Friday, August 24, 2012

Everything does matter.


Everything does matter. 

Its funny, you start medical school thinking you are going to matter. That’s why we do it right – we want to matter in this world. We want to matter to our family who are so proud, to the patients, to the patients’ family. We think what we will do as a doctor will matter. How can it not?

Then throughout medical school, you are bombarded with cynicism, some deserved, some undeserved. Your idealism is seriously challenged, but most make it through, holding strong to those simple, quite normal values a layperson would have. Treat people well, be ethical, do your job.

You start work. You start complaining about how many patients you have to see, whether it is 3 at a poorly attended clinic, or a patient suffering from chest pain at 2am. The family members are a pain in the ass.

The glory of medicine, you realise, does not exist. By the time you are re-writing you 400th medication chart, prescribing lactulose or yet another goddamn discharge summary, you start to think- nothing you do really matters. So why be extra careful? Why put importance into a job where you are a mere paper pusher and your consultant makes all the calls. Nothing you do really matters.

No one notices your mistakes. That missed ECG finding – that patient was probably going to die anyway. Gave that patient his warfarin when he had an intracerebral bleed, but luckily nothing happened, so that doesn’t count as a mistake. Millions of excuses so that we are not made to feel guilty for our actions, whether they have consequences or not. Nothing you do really matters.

Suddenly you are resuscitating a patient. You are confused. She has been here a long time. You saw her every day. How did this happen? Im sure I did nothing wrong right? This isnt my fault? And the classic go-to consoler- “she had a poor prognosis” anyway. Poor prognosis only should console when the patient dies from her illness, not from something you have created by being careless.

Everything does matter. Watch your pen, its your greatest weapon. Watch your words, it can make or break the way a  patient or their family cope. Watch your knowledge, we all have gaps and we all forget. Watch your patient, she or he may be dying in front of you. Being a doctor may not be glorious, but it could be.   Everything does matter.