I am just another average physician.
It wasn’t my first return from maternity leave, but this busy ED shift wasn’t going well. I kept putting off breast-pumping to complete “just one more thing.” Then my son’s school secretary called. I had told our nanny the wrong pick-up time. She wasn’t answering her phone. I was disappointed in myself and frustrated that I couldn’t leave. But I am a physician — I am responsible to patients.
I finally reached our nanny and took a break five hours into my shift, relieved to be in a quiet room. I pushed away my feelings of inadequacy and got back to work reviewing results. My heart sank again when I read the radiologist report: “mass suspicious for neoplasm.” My 40-something-year-old patient had arrived with chest pain, shortness of breath, and palpitations. Everything had checked out normal except his chest radiograph which showed a possible infiltrate. He didn’t have a cough, though, and I knew he needed a CT to rule out malignancy. It could have been done outpatient, but he accepted my offer to “just get it done today.”
Average physicians grieve.
Now I would tell him he might have cancer. His wife had left to pick up one of their children from school. He was eerily calm. When his voice cracked slightly, he apologized. Meanwhile, I was fighting tears as I thought about my patient, in the same decade of life as myself, with his spouse and young children, and what he faced. I imagined facing the same diagnosis and the fear I would have for my family. I wondered if I would regret becoming a physician with the accompanying sacrifices that it has required.
When his wife returned, I steeled myself and delivered the news. I expected tears and anger, but her reaction shocked me. Without a pause, she said:
Thank you. I have been praying, and I know he will be fine. You probably don’t believe this, but I am certain. He was meant to be here today — this is why he had a panic attack. His nurse told us that you just got back from maternity leave. I know it is really hard to leave your children and come back to work, but this is what you were meant to do in life. You were meant to save lives. This is the reason you were here today — to listen to your intuition, catch this early and save his life.
Average physicians are “raised” in medicine to believe that we must be superhuman.
I did cry. It was a bad day for me, but worse for her. Yet she unexpectedly showed me great kindness and taught me about receiving gratitude.
It can be difficult to feel a sense of accomplishment or pride in being a physician. We have the highest expectations of ourselves and are asked to do impossible things. Anything less than perfect 100 percent of the time is unacceptable. Even when we face overwhelming odds, we feel we have failed when there is a bad outcome. Our health care system judges us with survey ratings rather than meaningful quality measures and constantly adds more administrative work and new ways to fail. And lately, physicians are viewed with suspicion as adversaries or villains. TV shows portray us as greedy and unethical. The public instead trusts celebrities and essential oil purveyors. Some nurses, colleagues who should be allies, have waged a PR war, promoting themselves by cutting down physicians, portraying us as overbearing, stupid, dangerous, and lacking in “heart.” It is demoralizing.
When my patient’s wife thanked me, I felt like a fraud. I didn’t do anything special. I did what any physician would have done. I just happened to be the lucky one who got thanked.
Average physicians are extraordinary
I now realize that what we do as average physicians is not ordinary at all. An average physician:
- Worked hard enough in to be the ~5 percent to be accepted into medical school
- Devoted 7–11 years, spent upwards of 20,000 hours and passed numerous high-stakes examinations
- Owes more than $200,000 of educational debt
- Jumps through incessant documentation and administrative hoops
- Politely answers complaints from patients inconvenienced by factors out of her control or who didn’t get what they wanted because it wasn’t medically indicated
- Defers bathroom breaks, works through lunch, and spends hours of “pajama time” charting
- Is sometimes threatened and assaulted by her patients
- Faces malpractice litigation at least once but fears it for most of her career
- Works weekends, evenings and overnights, caring for patients without regard for ability to pay
- Misses important personal and family events frequently
- Never calls in sick because she can’t be easily replaced and has a duty to her patients
- Suffers from bearing witness to the terrible suffering patients and their families sometimes experience
You, too, might be just another average physician, but you are extraordinary.
It is true, though, that average physicians don’t listen … when patients thank us.
We remember every complaint, regardless of how absurd, but we don’t really hear when patients thank us. We should stop minimizing ourselves and reclaim our sense of pride in the work we do, even though we have come to think of it as ordinary and expected. We are doing extraordinary things — even if it is “just our job.” Few in our society are capable or willing to do this work. We chose the long road, did the hard work, paid a high price, and continue to make daily sacrifices to fulfill our oath. What we do truly matters to our patients.
So, shut up and listen! Take a pause to truly hear when your patient says thanks. Believe it. Savor it. Tell them how much their gratitude means to you. Write it down, so you remember. And share it with one another, because a thank you to one of us, is really a thank you to all of us.