Nov-Dec 2008 Table of Contents

THE LAST WORD

Learning From Troubled Patients



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Though we may sometimes be tempted to look down on troubled patients, they have much to teach us.

Fam Pract Manag. 2008 Nov-Dec;15(9):52.

Physicians who work at clinics for the underserved are sometimes pitied by their colleagues who ask, “Why would you want to work in a place like that?” The facilities – and pay – aren't always ideal, but those of us who practice in these settings know that we are actually a fortunate group of professionals.

On any given day, my patients' unique combination of personalities and stories make me pause and count my blessings as I care for their medical needs. Their lives are like oceans of trouble in which some drown, while others find enough strength to swim to shore. While we may be tempted to look down on them, I have come to admire their bravery and only wish I could be as strong when troubles as big as theirs strike me.

Let's start with John, a young man who was critically injured but survived a severe motor vehicle accident that killed his best friend. John continued to work in spite of severe back pain. He hadn't followed up with me for a while but came to see me one day because he needed more pain medication. He told me that he had moved about an hour away and had been using his wife's pain meds in the interim. My first thought was that he was probably a narcotic-dependant man with an addict wife and that both were likely sharing whatever drugs they could get from the different physicians in different cities, so I checked out their story. What shame it brought to me when I found out the truth: John's wife had meta-static cancer and was going for chemotherapy these days, in between caring for their five children, while he worked long hours to support the family.

And then there was Ann, a young woman with an infant in a stroller. She came in with cough and congestion, so I thought this would be a simple visit. Little did I know that she would disclose being an alcoholic and a recovering drug addict, but she was trying hard to turn her life around and take care of her child. I couldn't imagine what her pregnancy must have been like, and I could not bring myself to ask whether she had someone to help with the baby and support her – the usual questions I would ask as part of a social history. I would save that conversation for another day and, for now, simply offer my care and encouragement to this brave young woman.

I could go on and on with similar stories of patients who faced immense troubles but somehow persevered.

Those of us who serve this vulnerable community should realize how blessed we are not just in having what we have but in learning what we learn from our patients every day. They help us count our blessings, make us stronger in facing life's troubles and make us more humble, at least for a while. So, as we work at our clinics, let us take pride in the work we do, knowing we are rich in our experiences and lessons from our patients.

About the Author

Dr. Jain is a faculty associate at Lehigh Valley Hospital Family Medicine Residency Program in Allentown, Pa. Author disclosure: nothing to disclose.

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