During a patient’s time of crisis, being an Emergency Physician is truly a blessing. Using my medical training and skills, I have the tremendous responsibility to diagnose and manage medical conditions during emergent situations. Moreover, I don’t get to do this for one patient at a time. Rather, for multiple patients at the same time! This is no walk in the park. It took several years of training to get here. It took several years of experience to be here. There is not one day that goes by when I do not realize the power of my decisions on the job.
This is the perspective that I operate from. I walk into room after room and within minutes, I have to develop a rapport with the patient, a true understanding of what brought them to the Emergency Department, and a list of potential diagnoses and/or emergencies that they may be going through. Once that is found out, coming up with a proper treatment or management plan ensues. Minutes. We are talking about minutes. However, the patient may be there for an issue that had been brewing for days, weeks, months, and even years. Some people come to the ED for an immediate problem such as a fall with extremity pain, a laceration while preparing dinner, chest pain, abdominal pain, slurred speech, or paralysis that began minutes before arriving. Many people come to the ED for a problem that they thought was under control but realized that it may not be. Back pain that started some time ago that they figured would ease up, headaches that occur off and on, a rash that comes and goes, rapid weight loss, fatigue, sadness, alcohol dependency, and so much more. My understanding of the patient’s concern rests heavily on their ability to articulate all of what they had been experiencing. One small detail or misunderstanding can steer my emergency plan in a completely different direction.
Remember, I do not get to manage one patient at a time. Rather, I manage multiple patient’s at the same time. I see each patient one by one as they as brought into the Department but I have multiple workups or testing plans happening simultaneously. Add in the dynamic of communicating with other staff such as nurses to ensure everyone is up to speed with the plan. Moreover, when family and friends come in and would like an update, they want to speak to the doctor. Also, the family who can’t be present at that moment are calling to speak to the doctor. In addition, patients who have left the department but have additional questions call in to speak to the doctor. Not to mention, communication needs to occur for critical results from the laboratory and/or radiology as well as for consultations and admission reports for other doctors within the hospital. How could one forget if the family wants to know if the patient can eat, needs the bathroom, or a blanket, they come up to the nursing station and address the person that they know can make things happen, the doctor. All while the doctor has every patient’s life in their hands – the captain of the ship.
It is no secret that doctors have been dehumanized over time. I leave my shifts feeling fulfilled that I helped a lot of people. I feel happy that I am doing work that matters. However, I do not think from the perspective of most patients, that they realize the doctor is human too. Instead, patients and families are operating from the place of the patient. The perspective of the patient (and family) is, “I, Me, Myself”. It is understood! The most important person(s) in the department is the patient. All efforts are done in the best interest of the patient. Nothing needs to change from the perspective of the patient however, what needs to change is the level of understanding. Understanding that the doctor is depending on a succinct story of your ailments and concerns. Understanding the importance of having regular medical care with a doctor/office that knows your history. Understanding that Google is not the doctor’s source of information and knowledge. Understanding that they are not the only patient in the department. Understanding that tests and results take time. Understanding that not all Emergency Department testing will come up with an answer or diagnosis – that knowing what the diagnosis is NOT is just as important as knowing what it IS. Society wants physicians to be perfect. Society wants us to know all the answers and never say the wrong thing. And before anything else, we should always be there for patients.
Society wants a perfect person during their most imperfect of times.
The fact is, we are not perfect. We are not above mortality. We are the most qualified person in the room to manage and treat emergent medical conditions. We understand the power of our decisions. We uphold the Hippocratic Oath. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. I will keep patients from harm and injustice.
At the end of the day, it is difficult to not bring the emotions of our work home with us. With our schedules frequently packed, we can potentially see work interfering with our home life. In the department, I am that doctor that will spring into action to save a life but catch myself on the flip side reflecting and thinking about the fact that this may be the worst day of that patient’s life and that of their families… And I will break down into tears. I am human.
I write this post to make that clear. If you didn’t know, now you do. If you came to the Emergency Department to get to the bottom of things for a problem that you have had for months and I can help you and come to a diagnosis, great! However, if not, I will not leave you hanging. I will tell you what it is not and I will direct you to a doctor or specialist that may help you. I will never leave you hanging. If I am occupied in a room with a patient who may be hanging on to their last moments of life and you are not, be understanding of that. If it were you hanging in the balance, you would want the same. For the doctors who walk through those hospital doors with the purest of intentions, we are here for our patients and will dig deep through the depths of our medical knowledge and experience to help. We will never leave you to the wolves. However, perspective is everything. We are human, just like you.
