Wednesday, January 16, 2008

You know you are doing something right...

Just over 11 years ago, I decided to change my career. Damn the torpedoes and financial solvency… I went back to school. I spent the next 6 years studying to become competent and took an oath, “do no harm.” Then, I spent 3 more years learning “on the job,” so to speak, in residency.

If “do no harm” is your objective, that seems a pretty easy goal to meet. In retrospect, it is not so easy. If “the road to hell is paved with good intentions,” the road to harm is paved with good efforts. I can honestly say, I believe I have lived up to that oath. But not doing harm is not why I went into medicine.

I have no illusions about saving the world. The world is well beyond my scope of abilities and, at present, appears to be headed away from salvation toward something quite the opposite. But as the world is careening out of control, I hoped to help a few individuals live healthy, productive lives.

When you train for medicine, part of the medical machine involves brain washing. They try to teach you that the western medicine way is THE way to health. They teach you to maintain a “professional distance” and to not get “attached” to patients. The trouble is, western medicine and a “professional distance” have nothing to do with health and everything to do with disease. As a medical student one learns to find, identify, diagnose, and manage diseases. A professional distance means that you focus on the disease, not the person in whom the disease might be raging. Success involves meeting benchmarks in a patient’s disease management. Checking off the various diagnostic criteria and medicines that constitute “standard of care” is considered “good medicine.”

I’d like to know I do a good job in all that I do. I do check those boxes, dot the I’s and cross the T’s. But that is not how I have defined my success. Up to now, I have defined it in how patients send their friends and family to see me; in how my kiddos give me hugs; and in how my patients have told me they feel better, look better, and are healthier. Between the paperwork and complaints of the unhealthy who are not improving as quickly as they like, these rewards are huge. That little thank you note or that big hug mean so much.

A few months ago, I decided to make a huge change in my life. I am leaving this practice where I have been caring for (and getting attached to) people, real people not patients, for about 4 ½ years (2 ½ officially). This week, I began telling everyone I was leaving. I have only told a tiny fraction of my patients. None of them have started singing.

I remember old myths about how when you save someone’s life they are beholden to you forever. I see it the other way around. When I find something that might save someone’s life, they become important to me and I am very attached to them. It is those people who will be the hardest to let go.

One person who falls into that realm told me that his family would just have to move to the same town. Another came in today for follow up. She is very important to me. Her daughter is the most elegant woman I’ve ever seen… I have come to realize that her inner beauty is even more vast that the beauty on the outside… she got it from her mother. The whole family means a great deal to me. When I explained to them that I was leaving they were shocked, nearly speechless, and almost in tears. As I left the room at the end of the visit this elegant, elderly lady welled up with tears and said, “I love you.”

In that moment, I knew I had done something right. To hell with professional distance and standard of care. To do real medicine, to help people heal, you have to get attached and really CARE for them…you have to love them. It will be hard for me to let go of the family (all my patients) I care for so deeply. I will feel the loss of them when I am away and will still send healing thoughts. I know I will shed tears for those I care for as I have today for this dear lady. I have done something right when it heals my heart to help them.

1 comment:

Unknown said...

You are a true professional -- dedicated heart, mind and soul~!