October 10, 2014

a walking meditation

     My last month was spent in the hospital enrolled in the clerkship dubbed "acting intern".  It is essentially supposed to have me perform as an intern, or first year resident, would.  Now I see why so many residents start to become less empathetic towards the patients.  Overworked, too much red tape, sleep deprived, hassles with the EMR, clashes between the rest of the people taking care of the patient, and did I mention overworked?  I began to imagine ways of fighting against this natural pull of the stream.  One method I developed was to check on my patients in the afternoon for just a few minutes (assuming we were not slammed with new admissions).  When prerounding at 0 dark thirty, your time is spent hurriedly trying to figure out how the patient did overnight and whether they responded to the adjustments in treatments implemented the day before.  Then you have to take all that information and type it into a coherent note for the attending before actual rounds.  Then the patient is often overwhelmed by the presence of the entire team when rounding.  Who would want to talk candidly when 5-6 people step into the room looming over you in the hospital bed?  I know I wouldn't.
     But when I stop by in the afternoon, there is no agenda.  I just sit down and briefly talk to them.  That's it.  Mostly I just ask how they're doing?  It doesn't take long but it does take effort, especially if that time could be spent taking a power nap.  But I've been amazed at how that 3-5 minute visit deepens the connection with the patient far beyond what I would have expected.  They trust me more and are far more willing to engage more in their own treatment.  And in return, I am one step further removed from becoming burned out and jaded. 

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