Wednesday, April 29, 2009

The Doctor as the Patient

I hate being the patient. I know that sounds ironic given my choice of careers, but I do.

Last month, I was kept up until the wee hours of the morning with a dreadful bellyache. Placing the doctor’s thinking cap on my head, I made a mental checklist of all the possible sources of my discomfort. I ran through the usual home remedies and over-the-counter treatments without success. Ugh. Looks like it was time for me to make a trip to the doctor’s office.

Now, being at the tail end of medical school, and about to embark on my own career as a physician, going to the doctor is a completely different experience. I no longer go to the doctor as a patient. I go with the knowledge that doctors are human. They are not all knowing - they only know as much as they have read or experienced. They have other lives – meaning they’d like to get your visit over with soon so that they can go home to their families too. On the other hand, having spent the last two years seeing patients as a medical student, I also know what it’s like to have patients who are skeptical of your ability and desire to help them.

All this knowledge makes it a dreadful experience when it’s my turn to be the patient. Take last week, for example. I dutifully brought the Prilosec I had been taking as well as the dosage schedule. I brought the Mylanta. I articulated clearly the onset and character of my belly pain. I tried my hardest to respect the time and expertise of my physician. However, there was the voice in the back of my head, the medical student, that kept second guessing her. “I told her my pain is not epigastric and not related to meals, so why is she still talking about reflux? And why should I continue the same medication if it’s not working? Isn’t she going to check for H. Pylori? What if I have an ulcer?!?” So, in the politest way possible, I ask her these questions. And then I ask her some more. And some more. Until she finally throws her hands up and tells me “Let’s just treat it like reflux and see what happens.”

Soon I realize I have morphed into the patients we physicians all dread to encounter: The know-it-all, internet searching patient who knows a thousand times better than you what is wrong with her. She knows what tests to run and knows what medicines to take. In fact, the only reason she comes to you at all is because she needs you to write the orders. If she could do it herself, she would. I have also become the hypochondriac patient. The one that has made a list of all the things she could possibly have. It doesn’t matter that she doesn’t fit the patient profile. She is convinced she has all of them. And right now, I have it in my head that I have an ulcer. I have also become the non-compliant patient…because I am convinced I do not have reflux. I will not change the types of food I eat or times of the day I eat or my sleeping position.

Fast forward to today. The belly pain went away a couple days later with the tincture of time. And while I still don’t know what the cause was, I did learn a valuable lesson. Being a patient is no fun. Having the answers about your body in someone else’s hands is a scary and frustrating experience. Could the doctor have been a better listener? Sure. Could she have taken my questions more seriously? Of course. Could she have empathized better with my discomfort? Yes. Most importantly, will I always aim to do these things with my patients? Absolutely. And hopefully my patients will agree.