Bedside Manners

On this rotation, I've learned a lot of medicine, procedures, and medical decision making, but one of the most salient lessons is one in bedside manners. On seeing us, chronic pain patients can have a lot of different, understandable emotions. As we struggle to get their symptoms under control and improve their function, they go through periods of frustration, anger, distress, despair, and anxiety. One of my attendings here was a real role-model for me because of the way he managed these tough emotional responses. His soft demeanor, his body language, the tone of his voice, his empathy, the way he listens, and his validation of the patient's symptoms all put the patient at ease, encouraged her to open up and share, and engaged her as part of the team. Equally importantly, he managed these visits efficiently; it's easy for a visit to take twice its scheduled time if the patient is crying, but somehow, he magically smoothed things along and kept everything going. He also did not yield on principles he felt strongly about. If the patient wanted more opiates but medically did not warrant it, he comforted, acknowledged, and took care of the patient without pulling out the prescription pad.

The beginning of anesthesia residency is about learning procedures: placing the IV, the arterial line, the endotracheal tube, the central line. But in a way, the clinical interaction with a frustrated, distressed, angry, upset, or suffering patient is an equally challenging procedure. There is a learning curve to this; it's not just about "being nice." I'm glad I was able to work with this attending because it taught me a lot about something I don't think about often.