Point / Counterpoint II

This is a continuation of thoughts from yesterday's post. Despite all these changes that happen in training, I feel that I still make and try to make meaningful connections with my patients. Developing a solid patient-physician relationship is not only related to asking them about their hobbies, pets, and grandparents but also about having the confidence and reassuring presence of a doctor who will accompany someone through a challenging time of their life and make those hard decisions to get them through it. When I see a patient preoperatively, I spend only 10 minutes and my time is constrained by the surgeon's and operating room's desire to start promptly. But I hope that when I grasp a patient's hand as I place the IV, walk them through what to expect, and discuss their medical problems that I come across as warm, unhurried, knowledgeable, capable, and compassionate. I sit if I can. I make those 10 minutes count. And as I roll the patient back to the operating room, I try to get to know them. I want to know where they are from, what scares them about surgery, and what they hope to do once they're better.

Although I can do procedures without hesitating, it does not follow that I am not bothered by hurting someone. Perhaps it is being an anesthesiologist, but I believe there cannot be too much lidocaine (at least subdermally; plus, we can treat lidocaine toxicity if needed). Even in placing an IV, I don't want the patient to feel a thing and numb up the skin, something that doesn't happen in the emergency department or the wards. Pain can and should be treated and I hope I never become so callous as not to care.

And indeed, looking past residency, I find that attendings are able to get to know patients better. Whether because of more time flexibility or more comfort with the medical and technical aspects of anesthesia, they often engage patients in conversation, talk with the families, and really care for people. And outside of anesthesia, attendings develop long-term relationships that grow and flourish over time, a suggestion that we do not become more callous the longer we are in this field.