Wednesday, July 04, 2007

Seeing the World

Joya and I have packed our bags and we are off to see the world. We will be backpaking Europe while riding the rails for the next four weeks. I'll try to post some updates on where we are and what we are doing on Gridbook Notes when I am able to find affordable internet connections. I expect that the Gridbook Blog will be quiet for the next month, but hopefully afterwards I'll have some interesting thoughts inspired by different peoples and cultures to post here.

Tuesday, July 03, 2007

Leaving my Patients

When I finished my residency last week, I also left behind my panel of patients to other physicians who will care for them now. I am realizing it is actually my patients I will miss the most as I leave my residency behind. Three years ago I was terrified that a group of people would look to me as their doctor. I still see the doctor-patient relationship as one of the most solemn of responsibilities I will bear in my life. In some ways I feel closer to many of my patients than I do to people I have known for decades. The physician-patient relationship can lead to a level of human connection rare among today's interactions. Many of my patients have been with me for my entire 3 years in Kingsport. I often went home still carrying them in my mind. I rejoiced in their joys, recoveries, successes, and good news from their lives, and I bear the sorrow of their deaths, pain, failures, depressions. Strangely some of the people I was never able to “make better” by any objective standards were often the ones who said I was their favorite doctor, and some the ones that were my best medical successes didn't like me much. In the end, I think I learned more about being a physician from my patients than I ever did from my teachers.

But in the end the doctor-patient relationship is a business connection and not a friendship. I am hired by patients as a consultant on issues of their health. Glenda, the psychologist at our practice, pointed out that I was often emotionally over-invested in my patients. She is right and in many ways leaving the practice is probably good for me. On the other hand, patients do sometimes need a doctor who cares about them and knows them. Family Physicians are particularly focused on knowing their patients as individuals and not just diseases. I am still working on finding that balance. In some ways I wonder if being a physician is oddly like being a prostitute, required to connect intimately with others in her business and then forget them and move on. It makes sense that a lot of doctors are emotionally hard or distant after caring for patients and then having them die (or just simply move on to another physician). I don't want to be distant to patients who need me, at the same time my emotional energy belongs to my wife, family, and friends. I suspect this will be a balance I seek to create for my whole career in medicine.

So now my patients are with new doctors, and I am in another state. I wish them all well.