Sometimes I hate this deal, and feel that somebody should really have warned me what I was signing up for when I started – so that I could have headed for the hills, or California, or Key West, or somewhere far away, before getting sucked in. Other times, this job feels perfect, so good I want to keep doing it forever. The work is getting harder and more demanding as I go along, but those good episodes seem to be more often too, so maybe I should stick with this.

The other day, I was the first person in to see one of the bariatric patients on his first day after surgery. He had an NG tube down one end, and a foley up the other, and was very disgusted with both of them. I saw the order which would have allowed the nurses to take the NG out overnight, so I pulled it on my own. I paged the resident for the foley, and was getting the nurse to take it out (not because I’m not up for that job, but because I really should not take one hour to round on every patient every morning, which is what happens when I take too much care of them), when he asked me anxiously, “Were you there for the surgery? What happened to me?” This is the guy who almost coded on the table.

Somewhere in the back of my head I heard the old clinical skills professor admonishing us, “Always find out first what the patient already knows, before explaining their situation further.” “What have they already told you?” I asked him. “They said I had trouble with my blood pressure.” He looked so anxious, and I figured that I definitely knew what had happened (having paid more attention at that operation to the anesthesiologist than to the surgeon), and nothing I might say would hurt him worse than me floundering out and insisting on having a senior person talk to him. So I said, you had some problems thus and so, but the anesthesiologists gave you the appropriate medicines, and you turned around pretty quickly, and they did xyz appropriate tests to see what had caused it, and didn’t find anything concerning, and you haven’t had any problems since then, so it’s nothing to worry about. Between my explanations, and getting the NG and foley out, he pretty much loved me.

And then the other night, taking care of the girl with appendicitis. She and her family trusted me, and asked me questions as though I could know useful answers, and were happy to see me. Silly stuff; but I love the feeling I’m starting to get that I do know some things that can help people, and I can make them feel better, even by talking with them. That’s an incredible power, and I want more of it, and I want to use it responsibly. They should have told me this part of it too, when I was halfway through the first year of medical school. This is why we keep going.

In the cafeteria today the mother of that girl saw me, and stopped to thank me profusely. She gave me a CD from a band that her daughter sings for, with her picture on the cover, and asked me to pass it around to the night team, and thank them for taking care of her daughter. I love nice patients.

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