Dr. 100 (My Story): “I wasn’t the doctor I imagined I’d become. I wasn’t even close.”

Patients are the enemy. It didn’t take long for me to realize that was true. Their interests clashed with mine.

One night on call—twenty-one hours in, fifteen still to go—my pager screamed out in triplicate bursts, causing heart palpitations and a chill of panic every time:

Beep beep BEEP beep beep!

More enemies were coming. I needed to go up two flights to see a patient—a quick dash up the stairs in any other circumstance, but I took the elevator. No stairs at night. I didn’t want to risk facing an escaped incarcerated patient hiding in the shadows.

My fears were perhaps overcautious, but not completely unrealistic. I had heard stories.

Perspiration coursed down my patient’s forehead when I got into the room that smelled like sour gym clothes. He rocked himself on the bed, shivering. Long arms wrapped around long legs tucked underneath a tattered woolen sweater.

“My fears were perhaps overcautious, but not completely unrealistic. I had heard stories.”

Blood speckled the tissue as he coughed and spat. Glassy eyes looked up and around the room without seeing. Crusted scars marked up his hands and wrists where veins should have been. A junkie.

I did not introduce myself with a smile like I used to do. My first thought was not how can I help heal this man? or how can I calm his fears?

I used to think that way. But six months into my residency, my first thought was:

Beep beep BEEP beep beep!

Shit, this guy’s gonna infect us with tuberculosis.

My second thought was: Why can’t these people go into withdrawal during the daytime?

In medical school, I encountered many doctors who seemed to have a complete lack of sensitivity toward patients. I remember one who never listened to what his patients said, insisting only on brief answers to his rapid-fire questions before exiting the room.

At the time, I hated those types of doctors—they dishonored the profession and didn’t appreciate the privilege they had to practice medicine. But, after only a few months of residency training, I was one of them.

While rummaging through the cabinets to get a mask for this coughing patient, the screaming grenade blasted me again:

Beep beep BEEP beep beep!

“After working that long, you stop caring about things: a patient’s pain, review of a critical x-ray before going home, and even yourself. ”

The nearest phone was at the nurses station, nested near a pile of carbon copy radiology requests—the yellow and pink pages. It was an era before electronic medical records, before the computer screen became the primary interface for patient care.

“This is Doctor Williams. I was paged,” I said, grumbling into the heavy receiver.

“Yes, we have a patient who just had explosive bloody diarrhea. You have to come see him.”

After working twenty-one hours with fifteen still to go, your mind gets cloudy. It’s hard to think. You feel sick to your stomach. You forget things: the correct medication dosage, an allergy, a critical symptom to ask about.

And when you forget things or make mistakes, it means you’ll be berated and humiliated by your senior resident or Attending in front of your peers the next day after you’ve already cursed yourself for not being strong enough to keep it together.

After working that long, you stop caring about things: a patient’s pain, review of a critical x-ray before going home, and even yourself.

After months of working like this, it’s a struggle to remember what matters to you anymore because you had to give up everything else in your life for the sake of an oppressive job that doesn’t care about you.

“Okay, I’ll be up,” I said in a huff.

As soon as I hung up the phone, my pager screamed again:

My pulse raced at the sound. I felt a furious and angry burn in my stomach. I already admitted four patients to my service. ‘Coughing up blood’ guy was going to be #5, ‘bloody diarrhea’ guy would be #6, and this page was probably #7.

The enemy was gaining ground.

The next day was beginning even though the previous one never ended.

I was going to meet the new workday without sleep and be expected to keep up in all the usual ways: every patient update would need to be committed to memory by 7 AM rounds, every unanswerable question fired at me by the senior resident or Attending would need a respectable response, every abnormal test finding would need to be investigated and verified so that nothing fell through the cracks, and I would need to make sure my peers knew that even after being awake for twenty-one hours with fifteen to go, I was still just as tough as they were.

Several cups of strong coffee and Sudafed would keep me coherent and alert until about 3 PM. But then I’d start to crash and it would be noticeable that I was in no condition to perform a procedure, to prescribe medication, to drive home.

But I ended up doing all those things that day, without memory of it. Somehow, it turned out all right. There were no casualties—not that day.

It’s embarrassing to admit all this. Shameful, even. What doctor will admit to hating her patients? What doctor will admit to hating herself? I wasn’t who I imagined I’d become. I wasn’t even close.

I had imagined that I would cherish caring for patients and embrace the practice of medicine. But in less than a year, something within me changed and that image became unattainable.

Internal ExperiencesEnduring CaduceusAugust 24, 2018Comment