Physicians have to maintain a professional facade. Patients look up to you. In the ED, your staff looks up to you. If the room is up for grabs and the physician loses it, everything goes to hell in a handbasket.
I lost it last night, but I was able to keep my professional facade. For some stinking reason I still can’t stop thinking about one of my patients. Actually, I know the reason, and I’m human. I can’t help it. It’s that Age Game thing in reverse.
The charts were piling up in the “To Be Seen” rack. Four patients from an MVA were on their way in via ambulance from a car wreck. We were trying to clear out rooms for all the ambulances. One patient had already been waiting more than an hour. His well-dressed wife came to the desk and quietly asked if we could tell her how much longer it would be until the physician came in to see her husband. His stomach pain was getting worse. His chart was about three deep in the rack – before the ambulances arrived. I apologized for the wait and asked his nurse to give the patient some morphine for his pain. I looked up at the board and saw that he was my exact same age. “Come on,” I thought to myself, “I have been through diverticulitis with nary a shot of pain meds and I jogged home after my vasectomy. What’s the deal?” But the age thing got the best of me, so while listening to the ambulance report over the radio about “Accident Patient #3,” I poked my head in the room to get a quick look – half to satisfy my own curiosity, half to make sure that he didn’t have an acute abdomen.
The man my age with the abdominal pain was a stomach cancer patient. With liver mets. With new onset jaundice. He looked like hell. Probably weighed about 100 pounds. Not an ounce of fat anywhere. My mind quickly switched gears. Who cares if I look younger than another 40-something year old male my same age? Here I am looking forward to taking my family to a college football game next month and this poor guy and his wife are probably wondering if he’s going to live that long. I stood there in a trance for a second. What if that was me? How would I be different with my wife and my kids? What did this man do to deserve this? I felt remorse, anger, pity, and fear all in the span of about three seconds. I kept my professional facade, he didn’t have an acute abdomen and I got his pain under control. Wish I could have done more.
I always try to tell my family how much I love them, but when my kids got off the bus today, I gave them an extra-long hug, looked into their eyes and made sure it sunk in. Two of them gave me a half-cocked grin and looked at me like I was nuts. One of them smiled and gave me an even bigger hug back, looked deep into my eyes and said in a deep voice “I love you too, daaaaaad.” I ate it up.
Nope, dad hasn’t been drinking. Sometimes it just feels good to get rid of a few callouses, whether they’re on your feet or inside of your head.