Wednesday, August 01, 2012

Treat the person

"Treat the person, not the disease..."
One of my medschool mentors always said that. It's easy to identify a person by his or her illness. After all, when you're seeing 15-20 patients, names are hard to remember. It's so much easier to think of this person as someone with an MI, or DKA, or pneumonia.
However, it's important to remember that ultimately, it is a person we are treating. Not some interesting case from the textbooks.
I had the unpleasant experience recently of being in the doctors' lounge recently just when some of the surgical residents were performing their sign-out.
The sign-out is a vital meeting, a short 5-10 minute event when one team updates the incoming shift of the patients they have on their list. Diagnoses, hospital course, plan of care, pending test results and such.
And yes, we are all aware of the stereotyping of surgeons, and while I disagree with the generalization, well, simply put, this episode made that stereotype seem classic.
The residents, doctors but trainee surgeons in their 1st to 5th year post-medical school, were discussing the cases as I sat in the area, looking up my patients' results. And what I overhead was a callous, cold discussion. They laughed at their patients' misery. About this person's impaction, or what a screwed up colon they had. Talked about them like cuts of meat. Complained about their pain needs, and made accusations that they were opiate-seekers. While using profanity. The men and the women in the group. Almost like they were trying to outdo each other.
It was rude. It was heartless. It was not fitting of doctors. It wasn't even fitting of a caring human being.
I was disgusted, especially at the thought that these were young doctors, training to be surgeons. While I was tempted to make a complaint to their program director, I did not. Perhaps I should have, but I didn't. After all, 'caring' is a subjective term, and one that may not be deemed too important by certain quarters.
But I did recognize one of the residents as a student I had years ago; I pulled her aside and suggested perhaps they should not be talking of patients like that.
Whether it's going to change anything, I highly doubt so.
But I do hope I never talk of my patients that way.