Sigh. I was given a serious tongue lashing by a patient’s daughter today, for something that I have no control over, and for apparently NOT treating the patient adequately. Never mind that I’m the lowest man on the totem pole, that I have no power to make any real decisions, and that anything I say or suggest goes through at least 2 other (real!) doctors before it happens. Never mind that we, the entire treatment team, all agreed on the course of treatment (3 MDs and 2 other med students), and we did our best. It was just frustrating because she somehow seemed to expect her elderly, demented, hemiplegic father to magically be able to get up and walk after an acute case of gout in his wrist and knee that was still resolving.
She even threatened to sue us. Sigh.
I know she’s probably stressed out, and I will be the first to admit that her father is a difficult patient, because of all the things that are going on. He’s a big guy, too, so it can’t be easy to move him around and stuff.
It just annoys and saddens me, on many levels, because this is exactly the sort of experience that jades medical students and residents. My resident, the leader of my team, essentially told me “This is why you don’t spend time with the family, because it’ll only come back and bite you in the ass.” And he’s a nice guy, competent, cares about his patients, wants to see them get well and be on their own, but he’s jaded. Some would call it realistic. He’s at the end of his residency and he’s seen crap. He’s been treated like crap. Nurses have paged him at 3 am for the most ridiculous things, waking him up. Patients and their families have threatened to sue him before. They’ve yelled at him, cursed at him, been racist towards him.
Perhaps (very likely) I’m still idealistic, but man, that just sucks, to have to say, “I won’t spend time with the family unless I have to, and even then, it’s get in and get out, because anything more than that invariably leads to trouble.”
Everyone finds a way to cope. Some compartmentalize. Some detach. Some just avoid those patients in the future. Some are able to love well, regardless of how they’re treated. But is there a time when you just cut the lines and wash your hands of the situation? When is that? How do you do that with grace and dignity, without bitterness and anger?
Welcome to the wonderful inside world of medicine. No wonder why people want to go into private practice in the suburbs with relatively more compliant and intelligent patients.