Wednesday, September 19, 2007

Patience: it's not just a Quaker name

Today I had a patient who came in right before lunch. I thought that I could get everything done in 15 minutes, no problem. And, of course, that was where I jinxed myself. I like to think I'm a pretty good listener, but after twenty minutes of hearing about his entire cardiac history, his heart surgery, his problems getting his blood pressure medications from the pharmacy, even his snowblower, I was completely depleted in body and spirit. And when he started telling me about his wife's problem with her cholesterol medication, I just stood up and started examining him just to get him to stop talking. I thought to myself, this patient isn't nearly old enough to make me put up with his ramblings. Talk to me when you're in your eighties, buddy.

It's times like that when I realize how impatient medical school has made me. I never, ever considered myself a Type A person--you know, the kind of person medical students are supposed to be. I'm an English major, for crying out loud. And yet I see myself becoming more Type A all the time. I'm sure it's the people I'm around all day. When I was on internal medicine, my attending put great emphasis on not wasting a single word when presenting a patient. I definitely learned to be more concise in my speech, which is great. But now I find myself getting impatient with others who waste words when they talk. For a few months after that rotation, Fast and Testimony meeting was hell.

Impatience does have its virtues in medicine. Sometimes things need to be done immediately, and unless you bug the lab repeatedly or call down to radiology over and over again, it's not going to get done. A doctor should be unwilling to put up with delays or excuses when it comes to the health of a patient. Even so, healing is impossible without patience. It takes time for electrolytes to rebalance, bones to knit together, skin to reseal itself. And it usually takes even longer for the spirit to heal. A good doctor has to know how to wait. One of my favorite prescriptions is "tincture of time." Not every medical issue has to be pounced upon with feline ferocity. The body is pretty good at healing itself.

So even though I'm learning the value of impatience, I'm relearning the value of patience, too. Last week, I had a patient who, I soon realized, was going to do a lot of talking. I decided the best strategy would be to let him talk for as long as he liked. The visit lasted an hour and a half, and I could only stop him long enough to ask a medical question every five minutes. Despite all this, it was one of the most interesting and memorable patient encounters I've ever had. There's a time for patience and a time for impatience. I just hope I learn to tell the difference.

2 comments:

Lizardbreath McGee said...

I'd like to reiterate just how cool you are. (And this is something I have to do because I simply do not have the time to make you another excellent birthday card.) I like that you're thinking about the people you deal with in medicine and not just the science of it all.

Way to keep your humanity!

Kimberly Bluestocking said...

I'm trying to strike a similar balance as a stay-home mom. On the one hand, I need to make optimal use of every minute because I have tons to do and not enough time to do it. On the other hand, I can't let myself obsess over my to-do lists, because I CAN'T get it all done. When I focus too much on finishing everything, my inevitable failure to do so stresses me out terribly.

Worst of all, when I'm consumed with tasks and efficiency, I forget to relax and enjoy the fun of life, like hearing my baby squeal with laughter as we play peek-a-boo for the umpteenth time. That's worth more than a clean stove any day.

And so it goes - the endless pursuit of balance: work and play, spiritual and temporal, light heart and sober mind, bunnies and peanut butter.