The Mommy Doctor

 

 

 

 

 

 

 

 

It's very strange when you are a pediatrician and taking care of your own sick child.  Last week, my daughter became pretty sick.  I'm convinced she had RSV, though never actually had it checked.  For three straight days, I listened to her wheeze and watched her breathe heavily and really fast.  I didn't sleep for 3 nights just because I was so worried about her breathing and whether or not she was getting enough oxygen into her body.  Part of me just wanted to take her in to see her pediatrician so I wouldn't have to worry about it any longer.  Or have to make the decision of whether or not she was too sick or not sick enough.  The other part of me kept thinking, "you know she's going to get better.  Just wait it out.  You're overreacting".  Then another part of me kept thinking "don't be THAT parent who keeps blowing off her child until she's so sick she end up in the ICU on a ventilator".  Three days of pure exhaustion, which just made the whole thing even harder.  So finally, at 3:30am on night #3, my daughter was breathing about 70x/ minute and wheezing constantly, despite repeated Albuterol treatments, I gave up and took her to the Emergency Room.  While I'm there, they gave her a dose of Ibuprofen for the fever that developed while we were there.  Of course, 20 minutes later, her fever is down, the breathing and wheezing have improved, and she's smiling and cooing.  So ER physician is giving me "How stupid are you to come here at 4am?" looks and explaining to me (in a very condescending manner) what are appropriate reasons to go to the ER, none of which my daughter happened to be exhibiting at that time.  I got so pissed off.  I explained to him that I am a pediatrician and am more than aware of when and why I should take my daughter to the ER, and would not have necessarily brought her in at 4am unless I thought there was a really good reason for it.  Then, with as much dignity as I could muster in my pajamas, I walked out.

 

I think all physicians should either become patients or deal with physicians while caring for a loved one.  It completely changes how you react to things.  It changes how you answer your patient's questions regarding their illness or their health.  It changes how you explain to your patient what is going on with them, or with their loved one.  It changes your honesty and how straight you are with your patients.  You understand, that when giving bad news, your patient didn't hear a word you said after the shock of diagnosis.  I have been a patient with a serious illness since I was 19 years old.  I had to deal with horrible and truly wonderful physicians.  But I did learn how to treat my patients.  With respect and dignity.  That's such a cliche they made a whole movie about it (The Doctor, which was an excellent movie, despite its cliche-ness).  However, it's hard to truly understand that concept unless you have personally gone though the experience of a disrespectful or callous physician. 

 

Anyway, my guess is that the ER physician has neither:

1.  been a patient himself

2.  nor is a parent.

 

Because the other experience that has made me a better physician is being a parent. 

 

And understanding what goes through a parent's mind at 4am while they watch their child try to breathe.

My husband and I have decided to make the move clear across the country to the West Coast.  We've been living in the Midwest our entire lives, and my husband couldn't find what he wanted here, we began looking all over.  It's a terrifying move.  We have two small children, a house full of crap we've managed to acquire, and a very strong Midwest mentality.  My husband has his job all lined up.  His future office is so cool.  His window will look out onto the water!

 

I have interviewed and verbally accepted a job as a pediatrician.  Not any adults at all.  I'm torn about this for multiple reasons:

1.  Although I know at heart I'm a pediatrician, I'm going to miss my adult patients.  I have really enjoy a lot of my patients because they are willing to work with me on improving their health.  And even when they're not, they've been honest about what they will and won't do (i.e. quit smoking)

*****side note:  I just got this absolutely disgusting poster that I have hung behind me where I sit to write the patients' notes and scripts.  It's got a woman standing (about life-like) and little cut-outs into her body that show the effects of smoking.  It's so gross and I've gotten tons of comments on it.  As a former smoker, I feel no guilt, nor any sympathy for smokers and think they should all quit .... especially if they have children.  *******

 

2.  I will not be working in a community care center again.  I'll be working with the neurotically insured.  Part of me is thrilled about this but part of me is feeling guilty.  There is such a huge population of people who require healthcare and are not getting adequate care.  I feel like I have made a pretty good difference in my patients' lives these past years, specifically because I treat my patients well.  I know there are not enough doctors who work with the underpriveleged populations so I'm not sure I should be turning my back. 

 

I guess the decision is not final, though I feel like it is.  There is a community health center about 20min away from where we'll be living that I can always join if I want to go back. 

 

 

Saw one of my favorite patients today.  Not because she's nice, or because she listens to me at all.  But she's so honest.  She's morbidly obese and refuses to even discuss losing weight.  We've gone over her weight and the connection with her knee pain (arthritis in her 30's), her uncontrolled diabetes, her hypertension.  We've discussed (no we haven't....I've just talked) ad nauseum about how much worse her health will get if she continues to gain weight, all the consequences of diabetes and high blood pressure.  I've described how the human body was not created to carry that much weight on its frame and how the arthritis in her knees and how her back pain will continue to trouble her.  Nothing works.  Like talking to a brick wall.  Except I know she's listening because when I finished, she smiles, tells me she doesn't care, and has no intention of changing her habits.  I've tried to get her in counseling to discuss depression, but again nothing.  She doesn't always smile when she tells me to "go to h-ll" regarding her weight.  Sometimes she's downright mean.  I've actually considered cutting her from my practice, citing a poor doctor-patient relationship, but what's the point.  I know she likes me, she continues to see me.  And all that will accomplish is more ER visits on her part.  So she continues to see me, I continue to tell her the errors of her ways, and she continues to ignore my advice.  So why do I like her?  Because there is some amount of freedom having a patient who is entirely comfortable and honest with her decisions to remain unhealthy.