First watch this:
Then read this:
There is a part of me that gets Tiffany and Solomon. I am guilty of using humor to diffuse high-stress situations. I have made jokes about patients and their ailments. I have done my share of eye-rolling when they come in claiming to know more about their disease than I do. This is a common practice in healthcare. This is how we cope. It may not be just or right, but it exists inside and outside of the world of medicine. This is not an excuse. I try my best to be mindful about letting garbage spill out. I attempt to ask three questions before I use my voice: Is it true? Is it kind? Is it necessary? But like all, I’m a work in progress. In addition to this, I like to ask, “If this were my aunt or my best friend, would I speak to them or about them in this way?”
I had a surgery rotation in Phoenix with a world-renown surgeon. His story was fascinating, an immigrant who made a name and life for himself. I was in awe. Then we walked into the OR and he was horrible. He insulted and abused our unconscious patients in more grotesque ways than I can share. It took two weeks for me to report him to my clinical coordinator and for me to get out and that wasn’t soon enough.
But the vile, demeaning comments that Tiffany made are disgusting and unacceptable and go beyond anything that I could have created in my brain. And though I have an opinion about Tiffany and the leniency of her punishment, that is not what I’m here to share. She has her own path and lessons to learn. What I do feel necessary to address is about was the generalization that they made about patients. They blame patients for the ‘holier than thou’ attitude, but who are we to say what a patient knows and doesn’t know, particularly about their own body, symptoms and disease.
The internet is replete with accurate information about diseases, disorders, symptoms, side effects, everything. I often encourage patients to become ‘healthy hypochondriacs’ about their diagnoses once they get one. Patients are the experts in their own health, not us. I say this often and will stick to it. We as medical professionals, are experts of populations of people, that is what evidence based medicine is. We have no idea how each individual is going to manifest the symptoms of a disease(s) or respond to the adverse effects of a drug. When someone has diabetes, they are their own experts. They are the doctors- checking their blood sugar and make a decision on whether they will take their medications or inject their insulin, the pharmacists-deciding how much they’re going to take, nutritionists-making a choice on what they are going to eat, personal trainer- deciding on if they will exercise. Plus they have to consider their family, time, environment, work and make a decision about how that affects their health. We have a fairly easy job with chronic disease, diagnose and write medications. Then we sit on our high horse and wait. Followed by the blame game blame as the patient returns, non-compliant and sick as they were three months prior. We act as though our magic pill or ten-minute lecture would miraculously transformed their life and health.
So, Dr. Solomon, you in fact are acting ‘holier than thou’ when you speak of the Northern Virginia syndrome. Perhaps your patient had an uncle who was a GI doctor or a friend who died during a simple routine colonoscopy and he felt like he should educate and inform himself about the everything surrounding the procedure. I don’t know his story or history. But to think that you are the only one who could possibly know what goes on during any medical procedure is incredible arrogant and egotistical. People have brains and the ability to learn, just like you. My mother knows more about Alzheimer’s disease, it’s progression, signs, symptoms and treatments than my father’s neurologist and internal med doctors and she has a degree in linguistics
We have to give the power and respect back to the patient. Preventable medical errors claim the lives of 400,000 people a year, that is 1095 mistakes a day. Astounding. We’re not the gods that the world and modern culture has made us out to be. We’re human, fallible and do not know everything. Go to practice with that attitude and you can learn so much from your patients. Partner with them and help them understand the science behind the disease. Perhaps occasionally you’ll need to intervene with a few nuggets of population-based research to help guide them when they get off track.
I’m passionate about a lot of stuff. Shocking, I know. But allowing a space for patients to feel heard, respected and understood is one of my biggest points of advocacy and activism. As health care professionals, we need to use our minds and expertise when our patients are crashing or bleeding or broken. But in chronic care, I invite you to call on your heart to determine the best way to assist, educate and empower your patient.
I was called a heart-centered activist today. I’ll own that. I work with heart and have tried to let it lead me in my 10+ years in healthcare. I will always try my best to bring awareness to what is right and just or at least as long as my community allows me to.
Thank you for reading.