The Really Difficult Patients

October 20, 2014 in Difficult Patients, LOOKBOOK, Residency Talk

For my entire short medical career I’ve worked with under-served populations. This presents a few challenges. I initially had difficulty with the typical “narcotic-seeking” patient. They can be threatening and manipulative, not surprisingly. But after many of these interactions, they’re no longer especially difficult or stressful. Sure, I don’t appreciate the conflict, but I don’t go home upset about it. The patient’s that I find incredibly difficult are… let me see how I can explain this.

 

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Many of my patients have close to nothing (or, well, nothing). Maybe they did drugs or alcohol, maybe they still do. Many are homeless. Some have recently been in jail or prison. A few of them have family or friends, but often times the relationships they have with others are less than ideal. So. A patient like this comes in with chief complaint X. You listen to them, encourage them to talk openly and support them instead of judge them (illegal activities and all). You work up their complaint and tell them what’s going on with their health. They seem reassured. Then, you tell them that you’re worried about them, want them to succeed, and want to support them in any way you can. Wow. You can’t believe their reactions. That’s when you realize how much it means to these patients to hear that someone cares about them (I don’t know how many people I make cry after saying this). Its so damn sad to know that sometimes, you’re the most encouraging, supportive person this patient has.

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Most of the time we’re too burnt out to be able to handle this extra emotion, as sad as it is. I’m stressed about the upcoming month of nights I have… burnout happens so quickly.

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Alright, well, back to work. Take care.