I miss my family doctor.
That sounds like a really weird thing to say, seeing as I just saw her on Thursday, but I miss her. Because I haven’t seen just her in months. My family doctor teaches medical students and family medicine residents, and since last July I’ve only seen just her a couple of times. I’ve seen at least seven students in the last year, but there are probably some more that I’m forgetting. And I’ve had four appointments in a row now with students. So I miss her.
I mean, I still see her, but it’s not the same. When there are students, the appointments take twice as long, but I have probably less than half the usual time with my actual doctor. I’m very used to students and residents in the hospital, but it’s different when I’m seeing my family doctor. She’s the one who already knows everything and so it’s supposed to be easy. Students make it more complicated.
Anyway, I’ve seen a lot of students lately. And I have a lot of thoughts about the whole thing. And if I could talk to medical students everywhere this is what I would say.
You all generally have one of two reactions when you start talking to me about why I’m in front of you.
Some of you are quite obviously not interested in having me as your patient. I’m sure there are lots of possible reasons for this. I can guess at a few…you’re not interested in family medicine; you’re tired and you just want an easy patient; you’re uneasy because I know more about my conditions than you do; you’re put off because before you walked in my doctor straight up told you that I know more than you do; you’re hungry; you’re overwhelmed because med school is stressful…and I’m sure there are a dozen other reasons that I can’t understand because I’m not a med student.
I don’t hold it against you that it’s pretty obvious you don’t want to deal with me. Just keep in mind that if you’re not interested in dealing with me then I have no interest in dealing with you. I’d rather just see my doctor, so let’s hurry this up so she can come in.
Most of you have a very different reaction.
You are super interested and intrigued by me. I have conditions you’ve never seen before, maybe you haven’t even heard of them before, and this is exciting to you. I get that because I, too, am fascinated by the human body, how it all works and how it all goes wrong. I like that you’re eager to learn everything you can to be the best doctor you can, but please realize that what is a “really cool diagnosis” to you is less cool for me. Learning about rare and difficult to diagnose conditions is one thing, living with them is another very challenging, isolating and all-consuming thing. Please remember that. If you ask me whether I’m working or going to school, I will tell you that my job is keeping myself alive. And I really mean it. Please respect that.
You ask a lot of questions, and not just about why I’m in front of you on this particular day. I understand why this is necessary, because I’m never there for something straightforward, but rather something related to something else going on. You need to ask a lot of questions to get the whole picture. And then some, because I’m there to talk about a medication and now you’re asking me about disability rates in BC. Oh but wait, I can’t eat? What’s that like? Isn’t it hard to watch other people eat? How does TPN at home work? And where exactly does my central line go?
Again, I appreciate your interest in learning more. I like that you’re asking questions that medical professionals don’t usually ask me. They all know I can’t eat, but none of them ever ask me what that’s actually like. That said, I know my appointment time is limited. I would love to talk to you about all these things, and I wish there was enough time to cover it all, but there’s not and I need to get what I came in for. Yes, I want you to learn from my case, but I’m here to be a patient, not a teacher. And I know that you’re a student, but I also need you to be my doctor. I’ll be both if you’ll be both.
Since I mentioned my central line, can we talk about that for a second? Yes, TPN is amazing and it’s very cool that science has figured out a way to keep me alive even though I can’t eat. Yes, it is awesome!
It’s also terrifying. My life is on the line so that I can live. Let that sink in for a second. I’m fairly certain your reaction would be a lot different if you learned someone’s central line was in place for chemo. You would immediately understand that they had been through a lot, but it’s important you understand that I’ve been through a lot, too. I didn’t just end up here. I’ve had a lot of tests, a lot of procedures, and I’ve spent a lot of time in the hospital. And I will never be on the other side of that, but rather it will always be part of my present.
I just need you to remember that I’m a person. I’m a page of a textbook come to life on the exam table in front of you – footnotes, glossary and pharmaceutical information included, but I’m still a person. I’m your patient. I came to see a doctor. Actually, I came to see my doctor. That’s who I really want to see today.
And I don’t intend that to be mean, but you being here has me pulled in two directions. On the one hand, I really support and believe in your education, and I understand my role in that. That’s why I will always be cooperative, patient, and answer all your questions. Besides, if you’re going to learn from someone I want you to learn from my doctor because she’s excellent.
But on the other hand, I’m sick and I’m tired. I’m here because something is wrong and telling my entire story to someone new for the sixth or seventh or eighth time is exhausting. I don’t want to explain everything to someone I’m never going to see again. I just want to see the person who already knows everything.
When all is said and done, though, I know you don’t have an easy job and I don’t resent you doing it. I know you’re doing your best to be both a student and a doctor at the same time, all while trying to learn everything about everything. That can’t be easy and I want you to know you’re doing a good job.
So you keep doing your job, and I’ll keep doing mine, and we’ll go from there.