by Dianna M. Burns-Banks, MD
"When life circumstances force us as physicians to confront out limitations, we must do - at a minimum - what we ask our patients to do every day."
Patients frequently view their doctors as invincible, and physicians often fail to admit – even to themselves – that they too are susceptible to the routine frailties that victimize their patients.
Sick leave, 8-hour days and leisure lunches generally are not a part of the benefit package for the average practicing physician. Emotional and physical stress is such an integral component of the physician’s day that it is considered part of the norm rather than the exception.
In the course of a day, many physicians must manage morning hospital rounds, see patients in the office, provide appropriate chart documentation, stay current on treatment regimens, handle employee issues, deal with managed care companies, attend staff meetings and efficiently handle the “unexpected.” Success is the only standard that society tolerates for healthcare providers. Anything less is unacceptable and at times may be considered negligent.
The medical community quietly
permits the public to cast doctors
in super-human roles. Additionally, the medical profession’s unspoken code views imperfections and human frailties as failure to live up to expectations.
As I look back over my medical career, I remember very distinctly the first time I was confronted by my own “immortality.” In private practice only one year, I was energetic and focused. Despite the expectations of cynics, my partner and I were committed and determined that our practice would flourish on east side of San Antonio.
During that time, I began to notice some numbness in my hands. It got worse. It was not just my hands but my entire left side. Of course, being a pediatrician and therefore possessing minimal training in adult medicine, I immediately did a self-exam and came up with a diagnosis of Guillain-Barre Syndrome – an ascending paralysis with hyper-reflexia, and hyperkinesis. It was completely irrelevant that neither the history nor the progression of the illness supported the diagnosis.
Unwilling to accept the restrictions that my self-diagnosis would impose, I naturally deferred seeking any treatment because it was not the best time and I was too busy. An acute episode of paralysis forced me to seek emergency room treatment and evaluation by a neurologist, which yielded a diagnosis of probable multiple sclerosis.
I remember hearing only the diagnosis and nothing else.
My mind quickly reflected back to my anatomy class and the one specimen every medical student could identify – the sclerotic plaques in the brain of the patient with
multiple sclerosis.
The physician as the patient requires role reversal. The once dominant director of the play must now learn to follow directions, not only from his or her replacement but also from many other supporting cast members: the nurse, the respiratory therapists, X-ray technicians, even the phlebotomist. Uncertainty supplants the facade of omniscience and always being in control. The realization of illness also comes with fear of potential financial devastation and the possible loss of self-identity as a physician.
As much as we are champions for our patients, we must be just as active in advocating for our personal health. We stress compliance to our patients, we ask them for cooperation when we must repeat procedures, and we ask their understanding when we are unable to provide a definitive diagnosis.
We educate our patients on the importance of prevention, exercise, nutrition and support systems. When life circumstances force us as physicians to confront our limitations, we must do – at a minimum – what we ask our patients to do every day.
Our philosophy as physicians should be not to treat ourselves but to seek help, accept the opinion and follow the advice of our personal physician when we are sick.
As Hippocrates said, “A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses.”
