It really doesn’t take much to remind you just how human you are. I utilize the adjective “human” because most believe, both inside and outside of the confines of the medical community, that physicians are entitled and even expected to behave in somewhat robotic ways, with the long hours and constant absorption and dispensation of medical knowledge that often comes with performing the job and doing so well. Now in my last year of internal medicine residency, I can somewhat see what is meant by that by the lives we as residents lead professionally and the tough schedules we maneuver daily.
In May of last year, I underwent a somewhat extensive extraction of four wisdom teeth and a sublingual frenectomy by a well-respected and well-known oral surgeon in Rhode Island. I knew that it would be a little painful afterward, but didn’t expect much other than pain that should be appeased with adequate analgesia in my post-surgical days. Thanks be to God, the surgery went well. The pain was at first minimal and then slowly but surely crescendoed to a point where it was, at times, quit unbearable. Everybody was telling me, family and friends alike, that such was an ambitious feat to have all four removed at once, but I realized that it was the best decision at the time and I really had no other viable options, given my age, schedule, and time commitment to healing adequately. Doctors are often seen as being the not-so-best of patients, but I’ve always strove to refute this notion by being a good patient to the best of my abilities, and I’m sure my own primary physician will agree. However, I was reminded soon after having the oral surgery just how precious life is and how quickly one can be reminded of one’s “humanness.”
Two days after the wisdom teeth were removed, I awoke to start the day. The pain was under pretty good control, but I was taking the Percocet and ibuprofen prophylactically to prevent the inevitable, as recommended and prescribed. I went to my restroom at my condo, did my business, and immediately noted that my urine was darker than usual. I made a quick assumption that I needed to drink some fluids, which I probably had not been doing since the surgery because of the locale and severity of the pain. I turned around to wash my hands and the next thing I remembered was waking up on the floor, sweaty and breathing rapidly. Similar episodes had happened before, in August of 2008, and most recently in December of 2013, which were all considered to be secondary to dehydration, of which I’m prone to getting pretty severe cases. I was reliving these terrible episodes all over again, blaming myself for not remaining well-hydrated. I was eventually taken to the hospital where I received intravenous fluids and returned home. The following day, I started to have rigors. Being a physician, I was aware that rigors were a sign of fever and potentially systemic bacterial infection as a physiologic response of the body to try to cool itself down, but I had not experienced them first-hand before. I had just completed a conversation with my mother and sister when they started. I was shaking everywhere. I thought initially that maybe I was just chilly, as the corridors of my condo have a tendency to be drafty and I was not sweaty and didn’t feel hot. My temperature turned out to be 102. I was taken to the ED, was found to have a left maxillary sinus infection, was started on intravenous antibiotics, and sent home with an additional ten-day oral course.
It was oddly refreshing being on the other side, lying in the emergency department where I worked and where I admitted hundreds of patients and consoled their families. Being on the other side is oftentimes rare, especially while a trainee, but I had the opportunity to interact with nursing staff, patient transporters, ED physicians and hospital staff in a totally different way, and such experiences, I contend, provide the physician with opportunities to develop his or her humanistic efforts in an entirely disparate way — by first-hand experience. One is taught all over again, indirectly, the professional do’s and don’ts of medical practice and is compelled to put them into effective practice. This experience taught me something: we as physicians must remember that we are first and foremost, at our very core, human. This projects substantially onto our interaction with patients and our delivery of health care and health with care to each and every one of them. We must also remember our patients as fellow human beings first and patients second. They are not the diseases with which they present. They are not room numbers. They are not parts of the whole. They are each a whole, a sum total of their experiences, their conditions, their diagnoses, and their interactions. They, like us, are people, with families and other people who care about and love them dearly. I think it may be best articulated by the exhorting words of the Scottish Preacher Ian MacIaren in a Christmas message in 1897,
“Be pitiful, for every man is fighting a hard battle.”
We, together with our patients, are every man. May we as physicians always possess the humanistic quality found in our ability to connect with ourselves and our patients in our daily delivery of health care, and, in so doing, remember what life is like looking up from the examination bed, and be pitiful.