They Didn’t Teach Me

They Didn’t Teach Me

Yesterday I finished seeing patients around 6 PM.  I brought up my charts to the front reception area and returned to my office for a quick re-appraisal.  I’m trying to move out items without making the place look like a space under construction.  

On Monday I took a big 1930s style floor standing radio home.  Yesterday, it was the Ficus.  My former partner, Ralph will be taking over my office space and would like to move in before the end of the year.

Tonight my wife is taking me out to a fancy restaurant.  This weekend will be my last on-call for Genesis. Sunday there will be a little get-together at Mesa Sabinka, a fancy tapas (not topless!) bar. Monday, there will be a reception at the office.

Monday and Tuesday will be my last patient contact days at Genesis.  Dozens of goodbyes.  It shocks me how long I have been seeing many of my patients.  Ten, twenty, thirty years.  I have treated them and at times their spouses and kids.  Thirty years!  It shocks me.

There seems to be a similar theme when they thank me and tell me how I helped them.  It surprises me because what meant most to my patients was something that I didn’t give them with actual thought.  

Yes, many thanked me for getting them on the right medicine or keeping them out of the hospital.  However, most thanked me for not judging them.  For listening to them.  For guiding them without controlling them.  For being there.  For returning their phone calls.  For caring about them.

My mind focused on symptoms, medications, side effects, drug interactions, psychodynamic interpretations.  I wanted to deliver a superior service.  They needed this from me, but what they needed more was a connection with someone who would accept them, not judge them or try to control them.  They came back when their insurance changed and had to pay out-of-pocket.  They came back when they moved out of state.  They came back for the connection.

I spent four years in medical school and four years in residency.  This was after college and grad school.  Fourteen years of formal education learning anatomy and physiology, biochemistry, pathology, psychopharmacology.  Each piece of knowledge integrated into the next.  Fourteen years… and the aspects of my care that were most significant to many of my patients was something that I was not taught in a single class.  Perhaps it should be.

How many of us need to feel heard, accepted, and understood?  How many of us feel ignored, rejected, and misunderstood? How little it takes to be compassionate and accepting.  Why is it that we do the opposite with those people who we care for?

It is likely that some of my patients would never have needed to see me if they had someone who listened to them in their life. Fourteen years of education, thirty years as a doctor.  Moving forward, leaving behind.  More lessons learned.

The radio and ficus are now in my telepsychiatry studio.