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The Conversation has Changed

This essay won Resident Category first place in our second annual essay contest “Healthy and Happy doctors provide better care: define barriers and solutions to physician wellness.”

What we need now is more than just a pill. Genomes have been sequenced. Immunotherapy and personalized medicine have arrived. Billions of dollars have been spent. Many sleepless hours have gone by, yet our clinicians and scientists have failed to solve the world’s problems. Perhaps, in part, this is because wellness cannot be quantified in the laboratory. Perhaps our ability to provide true, compassionate care has been hampered by the weight of our own knowledge. Perhaps what we need now is a reminder that we have the right to be happy regardless of our circumstances and that we are not alone.

It has been fifteen years since I left home to pursue my dreams. I have come to realize how much I left behind. The road has been long but amazing. It doesn’t matter how many grants I have submitted (with marginal success), or how many central lines I have put in. What matters most is that when I look into my patient’s eyes I see their desire to get better and to go home. They have all touched my life and made me realize how much I miss home. Unfortunately, neither they nor I can be fixed with the flick of a wrist and a prescription pad.

I am certainly more knowledgeable than when I left home, and that knowledge has undoubtedly helped many of my patients. I have also accepted that knowledge without prudence only goes so far. Often times my patients do not need to hear my meticulous differential and treatment plan. Rather, they need to hear that they are not alone. They need to hear that life going forward may be different, however, there is a path not only to recovery, but to happiness as well. They need to know that time spent with their loved ones, their favorite songs and their hobbies may be just as important as the tests that we run and medicines we administer. They need to understand that getting up is more important than falling down, that healing does not stop once the visit is over, and that wellness will require a communal effort.

Years have gone by and the squeak of my sneakers has not echoed through a gym, nor has my former garden seen much tilling or sowing. The free weights seem heavier now and my plants, they are a little more yellow than I recall. As the days go on and my residency training winds down I am able recall what it was like to be human. I have begun rediscovering the joys, and the hardships, of living a wholesome life. I have also come to understand that many of these hardships are in no way unfamiliar to my patients. I may not be recovering from a stroke, or sepsis, or motor vehicle trauma. I never once required IV antibiotics, chemotherapy or dialysis as a result of residency. Yet, I still feel as though I lost part of myself in that hospital. Ultimately, I have the joy of knowing that with a little work I will find myself again. I have the joy of going home, spending more time with my family and to investing in my own wellness.

I have learned to remind my patients of their right to celebrate a life well lived. Others I try to remind of their right to be happy, even if what makes them happy is killing them. Not everyone will change. Spending a little more time sharing stories with my patients and a little less time focusing on documentation has reminded me why I got into medicine. It has given me the chance to reflect on the many blessings in my life. It reminds me to enjoy hugs from my daughter, sloppy kisses from my dog, and quiet time alone with my wife. Realizing now how addicted I was to work, to perfection and to success reminds me of the power of addiction in the lives of my patients. Now that I see the light at the end of the tunnel I can turn my conversation with them toward happiness and the things in our lives that have made us feel true joy.

The conversation is different now. During my earlier years in training I hoped to educate patients as to the marvels of modern medicine. After several years at the bench and several more at the bedside I have realized how tremendously technology has outpaced modern society, and to some extent even modern physicians. Even if I could interpret a patient’s genotype in such a way to explain to them how that their genetic risk for diabetes is magnified by their sedentary lifestyle, could I convince them to lose weight? What if I take the time to get to know them and to understand what makes them happy? Could I motivate them to change their lives, to maintain and enhance their independence rather than just their A1c?

I have a lot yet to learn. That doesn’t mean I get to ignore the indications and contraindications of new pharmaceuticals that seem to roll out every day. I won’t stop reminding my patients of the many implications smoking has on their health. I will however continue to focus on wellbeing, and to address the emotional as well as physical (and perhaps even genetic) stumbling blocks we face in life. In doing so I will be reminded of the joys of health and independence that some of my patients have lost. I still need to face the challenge of getting back in shape and catching up on lost time with my family. I need to remind my patients of the importance of doing the same. In spite of the inevitable pillboxes in our futures I hope we never lose sight of the value of happiness and the knowledge that wellness cannot simply be measured in milligrams per deciliter.

About the Author
Dr. Simmons is a fourth year Internal Medicine-Pediatrics resident at the University of Kentucky.  He intends to pursue a career in academic medicine and has interests in clinical and translational research as well as medical education.



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