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.

1 comment:

J. Samuel Thomas said...

Congratulations, brother!