figure out why a patient is coming to the hospital, but to also be part of their support system, especially when a patient is alone without visits from family or friends. No matter how busy the day gets, I will always spend time with my patients to listen to their thoughts, their worries, their fears, and to help them cope with the situation by the words that I say and the gestures I use.
Sometimes, I feel that empathy is lost in medicine when doctors are seeing several new patients a day, and it shouldn’t be that way. If it’s important enough for the doctor to talk to a patient, the doctor will make time to do so and not rush the conversation. Overall, the hardest part of being a doctor is seeing a fellow human being suffer from emotional and physical pain. It is up then to the provider to listen to the patient’s story, to understand the patient’s motivations and beliefs, to build a narrative, and to act in the best interest of the patient’s wishes. These are the reasons why I chose medicine.
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