Doctoring is serious work

This is a piece from last year that is kinda resonating today, so I'm gonna share it with you.  --PalMD

I've written before, I love my work. You really have to love medicine
to do it, because, contrary to popular belief, it's a lousy way to get
rich. I'm not starving or anything, but there are dozens of easier ways
to make a much better living...

I'm sitting here in my robe, drinking coffee, getting ready to go
out for a birthday party. I'm drinking coffee because at 2:38 a.m., the
E.R. called me to tell me a patient of mine was being admitted--to

"So, why are you calling me?" I asked groggily.

"I just wanted to let you know," the E.R. resident answered.

Most doctors recognize this phenomenon. We are often perceived as
sitting in a lucite box somewhere with a phone and a notepad, anxiously
awaiting calls, trivial or otherwise.

Last night a patient was furious that no one had gotten back to him
sooner about his sinus infection--a problem that his doctor has just
diagnosed and started treating. He wasn't better yet, and, well, it was
damned inconvenient.

Sorry, folks. Medicine isn't magic, and doctors aren't magicians.
Sure, we have decades of medical science to help us out, but c'mon! If
you have a cold, I don't have a secret cure that I'm holding back from
you. It takes 10-14 days to get better, unless you're lucky, in which
case it takes a week to a week-and-a-half.

But when you get a trivial call from a nurse in the middle of the
night ("Doctor, Mr. Smith is constipated and hasn't had a BM in 3
days." "Great, why do you want me to know this at 4 a.m.??") you don't
want to react harshly. It's better to have the nurses feel comfortable
calling you. I would hate to think the nurse was scared to call me when
my patient takes a turn for the worse.

So, as a doctor you walk a lot of fine lines. I'm a little tired
tonight from some trivial phone calls. The next one might be important.
That's why I'm not drinking at the party tonight. It's a job that
doesn't stop at the office door.

I've heard a lot of docs discourage their kids from going into
medicine, but I don't get it. Yes, it's hard, it's not always
financially lucrative, but I wouldn't trade it for the world. If my
daughter wants to do it, I'll weep with joy (hell, anytime she does
something I weep with joy).

Which brings me to one last point in my weekend blathering...

Medicine is very hard, very serious work--people's lives are in your
hands. So when I see "google experts" and others bloviating about the
latest woo, it really, really pisses me off. These are people's lives were dealing with here.
I spent 11 years training for this, and I'm constantly learning. If
that doesn't apply to you, then shut up--please. Your opinions on
vaccines, homeopathy, reiki, etc. are worthless.

Arrogant? You bet your ass it's arrogant. I've earned the right. All
the googling in the world won't earn you the right to publicly express
medical opinions.

/End of current rant.

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Now THIS I get. I'm NOT 11 years of training in, I'm three years of training in. It still is hard not to either laugh or cry when a patient comes in with a stack of printouts from their Wooctor of choice.
"So he says your energy field is off? And he diagnosed this over the internet? No I don't think that means we can take you off the clopidogrel, you still had a heart attack last week."

We are often perceived as sitting in a lucite box somewhere with a phone and a notepad, anxiously awaiting calls, trivial or otherwise.

Don't let him fool you: we are sitting in lucite boxes awaiting calls...except Orac, of course. He is a lucite box...I wonder if the 3 am constipation calls aren't sparked by patients who have been asleep all day now feeling wide awake and suddenly uncomfortably aware of their constipation. Arguably a patient who is feeling well enough to worry about constipation is doing reasonably well. It's still an annoying call though.

My father hated the 6am calls to tell him a terminally ill patient, expected to die, had died at 3am - the nurse was going off shift in another hour and "needed" to make the call rather than leaving it to someone else at a civilised hour. It was a pity that shift change time was around the best time to call.

I didn't become a doctor partly because my father worked too hard for too many hours and stressed himself too much (personality plus the challenges of specialist internal medicine including keeping up with everything)

> I spent 11 years training for this,
> and I'm constantly learning. If that
> doesn't apply to you, then shut
> up--please.

What a steaming pile of bs! I am NOT a medical doctor, but I am not going to silently listen to people tell dangerous lies and say nothing in response. If someone claims that eating a pile of arsenic is good, I am not going to bother asking around - I am going to tell that person how dumb an idea it is.

By anonymous (not verified) on 12 Mar 2009 #permalink

Sure, of course, but where would he get a pile of arsenic? what if you thought that it was in his vaccines?

If someone claims that eating a pile of arsenic is good,

Eating arsenic is bad under all circumstances that I know about, but under certain circumstances, injecting a carefully measured "pile" of arsenic into a person's veins can be good, life saving even. Specifically, a person with APL who has failed first line therapy might well have their life saved by a pile of arsenic being injected into their veins. Whatever "common sense" would have to say about that plan.

point -------------------->
anonymous' head

My point is not that sometimes dangerous things can be helpful, or that some specific amount can't be put to use. My point is that I am not going to let people lie about the health benefits of ingesting a few pounds of something toxic enough to kill. I think it is crazy to claim that only a medical doctor can respond to such nonsense.

By anonymous (not verified) on 14 Mar 2009 #permalink