Frequently the response when I tell someone I am an obstetrician is "What a wonderful job!" It is a wonderful job however not in the way most people who make that statement believe it to be. Here are reasons that I believe my job to be wonderful:
First, obstetrical patients are the most appreciative people on the planet. Even if all the obstetrician did was show up as the baby is being born (let's face it, in a large percentage of cases childbirth could happen without an obstetrician), the mother, the father, the grandparents all think that this child could not have made her way into the world without the assistance of the obstetrician. I generally stop to remind the parents (and myself) that their job is much more difficult and much more important than mine. I know. I have been a parent for over eighteen years.
Second, I like my job because when complications do arise during delivery or if it is a difficult pregnancy and the outcome is indeed a good one then I do feel as if I have contributed in making life better for all involved. In these cases the patient may not be as grateful. Perhaps it was not the story book pregnancy she imagined for herself. She and her family may have struggled through some difficult days or even months where she did not feel well, was confined to bed or hospitalized. If she has a healthy baby and she herself is well at the end of the process I will celebrate and then commiserate with the patient and her family for the next several years about how a truly awful pregnancy produced such a wonderful child.
Finally, when the outcome of the pregnancy is terrible, when the baby is born much too early, when he doesn't survive the neonatal period or she is stillborn, I have a chance to be with the family as they begin to heal from a terrible loss. I have learned in my more than twenty seven years of practicing medicine that I will never be able to make sense of these outcomes. I should not expect these people grieving the loss of their child, to make sense of this either. Until the baby is born, I am working as hard as I can to find ways to prolong the pregnancy or treat the condition threatening the baby's health. Once the baby has arrived my job is one of emotional support. If the baby is disabled or dies then the parents will still need care.
Healing comes on many levels at different times through a variety of sources. At times the physician plays a very active role deciding, prescribing, preforming. At other times it is just as important that the physician be present and be still.
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Musings of a physician in private practice for 24 years, now teaching in a residency program and working as an ob-gyn hospitalist in a large metropolitan hospital.
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The Local MD
Having now been a physician in private practice for twenty-one years, twenty-six days and about an hour and twenty minutes, it occurs to me that I have become what in medical school was often a derogatory term, the local MD.The presentation on rounds often went something like: "This 45 year old Caucasian male was seen last week by his LMD, and diagnosed with a viral upper respiratory infection..." At that point everyone knew that the LMD had missed the diagnosis. Otherwise the poor patient would not have ended up in a tertiary medical center with three consulting specialist, a fellow, a resident and four medical students at his bedside.What we, the medical students, the resident, the fellow and even the attending hospital physicians did not realize is that we would never know John Smith as well as the LMD. We would never speak to his wife using her first name. We would never be able to recall the names of all his children and know where they were in the world. We would never remember his favorite hobby let alone joke with him about it. Nor would we shed a heart felt tear when we gave him the diagnosis of the aggressive small cell carcinoma of the lung that had landed him in our midst and would kill him in less than three months despite our aggressive treatment that was the best medical science has to offer.At that point in my life I was very proud to be even the lowest ranking person on the team that was on the cutting edge of the diagnosis and the treatment of the gravest of conditions that plagued mankind. I felt so very lucky that I was being initiated in to this sacred fraternity. That I would soon be able to write "MD" after my name. I am still proud of my vocation yet I believe there is a wisdom that has only come with those twenty-years of practice.Today I realize what people want most of their physician is that he or she is someone who cares.Yes, we all want "everything medical science has to offer." Yet, what most of patients need is someone who will listen with their heart as well as with their head. Physician eyes are important, not only for seeing signs of disease in the body but for making contact with the patient's eyes where we are often allowed to see into their soul. All of the technology in the world will not replace a warm clasp of the hand or sitting at the bedside to share a few moments of the day along with the test results.So, I have created this blog. In large part it is a place for me to put my feelings. My hope is that at least some of these posts will resonate with others out there. Not just physicians, but others in caregiving vocations and even those for whom we care. If we are not here for each other then why are we here?
1 comment:
You are in ministry. Period. No other way to look at it. :)
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