Irony

One of the great ironies of medicine, from paramedicine on up, is this: even if you're a great doctor, if you're an asshole you'll get sued, but you can be a crappy doctor as long as you're nice to patients, and they won't sue you.

Following that irony, I received my first patient letter yesterday from a very nice young lady in her mid-twenties who's been chronically ill since she was a toddler. She's one of the calcifying patients I mentioned in an earlier post. In her letter, she said she's had lots of experience with doctors, but I stood out as someone who was so kind to her and her family. She's had all sorts of expert care and I know the least amount of medicine on my team of course, but it was simply that I sat down at her bedside and talked with her and her mother for about 20 minutes that must have made all the difference. Maybe it was also because I said, "Hi XXX" and addressed her by name whenever my team visited her, who knows? I certainly didn't do anything superhuman.

I was actually very inclined to be nice to her because I had met her before my internal medicine rotation began. She didn't remember me, but as part of a different rotation two months ago, my group was assigned to fan out around the hospital to look for patients with interesting physical findings. One of them was her, on her prior admission. About eight of us crammed into her small room, checking out her body parts, himming and hawing, staring, talking about her, but she was very gracious and talked about her disease course with us, let us poke and prod, and answered our questions thoroughly. At the time I kind of thought it a little distasteful that we were marching in huge groups into patients' rooms to stare at them, even if UCI is a teaching hospital. So when I discovered that she had come back and was assigned to my team, I guess I wanted to make amends, or at least show appreciation. I never told her directly why I was being so nice, so I feel a little bad, like I tricked her. In any case, one day she asked the attending if she would be able to have a baby some day. He gave her a general positive answer, but somehow I got motivated later that night and found an article. It said that women with her condition should be monitored prenatally as high-risk, but that there was a good chance she would have a healthy pregnancy. When the attending gave her the article the next morning, she said that it was the best news ever. It took me only about an hour to research the article, and about 20 minutes of extra conversation to apparently make a big difference in her life.

As we discharged her, I wished her a happy fourth anniversary with her boyfriend. She had told me she wanted to be home by Monday so she could celebrate it with him. I hope she has a long and happy life with as many healthy children as she wants.