To know one life has breathed easier because you have lived. That is to have succeeded. - RW Emerson

Wednesday, November 5, 2014

No Power to Change

We have community placements in our first and second year for 3 hours every week. As a first year, I essentially know nothing at all. I might know a bit more than some of my classmates because my background/bad luck with my body experiences, but over all, I don't know anything. The lack of knowledge and experience makes me feel completely powerless to say anything about things that bother me.

For example, I was observing in a specialized clinic that deals with very specific issues, and a patient asked if the doctor would be able to prescribe her an inhaler for her bronchitis, even though it was well outside the scope of the clinic. It wasn't however outside the scope of a very experienced family doctor. I saw the look on the patients face of frustration, anger, neglect and disappointment when the doc said that she couldn't and walked out of the room. I don't know if the doc saw it, but it felt like I was being punched in the gut to see her face and then to walk away like it wasn't a big deal.

Obviously, on the level of medical neglect, not being prescribed an inhaler for a non-emergent situation is not a big deal. Possibly the doc didn't feel comfortable prescribing an inhaler given she didn't know the patient's medical background. I don't think the doc should have given the patient the inhaler given the scope of the practice, but I do think she should have addressed it in a better way. Ask why the patient wanted one, explain in a less abrupt way why it couldn't be prescribed, and at least acknowledge that the patient was suffering. I don't think I will ever forget the look on the patient's face and in her eyes, you could tell she was upset, and wanted to say something, but didn't know how. I felt the same.

Maybe this experience resonated with me more because the very same day, just hours before I was observing at the clinic, the same thing happened to me. I had an appointment with my family doc to talk about a chronic GI issue that I have had since returning from Tanzania in June. Back in September I had been referred to one of the two GI docs in town, and I expected from what my doc told me that the wait time would be 3-5months. I could live with that. But when I called the GI's booking nurse to ask roughly where I was on the list, I was told I was number 500, and I would be lucky I would get in by May. I'm not going to be in the city from May-Sept because of a placement and then I'm going home for the summer. So I wanted to talk about that and what my options were. I also wanted to talk about the fact my symptoms had gotten worse and that I now had nose bleeds and abdo pain that I had never had before. She didn't acknowledge it at all. I had to FIFE (Feelings, Ideas, Function and Expectations) myself to try to get her to understand what I was going through. Even though I was trying to spell it out clear as day for her, she just brushed it off like it wasn't her problem, which is what the doc I was observing later that day did to her patient.

I wanted to tell my doc I wasn't sure if I could make it through another 6 months of school with these symptoms, but considering she graduated 4 years ago from the same school I am attending, I felt like I would be judged for being too weak to handle being in medicine. I honestly thought she was going to be a really great doctor, I keep being told that the docs coming out of my school are different and practice patient centred care, but now I am wondering. Now I am not only worried that I won't make it through the year, but if I make it through the next 4 years that I am going to do the same thing to my own patients.

I think being a patient is harder than training to become a doctor. Acknowledging that might not only make doctors more compassionate, but give patients permission to be sick.




No comments:

Post a Comment