The paradox of patience

11 12 2011

I was talking with some of my peers the other day and we’ve come to the conclusion that medicine is changing us in an odd way: Many of us feel that med school has made us more patient, and simultaneously less patient.

It’s weird, but so true.  My patience and sympathy threshold for most of my patients, as well as most of the medical education process, has multiplied tenfold since I started this gig. Unfortunately, this makes me quite a bit less patient with other things in my life, like when the grocery store is out of the apples I like or that one traffic light that only lets 3 cars turn left every 2 minutes.   No joke, I almost threw a fit the other day when I got word that the repairs on my car are now likely delayed until January.

When I first started clinicals, I had a really hard time being patient with some of the people who came in with suicidal ideation and anxiety because of the reasons they gave.  Everybody has a different tolerance for the challenges in life, and some people have much different breaking points.  I understand that now, and so the empathy comes much more easily.  This realization means I no longer play the 1-up game with my friends.   A number of my peers here feel the same way: we value our relationships, and trying to force people understand the situation usually does more harm than good.

There are still many aspects of lost patience that I need to overcome.  For example, I’m really great at patience and sympathy when it comes to my patients, but I’ve become less patient with everyone else.  This is very, very bad, and it’s taken a lot to try to overcome.  It’s funny, too, I was chatting with a friend (one of my classmates) whose boyfriend came down with a cold.  He called her wanting her help finding a doctor to get antibiotics because he was sure he had a sinus infection.  She told him he had a cold and to suck it up.  He was not a fan of that response.  I would have said the same thing.

It’s hard when most of the other people in your life don’t automatically understand what you’re going through.  I’m sure all of you have struggled at some time with feeling misunderstood, underestimated, or oversimplified.  It’s not realistic for everyone to understand your perspective on life, because every person has lived such a unique story, and to some people, getting rejected from your top choice college and losing a sports game or your car being totaled can all be equally bad depending on the person.

So I wrote all of the above, much of which, on rereading, sounds surprisingly philosophical (weird, right?), last week with the intent of publishing it this weekend.  And then this happened:

Last week I had the worst day yet in medicine.  One resident called in sick, another had to leave early, and on top of it there were like 12 new patients, the attending passed out on rounds and wound up in the ER, and the new attending reamed me and the one remaining resident for not knowing every detail of like 20 patients, most of whom we were covering for or were new altogether.  On top of that, my favorite patient took a turn for the worst.  She was the sweetest old lady who came in two weeks before with a cough, ended up with a massive lung cancer (she’d never smoked), and despite everything she was unresponsive to everyone that day.  I had been helping take care of her for the past two weeks, and the attending wanted us to have the conversation with the family about making her completely DNR and transferring to hospice.  This was the first time I’d dealt with the situation having known the family and the patient well, and it was awful.

Afterwards I went home and saw a facebook status from someone having a drama about accidentally eating a bite of a non-vegan brownie, and how it was killing them from the inside out.

That was a moment for a deep breath.  My patience for one situation clearly failed to extend to the other, and I trivialized someone else’s problem without knowing the whole situation.  oops.

I can’t take back what I said before, but this is the truth: easier said than done.

What can I say, it’s a process 🙂

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