If my book ever gets written it will be like this. I have my feet up waiting for a case to go to the operating room.
Maya Angelo has a quote I read recently which goes something like, "Never whine. Whining only lets the bullies know who you are." Reading this has given me new resolve to figure life out. Which you would think I would have done by now. After all I have been at this more than half a century. But then maybe I have spent too much time whining.
Taking this job I believed I could make better use of the down time. Yet, in over 4 months I have not gotten the hang of it. I have yet to sleep on the mornings when I am on call. This is the best time in my twenty four hour shift to do so but I am either simply not tired, as today, or I have too much left over stuff to do. I have written lecture notes and articles. I catch up on odds and ends. Anything I can do from a laptop computer and the telephone, I will do in those quieter hours of the morning.
Before I know it, the downtime is gone. I am in the ER or doing a C-section or some other procedure with one of the first year residents. Surgery with them takes twice as long as it would for me to do it myself. I remind myself this is normal and make a mental note to buy some support hose.
Well, it is time to go upstairs to the OR but this is what I should be doing with the down time.
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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?
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