In my few years as a resident physician, I’ve denied myself sleep and food for my patients, neglected myself and my loved ones.
I aborted my pregnancies to be fully present for my patients and not hampered by fatigue beyond words, nausea with endless vomiting, or dangerous depression interfering with my daily 12 to 24 hour shifts. I ended my pregnancies to not miss work for prenatal appointments, labor, or delivering my baby to someone who had time to take care of them.
Many patients repaid me with a ‘thank you’, however some repaid me with lies and manipulation, threatening suicide if I didn’t prescribe them controlled substances for inappropriate reasons like ‘it’s the holidays’ or ‘I only ask this one favor’.
My patients have shaken fists at me, shouted and sworn at me, told me it would be my fault if their electricity went out because they didn’t pay the bill and it was my job to write a letter of medical necessity and fax it to the electric company ASAP, despite no explanation for the delinquent bill other than their slovenliness. They addressed me by my first name only, insulted me directly and indirectly. I write in the past tense in hopes that this will end, but it is ongoing.
I received a malpractice lawsuit from a patient I never met but on whose chart I placed an essential order while my colleague delivered news of intrauterine demise at bedside, as I hoped to be helpful during a time of need.
I’ve heard it said that no good deed goes unpunished.
Some patients feigned crises or falls in protest of not getting exactly what they wanted when they wanted it, regardless of what their physician knew was in their best interest; knowledge garnered through long years of hard knock training.
Despite all the sacrifice and ongoing mistreatment, I care for my patients deeply. We are a sort of surrogate family for each other, and as dysfunctional and volatile as my nuclear family. My patients are the people I call when I should be having lunch or dinner, when I might otherwise have had an opportunity to contact friends or family, when I could have nursed my baby if I had had the courage to prioritize my pregnancy over the expectations of my patients, colleagues and bosses.
I’m a good team player to everyone but myself.
I have learned to realize when my emotions are mucking up my mental waters, learned to work around the ways that patients interfere with their own care by not showing up for appointments, not answering their phone, and talking so much blaming their doctors for their poor health that they are incapable of hearing information that may allow them to heal.
I’ve heart it said that when the student is ready, the teacher will appear.
Some days I consider trying to set a gentle boundary when my patient shouts ‘WHAT THE FUCK!?’ at me repeatedly and takes personal jabs at me, as they recreate the dynamic of my childhood where I learned to stay calm and quiet amidst the storm because my life depended on it. My stunted ego whimpers under their blows.
My body still believes that my safety depends on a lack of reactivity.
How hard to unlearn my sole understanding of how I can survive in the world. How difficult to rebuild the foundation on which I stand.
I’m still too scared to act in any way but a doormat.
I focus my energy not on teaching these adult children how to be respectful, but on being their physician. I share my diagnosis, give an explanation of their ailment with pathophysiology, and form a plan for their healing.
I too am healing, though it is not yet outwardly visible.
I am both strong and weak. Strong in my ability to tolerate other people’s bullshit. Weak in my ability to speak up for myself. I am afraid to make matters worse, to fan the fire and get burned with even more shouting, swearing, insults and potential violence.
In vain, I try to avoid getting chewed out, which despite my best efforts still occurs too frequently. I long to somehow eliminate toxic people from my life.
They trample on me, leave their muddy stains across my face, but I stay in place.
I have endured worse.
I hope it is true, about blessed are the meek. It is thankless sharing the Earth with ingrates.