When “Patient Care First” Means Doctor Care First

When “Patient Care First” Means Doctor Care First

Adetokunbo Oluwasanjo, MD

Jun 09, 2017

After a 5-hour infusion I walked back to my car.

There was a good chance, my hematologist had teased, that in a few weeks I would feel like Super Woman—or more like Iron Woman, if she existed. With an almost nil ferritin level and fatigue on the brink of exhaustion, I finally took the advice I had given many of my patients: “When oral iron fails, it might be time to consider intravenous iron.” So I got scheduled to have an iron infusion at the hospital’s cancer center. I had a strange feeling of accomplishment leaving the hospital that day.

I had taken time to care for myself.

I was feeling real good. After almost 2 years of struggling with fatigue to the point where I sometimes thought I couldn’t take the next breath, I had made it to my appointment.

My primary care physician had chalked the fatigue up to residency (aka some sleep deprivation) and mum-with-a-toddler (aka major sleep deprivation). I had to be my own advocate and ask we check a TSH and do iron studies… Turned out it was iron deficiency anemia.

So yeah, I was feeling real good. Real proud of the fact that I finally had enough insight to agree that my life was worth just as much as my patients’ and I deserved care too.

As I got closer to my car, an orange note under my wiper caught my eye.

I cannot recall the exact words, but having a physician tag on my windshield, I had gotten a stern reminder that patients were important… this was their parking lot… I was to be considerate and use the physicians’ parking next time… something to that effect. It was something along the lines of, “Out of respect to our patients, we ask you not park here…”

The thing was, though, that day, I was a patient. The patient.

What, years ago, I might have chuckled at, today, really irritated me. I had to stop to think about why it really bothered me.

I thought of a dear friend with a hematologic condition, who, in spite of being sick for 2 days, did not seek medical care because there was no one to cover him in the clinic where he worked. He passed away from acute complications 4 days later and the work still got done.

I thought of my colleague, who was told she needed a 30-day notice to take 1 day off when she needed to see her rheumatologist for a condition involving her wrist.

I thought about a colleague who confided in me after being out for a heart attack that he let his chest pain go on for longer than he should have before he addressed it.

I think of articles I’ve read, stuff on the news—physician wellness, physician suicide, physician dies…

While I realize that physicians may sometimes inappropriately take up patients’ parking spaces, that day, I had picked the right spot.

I did not blame the person who did their job by giving me a ticket. I guess I was expected to remove my ‘PH’ tag before parking in the patient lot. My anger deescalated into reflection.

I guess what I really wanted was to be treated like the next patient.

Notes like that tell me I don’t belong here, with the patients. Instead, I belong in a white coat, straddled to a piece of rubber tubing listening to heartbeats with no concerns for my own. Notes like that remind me that I am one, not the other—a doctor, period.

But life has taught me different, so I choose to think different.

My health is important, just as my job is important. And it is so okay to be a doctor and a patient at the same time.

I wanted to erase the assumption that as a physician I was invincible. To let the parking monitor know that just like the patients I care for daily, I am human.

I bleed too. My health matters too. And that I belong here.

I wanted to let my patients know that I need to be well in order to take care of them.

That day I felt like telling someone, “Hey! Guess what! I am a patient!”

They say things happen for a reason and I’m so glad I learned this before diving head first into the throes of fellowship. As the days got longer and the nights shorter, with a seemingly endless commute and a 6-year-old to keep up with, I found my screws coming undone.

So I knew just what to do. I had to be a voice for my own soul.

I took off the mask of invincibility and shared with a safe faculty member, who helped me navigate finding a new family doctor in a new city, getting labs done amidst a busy schedule.

This time it wasn’t my iron, though; I was just in need of a few more hours of sleep each night and some self-directed health maintenance… plain old self-care. After a couple deep tissue massages and a revamped, more manageable childcare schedule, I could see the sun again and was ready to take care of my patients and my training.

This will happen again, to me, to you. Where we feel overbaked, fried, burnt to a crisp. Truly burnt out. Remember, in that moment, it’s patient care first. Yes, it’s all about the patient.

And this time, that patient is you.

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