Matt Freeman DNP, MPH
“Can I help you?” The receptionist rolled her eyes, hidden behind bullet-proof glass. “What is your problem? I can’t hear you!” she snapped. I offered by identification and insurance card. “I don’t need that,” she retorted. “Someone will help you later.”
The waiting room was covered with admonishments about not using mobile phones, commitments to “excellence in customer service,” and a bizarre poster about sleep apnea awareness.
A triage nurse eventually emerged. No pleasantries, no introductions. Instead, she just shamed me for not coming to the emergency department sooner.
I had the misfortune of suffering from an embarrassing and painful problem that was not improving with medication. (It did not involve a foreign body stuck into me, just in case that is where your mind was headed.)
After exchanging chat with another nurse about their boredom, I was escorted to an almost vacant emergency department. The staff were lounging; one brought her four small children with her.
Another nurse emerged without introduction. She offered similar shaming commentary. I did not reveal my profession, but I had the urge to say, “I’m here now; why shame me?” She fussed with a computer, not asking if I was in pain or cold (I was freezing and very much in pain.) She wandered off.
A chilly and detached physician emerged. He at least knew to introduce himself. With cold efficiency, I was filled with needles and chemicals.
Perhaps the overwhelming sense was feeling so cold. I was without clothes, without a pillow, on an oddly small gurney. The only clothing on me was a bar-coded bracelet. The door swung in and out to the public area, featuring little kids and a lot of loud discussions about food.
The frigidity did not instill confidence. I got the impression that I knew more than the physician did. But he did not seem to do anything absurd. I was prepared, however, to jump in at any moment.
Eventually, after drugs, an unpleasant medical procedure, and some observation, I was deemed stable enough to leave. Now, a few days later, I’m just sore and tired… hoping to vanish the memory to some sort of protective repression.
That afternoon, I went to work. I felt no benefit from sitting at home, and I wanted the distraction.
A young patient came in with an unpleasant and sensitive condition that required treatment with liquid nitrogen. I instinctively patted him on the back, saying “You didn’t do anything wrong. This is going to be okay, and I’m going to be with you the whole time.” I would periodically stop and ask how he was doing. It was not some overabundance of compassion; it was common sense.
I thought back to my education. I had fond memories of my emergency department rotations. My favorite attending physician and nurse were perfect role models. Even when a patient was in the midst of a heart attack, there was a certain casual but caring approach. “How are you doing over here?” How’s the pain? Can I get you anything?” Despite the gravity and urgency of the situation, the patient was still our guest.
There was also a certain automatic assumption of the emotional response to an emergency. I recall one attending physician saying, “I’m sure that this is anxiety-producing, but it’s not going to take too long.” His calm confidence reinforced a sense of stability and safety.
There are any number of books about doctors facing serious illnesses themselves. David Biro’s One Hundred Days: My Journey from Doctor to Patient is unforgettable. Kay Redfield Jamison’s The Unquiet Mind opened my eyes to bipolar disorder. Although I would not with a serious illness on anyone, there is boundless insight to be gained from professionals who have the experience of illness themselves. The absurdity, indignity, uncertainty, and fear are miserable for anyone; perhaps even more agonizing for those who are used to being on the other side of the examination table.
What can students and clinicians gain from the experience?
- The experience of being patient can be painful, immodest, and demeaning. It is so easy to forget that in clinical practice.
- Despite the many classes and assignments on clinical skills, patient rapport, and sensitivity, such attention disappears in the impersonal world of the hospital.
- Names are deeply meaningful. I certainly do not expect to be called “Dr. Freeman” as a patient, but I wished someone had used my first name. Instead, I was spoken about in the third person. One time I was called, “The gentleman.” It would have meant so much to use my name, just for a moment, to remind me that I am still a person, not naked on an uncomfortable and freezing cart.
- Although there are debates about the kindness versus barriers of touch between clinicians and patients, a handshake, a pat on the back, or—if necessary–a hug or hand holding—bring humanity and connection to an otherwise inhumane environment.
- Hospitals are not hotels, but it is not extraordinary to ask, “Can I get you anything?” I dreamt of asking for socks or a blanket, but I felt powerless… as if I would have been an entitled, squeaky wheel, treating the hospital “like a Holiday Inn” if asked for the simplest of comforts. The power dynamic is such that I was there as a body, not a person.
If anything, I hope that this week’s experience will make me even a more sensitive clinician and role model for students. Medical and nursing education can be fragmented, there can be eye-rolling about the so-called “touchy feely” aspects of patient care. In fact, sensitivity and dignity are integral parts of patient care.
For now, I hope to not be in the hospital (as a patient) for a long time.
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