Revelations.

This summer marked 12 years since I became a family physician.  I have had my family practice, whereby I am primary care physician for close to a thousand patients, for the past 10 years.  I have learned a tremendous amount this past decade but over the past couple of years I have come to realize that I cannot be everything to everyone.

Let me state that again.

I cannot be everything to everyone.

In the early days of practice, I used to believe that if I couldn’t help a patient that must mean I failed them in some way.  After one patient yelled at me because I wasn’t helping them enough, I nearly broke down.  I was just back from my first maternity leave and struggling with my own post-partum depression.  To be yelled at in my own office and basically told that I was a shitty doctor, well it was the first time I came to tears while seeing a patient.  I had to excuse myself and take a breath.  Thank goodness for my colleagues present in the office that day.  After I composed myself and debriefed with one of them, I walked back into the exam room.  I listened to his concerns and formulated a plan for him.  The appointment ended.

I learned a valuable lesson that day.  I can’t fix people’s lives and while I believe that many patients don’t really expect me to, there is often an unspoken expectation that because I am a physician, I somehow have the answer to all that ails them.

Let me be perfectly clear on this….  I do not.

I can’t fix your life.

I can provide you advice, counsel and recommend options to you – all this in about 15 minutes, sometimes half an hour.  I just can’t delve into your life and pick the up the pieces for you. I can’t do that for one patient, let alone close to a thousand patients.

Having said that, I still do sometimes want to be able to be present for and participate in all aspects of a patient’s care –  to be there when their baby is born; to be there when the breast cancer is surgically removed; to be there when the chemotherapy is administered; to hold their hand as they take their last breath.

I want to do it all.  I want to be that all-encompassing physician who does it all.

But I can’t.

I need to come to terms with that.

 

A Pain in the Eye

Day 6 – National Blog Posting Month.

All day my eye was bothering me. Between patients I’d go to the bathroom with a saline spray and remove my contact lens to clean it. My eye would feel better after a while but then the irritation would return. It felt like a grain of sand or dust was in my eye. I thought I might be getting a stye. By the end of the day I felt like scratching my eye out.

I had some fluorescein stain at home so I put a few drops in my eye and used the blue light of my ophthalmoscope to look at my eye. Yellow and blue make green. A corneal scratch or abrasion will light up green.

http://www.rcemlearning.co.uk/references/corneal-injuries/

Above photo credit: http://www.rcemlearning.co.uk/references/corneal-injuries/

I was a little surprised to actually see that I indeed had a few scratches on my cornea. Suddenly the pain got worse (psychosomatic?). I called for my two older kids to come to the bathroom so I could show them.

Needless to say they thought it was pretty cool. I had to wear my glasses for the rest of the evening. They have lenses from 2006. They haven’t been updated and my eyes have gotten worse. I really need to get the lenses updated.

Corneal abrasions hurt. Wow. Do they ever hurt. I woke up with a brutal migraine today and I still want to scratch my eye out. It’s going to be a great day.

92.5%

I saw twenty-seven patients today. It was busy. There were several add-ons to an already packed schedule. I book 15-minute appointment slots. I have colleagues that book 10-minute appointments but I just don’t see how one can possibly deliver good medicine in such a short period of time. So for me, having an extra patient booked every hour makes for a really busy day.

Of the twenty-seven patients, no word of a lie, twenty-five came in because of cold and cough symptoms and only one patient left with a prescription for antibiotics. One. Did they all need to be seen? Absolutely not. I’ve been coughing for five weeks and haven’t thought to see a doctor. It’s a virus. It will get better on it’s own. If it doesn’t it’ll be pretty obvious and will declare itself with fever, chills, shortness of breath and exhaustion.

I like educating my patients about colds and flu. But damn me if they don’t remember the advice on a year to year basis. It can be really frustrating – for them and for me. They’ve taken time off work to see me, they feel awful and just want to get better. I understand that. But when they see everyone else around them with the same symptoms isn’t it obvious to them that going to see their doctor is kind of useless?

After the day I had, apparently not.

I just hope tomorrow something a little more interesting happens.

Role Models

Did you have a role model growing up?  I mean someone other than your mom or   dad?

I did – it was my godfather.  He was a doctor.  He died tragically in a car accident when I was 13, but even before that, I knew I wanted to be like him.  I wanted to be a doctor.  I never actually saw him working as a doctor, except when I would go see him at his office for a cold.  But somehow I knew what he did and I wanted to do the same.  My mother always tells me that when I was about 3 years old he put a stethoscope in my ears and let me listen to the sound of my own heartbeat.  She’s convinced the seed was planted then.

It’s “Occupation” week at my daughter’s pre-school.  The school sent out a notice asking if any parents would like to speak to the class.  Of course, my husband volunteered me.  I took daughter to school today and spoke to her class.  Imagine about 20 sets of eyes staring up at you, eagerly awaiting what you have to say.  I was scared out of my mind.  There I was, frightened by a group of pre-schoolers.  How absurd!  I hadn’t really done anything like this before. I didn’t know what to say!  Husband actually coached me a bit.  I was just going to go there and talk about being a doctor but he suggested I ask the kids questions instead.  It was a bit of a gong show – I mean, how long can a group of 3-5 year olds sit still?  About 2 minutes, I learned today.

As an aside — I have nothing but the utmost respect for early childhood educators.  Reigning in a class of 20 3-5 year old children requires a special kind of patience.  It is something I lack.  Good thing I’m not a teacher!

Anyway, back to the topic at hand.  One of the reasons I was so nervous is because it suddenly occurred to me that I’m the grown up  to these kids. Something I say to this group of children might plant that seed of hope, determination and drive.  One of those kids might decide to become a doctor because of me.  (I hope it’s my own child, but that’s another post!) It dawned on me that   I am the potential role model! It’s a little unsettling.  I still think of myself as the 20-something girl working her ass off to get into medical school.

But now I’m a mother, a professional, a responsible adult! A role model.

When did that happen?