Urine Good Hands

For anyone going into a career in medicine, you can never escape, why medicine? To be fair, it’s a solid, more or less appropriate question. If you are going to dedicate years and years of your life, pouring blood, sweat, and tears into studying, late nights, and countless moments of self-doubt… you know what you signed up for.

Sounds kind of dreary, doesn’t it? Like I am ready to sell my soul. To be honest, if it came down to that, I probably would. This is a question I love to answer but at the same time, feel that oncoming dread and dead weight when it’s asked. Is there any better reason to go into medicine than to save lives and use your healing hands for the ultimate good of the people? To be the hero that everyone needs and loves? Well, duh. Seems like the “right” answer, but is it really that simple?

Maybe it is too obvious; medical schools seem to think so. Of course you want to help others, what else would you expect of a doctor? When I think about this loaded question, there is a lot to consider. What’s the recipe to make an exceptional doctor? The first words someone might say are: dedication, compassion, and selflessness. I never gave it much thought as a kid; my pediatrician was kind and just wanted to help me. I thought that was all it took.

When I turned 8 and starting experiencing more health problems and seeing multiple physicians at any one given time, I began to realize it might take a bit more than kindness and hard work to be the kind of doctor that can connect with their patient and give them the best healthcare.

I was seeing a doctor for an esophageal sphincter issue in my stomach. For those of you who aren’t familiar with anatomy, the esophageal sphincter, sits towards the upper opening of the stomach. It helps with controlling food entering the stomach and then keeping the digested food from coming back up. Mine, for some reason or another would not open and close properly and it became hard to keep food down any time I would eat. At the time, I was seeing this very kind, sweet woman who helped me understand why I needed to get more diagnostic tests and why I had to visit the hospital so much. She made me feel safe. I began to love her. She made every test I had to go through seem fun and not one bit scary. One day she told me that she would not see me for a couple months since she decided she was going to be a part of Doctors without Borders and treat patients free of charge. I was blown away. Someone could be that selfless? A wave of awe and inspiration swept over me. As an 8 yr. old kid, I firmly decided right then: I am going to be a doctor.

As one of the first moments of my life I can remember, I was inspired and knew I was destined to be great. This was the first time I found another component of what made a doctor great: selflessness. As the years go by, I have had physicians who were great and some who were not. Some physicians, even if they were so knowledgeable in their practice, I felt they were not the physician I wanted or who genuinely cared about me and my health.

I noticed more and more growing up, that unfortunately some physicians care more that they know more than you. This brings me back to a long, dreary, upsetting night junior year in high school, circa 2013. I was stuck on bed rest after having an angioplasty procedure on my kidneys. I have renal artery stenosis, a condition where my renal (kidney) artery was narrowed due to an abnormality in tissue/muscle growth (fibro-muscular dysplasia). The procedure was not an invasive one, however, sending a catheter up my thigh to my artery to blow up a balloon which widened the artery was rough on me. I was visited by the senior resident doctor; you could tell she was a more seasoned physician. She was not as finicky as the medical students and she had this cool, collected air about her. Mind you, I’ve already been poked and prodded for constant blood draws every half hour and I was exhausted. Coldly, with no emotion, just this dead stare, she asked me how I was. I told her the pain I was feeling and how it was farther away from the incision site; how it was so odd. She looked beside herself and claimed I didn’t know what I was talking about, like how could I? I didn’t go to school as long as she did and she supposedly knew everything that was right or wrong. My heart dropped. I felt discouraged. Hurt. Disregarded. Confused.

How could a physician tell me my pain was not real? That it was made up? Really? I’m pretty sure I felt that sharp pain in my lower back and hips. Give me that wellness chart, I’ll point straight to the pain scale at a 10, with that super unhappy face. Empathy. Understanding. That’s all I wanted and what any patient would ask for. This was another ingredient I could add to my growing list to become my ideal physician. Let’s recap! We want… a cup of dedication and hard work, a cup or two of compassion, and a generous dash of selflessness and empathy.

Skip a few years and at this point in time, I’ve been accepted to a great school, University of Washington Bothell, working towards a molecular biology degree while completing pre-requisites for medical school. Even with the bad experiences at the hospital that night, I still had the most drive of all my friends to keep going; despite all the difficult coursework (and the many more to go). Up until this point, all I could answer as to why I want to be a doctor is that I want to be a selfless, empathetic, compassionate individual who wanted to make a difference in the world and work diligently to save lives.

But present day me realizes my answer has yet again changed. It wasn’t that the ingredients to the perfect, exceptional doctor had changed, it was the realization of what I could do and what I was able to do with the medical degree once I received it.

It’s 2018 and by this time I have done an amazing internship with the COPE Health Scholar Program at Swedish Medical Center in Issaquah and a shadowing fellowship program with Atlantis Fellowships in Madrid, Spain. I was finally able to see the clinical side of things, from the physician and healthcare team perspective, rather than the patient perspective. I have seen some incredible procedures and at the same time, I was able to observe different healthcare systems and the true inner workings of a hospital.

Throughout my rotations at Swedish Issaquah, I learned standard hospital policies, and of course the different codes on the floor. Blue: Patient needs resuscitation. Amber: Missing child. Gray: Aggressive person. Red, orange, etc. What I was most fascinated about though, despite surgical and other medical procedures, was the interactions among staff and interactions between staff and the patient and their family.

There was a unique incident between a physician and their patient. This physician had two patients with Alzheimer’s and was rounding on these two patients in the ICU. I was passing by the patient’s room, doing rounds as well and logging vital signs for the entire floor when I heard something along the lines of, “You don’t know anything! I’m the one who’s the doctor, just listen to what I say. Let me do my job and fix you”. I was shocked, not only because that was unprofessional, it was way out of line. As a frequent patient myself and that one incident years ago, I felt the patient’s pain; their shock. I walked in a bit after, nodding to the patient and gave their hand a comforting squeeze. I did not have Alzheimer’s, but I can understand from a disabled person’s perspective. No two patients with the same condition will ever share the same exact experiences, whether it be medically or emotionally. Their pain, feelings, and experiences are real. No one is allowed to tell you your experience is unimportant.

What bothers me the most about this incident and healthcare in general is, “let me fix you”. For that patient and for myself with my renal condition, I have fully accepted that this condition is what I live with. My condition is not life-threatening and even if it came to be, I have come to terms with it. I am not a problem. Tell me how to cope with it and manage it day to day. It’s still astounding to me that physicians cannot and will not look past the medical chart. How are we as patients supposed to put trust in our healthcare team when all they see first is what’s on the chart? To see my condition and disability first without knowing me? If a patient cannot put their full trust in you to share every symptom and experience, no matter how phenomenal a physician you are, you will not be able to give the best care for your patient.