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17 August 2009

Lowered Expectations



(**Warning: venting today... warning! warning! warning! High pressure release! warning! warning! warning!)

And, I had such high expectations for today because we started off with three patients on the board...

I have goals for the year. Every day I strive to improve my efficiency. Every day I set a goal that I will succeed in learning one new thing about a disease process. Every day I will treat my patients with the honor and dignity due to a member of the human race. Today I failed miserably on the last.

I went to a private Catholic parochial school. Somewhere around 5th or 6th grade we were visiting neighboring churches (Lutheran, Methodist, Jewish, etc.) to learn about the similarities and differences in our faiths. At the Jewish temple, the rabbi asked us what the worst word in the world was. My naive brain could only come up with one or two words that are tame compared to some of the words used on network TV these days.

Then the rabbi told us that "weird" was the worst word in the world. He said we should never call anyone "weird." Just because someone does something in their culture or faith that you don't doesn't make them any less deserving of respect. This started my understanding of the idea of tolerance. I never forgot that.

My husband feels that the word "stupid" is the worst thing you can call a person. It implies, to him, that you are the lowest, most ignorant being on the planet. Worse than "retarded" because "retards don't know any better." When you're stupid you have brains, you just can't use them. You are, in a way, "low class" and uneducated.

Unfortunately, my first round of patients this morning were seriously stupid. And, then they just got weird. So much so to the point that I got very frustrated this morning with what I was doing during my shift. And, to add to the mess, there was a situation with a sick patient that was signed out to me from the night before that just pushed me over the edge.

I was lamenting, in part, to an unsympathetic ear who told me that I needed to lower my expectations. Once I did that, they said, I would be able to survive my shifts in Emergency Medicine. Seriously? Really? Seriously? I'm about a year from starting my career and you're telling me this?

I went off in need of a break. I considered my options: try to match in surgery, take a year off and do a fellowship, move to Mexico and be a beach-side doc-in-the-box catering to tourists, get a new career, maybe something in retail or truck driving.

I pictured myself at a town hall meeting standing up and saying, "You know, instead of spending my hard-earned tax dollars on taking over medicine with a potentially corrupt and inexperienced socialistic government Health Czar, why don't you take those billions of dollars and educate people on the importance of preventative medicine, on seeing your doctor on a regular basis, on taking medication as directed, on not cutting off your cast every two weeks because you think it smells and you want a new one, on not treating the emergency department like a drive-through that will provide services on your time schedule? How about that? Why don't you tax them for taking up valuable time in the E.D. and wasting, oh yeah, again, my small resident's salary tax dollars? Instead of Hope and Change how about Personal Responsibility and a sense of agape (ἀγάπη)?" Huh? I can't hear you....!

At what point should I expect nothing of my fellow human beings? My colleagues in medicine? I was very surly. I was thinking I would like nothing more than to pack it all up and go home. Start again in the morning.

Anyway, my foul mood might have continued had my attending not come around the corner at this point and, seeing me, started singing, "Don't go changing... to try and please me..." in the most honest and sincere voice I think I've ever heard out of him. I had to smile and then laugh. I was still snickering to myself as I continued to work my way through the flood of patients that came in this afternoon.

Somehow, it didn't seem so bad after that....

Early in our relationship my husband and I discussed an email that was circulating around the web at that time. It had to do with a man who went home every night and touched the tree that stood just outside his door. One day a neighbor asked about his ritual. He said that the tree was their "Problem Tree." Before walking in the door, any problems from the day were "hung on the tree." The neighbor asked what happened when he left in the morning. The man answered that somehow the problems never seemed to be there.

We made a promise to leave any problems "hanging outside" and not bring them in. Tomorrow I will wake up and head into my shift. There will be a clean slate and anything from today will not be carried forward. Sure lessons will be learned, but I will again try to achieve my goals, especially the one that can be restated simply as, "Love thy neighbor." Lord, love it, but it's hard sometimes...

5 comments:

a corgi said...

((Veronica))) not only do we have to love our neighbor, but most importantly, we have to love our enemy, which often includes the "weird" and the "stupid" and the ones who don't listen to good sound medical advice, who go against medical advice, who have no intention of following medical advice, etc. and we just keep on trying as hard as it may be to love them.........

it is hard though..........

but keep on trying!! it makes Someone happy when we try :)

betty

Julie said...

One of our very hard to love, like, talk too, take care of patients threatened to go AMA the other night, 4 of us ran to get the paper for her to sign. But calmer heads prevailed and we once again talked the patient into staying for life saving treatment.

The shift I get report from is not allowed to tell me I am getting a crab, constant complainer, drug seeking non-compliant detoxing low life of a slug ever.....I like to make up my own mind.

I like the idea of the problem tree. When you get so you can't stand people at all...then it starts to come back and you can see the reasons why they do what they do. With the price of meds.....I would probably be non-compliant some day also. Take care.

the Provident Woman said...

Just let the day flow off of your back. Hopefully you treated all of the stupid people already and tomorrow will be filled with smart ones.

Claudia's thoughts said...

What I wonder is "Whatever Made You Think That _______ Was A Good Idea"
I honestly wonder about some people, the whole population could not be stupid, but I see a large percentage of them.

We had a recent shooting at LA Fitness in the Pittsburgh area. This guy always had a problem attracting females. He was not ugly, but I guess he was different. He was probably that weird, creepy guy. It was really sad, he attended classes on meeting females. I guess some people are unable to form relationships and this was very traumatic for him. He killed three women and himself and wounded several more.

Lisa said...

I found this entry to be inspirational as opposed to ranting. I am extremely intolerant of what I consider stupidity and I make no bones about it. You've made me think about that. Too bad you have to deal with the bad patients, I would think that can lead to burnout.