By HAIDER JAVED WARRAICH, M.D, from the NYT
I love this. Essentially:
““Doc, give it to me straight. If this were your mother, what would you do?”
While the patient-doctor interaction varies widely across cultures and continents, this question seems to be a universal constant…From a patient or family member’s perspective…. this question helps them make sense of the confusion, desolation and powerlessness that so often defines the hospital experience, which usually involves a full-on assault of numbers, jargon and ‘expert’ opinion… it makes sense that they would defer the choice to those who appear to know what they are doing. And by invoking the physician’s parent, they hope to humanize the physician and have a conversation with real stakes.
Yet I still find this question hard to answer. See…my answer to the question would be very different, as it would be for anyone, depending on which parent you asked me about.
So I have come to believe that the right answer to the question, “If this were your mother, doctor…” is: “Tell me more about your mother.”
This response gives patients’ families the chance to think about their loved ones, about what they would value and what they would consider a good life, what they would think was worth fighting for if they were available to answer the question for themselves…It takes them away from a place where they feel solely responsible for the trajectory of their relative’s life to one where they simply communicate what the patient would want out of her life. We as physicians can then weigh in on whether it is reasonable to expect that to happen.”
YES. Totally using this.
…and you BET I’m honored to be in it. Medicine definitely has it’s dark and humbling side, as exposed by this article: To-being-doctors-to-be by Mrigank. However, as physicians, we have the incredible honor of seeing what our bodies can…and can’t do…face to face. Mrigank’s entry was too beautiful and so eloquently written, I had to repost.
“We who began our adult lives spending alternate days with corpses… Who spend the prime of our youth in the grime of wards. Who have already witnessed a lifetime’s share of deaths. Who learn about depression but fail to recognise it in ourselves…We who are hunted and haunted by questions that have no answers. Who feel guilty when we know less than we should. Who fear that we will never be good enough…
We who cannot ever abandon logic. Who are rational but must allow for prejudices. Who have no choice but to listen…
We who will never tell you any of this.
We who really need to step back and appreciate ourselves.”
50-soomeyr old male comes into ED complaining of extreme left lower extremity pain, shooting from his left lower back to his left foot, going on for the past 3 weeks. The pain is described as ’10/10′, throbbing in nature, persists through walking and at rest and ‘is unbearable’–it keeps the patient from sleeping and has made him depressed. No appreciable weakness or numbness in any extremities. The patient has tried taking oxycodone 30mg every 4 hours, with minimal benefit. Of note, the patient tried cocaine yesterday in hopes of alleviating the pain–that also did not help.
I can’t believe it’s already been 2 months into my 3rd year of medical school–a year that some presume to be the most physically demanding and intellectually straining, but also the most eye-opening. I couldn’t have started it with less of a bang, with general surgery. Needless to say, though going to Haiti didn’t give me much of a break between boards and 3rd year, it definitely prepared me to get back into full-fledged clinic work right away. Thank God again for providing such a great opportunity…it couldn’t have fallen at a better time.
I went into surgery almost CERTAIN I had ruled it out of the picture, but left actually really enjoying the cases I got to scrub in on. Though the hours were long and hard, I found myself looking forward to every day. I guess some can view the medical profession as morbid in its fascination with the very sick, complicated patient, but I genuinely loved the numerous complex cases in surgery and was surprised to realize my disappointment in the lesser amount of acute emergencies in ophtho (though I shouldn’t have been surprised). Lately on ophthalmology, I’ve found myself quite bored. At least now I’ve ruled out ophtho 😛 A scary thought is that considering surgery would completely change my plans for the future…so I’m still on the fence about allowing surgery into the picture. But there are fields that involve medicine and procedures too…like gynecology, urology, GI, etc. So the verdict has yet to be decided
3rd year so far has shown me how amazing God’s plan for me has been. I knew I liked science and talking to people, and I figured I would like medicine, but I had no idea going into my program what medicine would entail. Now, having been in the hospital for the past 2 months (and pretty much living there for a month and a half), I’ve realized medicine is quite possible the best fit profession out there for me. God is so good…when I took a leap of faith and went for the program, I still had my mind set on research. But being the clinic has opened my eyes to a field I knew nothing about before…but am so blessed to be a part of 🙂 Thank you God.
May he continue to be my motivation to be diligent! haha 🙂