People.

Today I learned what truly makes me love my job. People. People like Mr.H and Mrs.A, whom I saw in clinic today. On the flipside, there are people that make me feel the opposite about my profession.

“I’m going to be 83 soon and God hasn’t taken me yet, I guess he just doesn’t have room up there for me yet.” Said Mr. H, who has had his big share of medical problems in his long years including a brain tumor that was removed in open brain surgery.

Full of stories that could only come with years of life, Mr.H said, “After my brain surgery, there would be people that look at me on the streets, sometimes they don’t say anything but I know they are curious and want to ask me what happened to my head and why I have a the scar. I’d say to them, ‘my brain was too big and the doc had to take some out!’ ” Ha ha, I thought that was so funny. I wasn’t following up on his brain surgery today but rather his diabetes, hypertension, etc. He is what we call a very compliant patient, takes his meds and follows up with all his docs, and entertains the staff when he comes to visit the clinic, no less.

Another patient was a woman I first met in the ER and admitted to the hospital. She knew she had diabetes a year ago but decided not to get any treatment. In fact, she hasn’t seen a doctor in over a year. Her blood sugar in the ER was through the roof. We stabilized her and on her day of discharge I gave her my lecture on the importance of getting her diabetes managed by seeing a doctor regularly. “Since you don’t have a PCP (primary care physician), you can come to see me in the clinic.” I told her. As I said this, I hoped she would follow up, but with the population we see in the hospital, I knew it’s a slim chance. But today in clinic, I recognized her name immediately on the schedule. She proudly reported she’s been taking all the medicine I gave her and even came with a pen and notepad to jot down changes I made to her medicines. Mrs.A is on the reserved side and her expression is rather flat most of the time, but today I knew she cared about her health and was ready to do what’s right for herself.

Those two patients are bright examples of what makes me love my job. They take control of their own health and are in partnership with their doctors. When I encounter people like that, I don’t mind taking that extra step or coming early and stay late in the hospital for them. The patients are in the driver’s seat, I can only give them directions. It’s up to them to get themselves from point A to point B, where they should be. Sometimes, it’s that very point that makes medicine so hard and makes me wonder if I would have gone into medicine 8 years ago knowing what I know now. Take Mr. D.

Mr.D was the last patient that I admitted on a 32 hour call (from 8am on Sunday to 4pm on Monday). I haven’t had dinner, didn’t have breakfast the next morning, and of course no sleep. On top of that, I had all the nervousness of trying my hand at placing my first central line on a patient in the ICU that night. Before that, a patient of mine coded and after 40 minutes of CPR, drugs, and shocks, the patient expired. The whole family was there, crying and bawling, the chaplain came, we told them we did everything we could. It’s was a bad night. Then came Mr.D at 3am, a 40-something homeless cocaine abuser who had abused his heart all the way into failure. He was barely alert enough to answer my questions. I thought, “If it weren’t for you, mister, I would be getting a couple hours of much needed sleep right now instead of trying to talk to you.” I was genuinely miffed, but I took care of him the best my groggy brain and hands would allow me. What’s more upsetting is this fact: Mr. A, this relatively young guy who has no other health problems except for cocaine-induced heart failure gets hundreds of thousands of dollars in procedures and treatment, free, because he’s penniless and all the while another patient of mine who’s responsible and has a job doesn’t get the same life-saving heart catherization that Mr. D received all because she happens to work and makes a little too much to qualify for government assistance but not enough to pay for the procedure. She is saving up her money for a heart cath while Mr.D will likely go back on the street tomorrow and shoot cocaine and abuse his heart. Okay, it begs the question, where does Mr.D get his money for his drug habit?! Yes, this is the kind of system that I learned that our country has, the system that I work under. “Unfair” doesn’t seem to begin to cover it.

All in all, I choose to focus on lovely people like my two patients in the clinic. They show me that I am working 80-plus-hour weeks, sleep deprived, and bone-tired for good reasons. At least most of the time.