A Tale of Two Doctors
Imagine yourself in my shoes. Or rather, out of my shoes. I was out of my shoes. So in a hypothetical sense, you too, would not be wearing shoes. Not by choice, but by necessity, as I (hypothetical you) sat, cringing, in an emergency room with an ankle the size of the baseball that got me into this predicament. A faulty slide, or maybe a small attempt at malice on the part of the rival catcher, landed me in the hospital on May 31st, with a spirally fractured fibula and torn ligaments and bruised tendons; in layman’s terms, my ankle was broken.
I had never in my life been in such a position. I had never broken a toe or any other bone for that matter. This was new. More importantly, this was frightening. The thought of a two month recovery in the heat of the summer made it even moreso. And yes, of course, I objectively understand how inconsequential a broken ankle is in the grand scheme, but that does not take away from the fact that the last thing a fourteen year old boy wants is a broken ankle in the heat of the summer. However, this isn’t a story about sweaty crutches and truncated pool time. This isn’t a story about my broken ankle. This a story about the guys who fixed my broken ankle.
I’ll call the first doctor, Dr. A. Dr. A was big and jolly. All he needed was a beard and a few reindeer. He was a pediatric orthopedic surgeon with a penchant for storytelling, and took an incredible amount of care to ensure that I, his fourteen year old patient, knew what he was talking about. In the modern conversations about healthcare, the main concerns are almost always economic: efficiency and the integration of new technology. Yet, sitting with Dr. A, I couldn’t help but wonder why the human element of doctoring has taken a backseat to these concerns. I knew nothing about Dr. A’s technical prowess in the operating room. But I was thoroughly convinced that he cared about my recovery just as much as I did. And this meant the world to me as a young patient.
A lot of people have medical experiences that convince them that they need to be just like the doctor who treated them. But this tendency usually helps dictate a desired medical specialty, i.e., athletes who aspire to be orthopedic surgeons. I had, and still have, very little interest in orthopedics, but I know for a fact that I want to be just like Dr. A. By treating me with respect and ensuring that my concerns (and my mother’s concerns) were taken care of, I felt as though I was in good hands.
Unfortunately, Dr. A could not get around the fact that he was overbooked, and for a better outcome, he ensured us that it would be wise to let one of his partners actually perform the surgery. And so into the picture walked Dr. B. I didn’t meet Dr. B until the morning of my surgery but things went downhill very quickly. Clearly, there had been a miscommunication, but Dr. B was thoroughly convinced that I needed both a catheter and general anesthesia -- two very different, equally terrifying surgical interventions. Given my age and inexperience with surgery, these were two matters that we had explicitly discussed with Dr. A, who claimed that the surgery was simple enough to avoid general anesthesia and catheterization. Of course, I’d like to give Dr. B the benefit of the doubt. Maybe Dr. A wasn’t clear in his notes. Maybe we hadn’t been as clear as we should have been with Dr. A. And of course, anyone can make a mistake. Mistakes were not the issue. The issue was Dr. B felt the need to argue with my mother, as I sat, 85% exposed in my hospital gown, the morning of the biggest surgery I have ever had. All he had to do was check the chart, or quickly page Dr. A. And if he didn’t feel comfortable completing the surgery in the way it had been discussed, he could have made that clear as well. Dr. B’s immediate exasperation with our relatively simple request painted him in a very negative light. Again, this had nothing to do with his ability to fix my ankle. He did a great job with that. But by failing to gain my trust as a patient, Dr. B drastically impacted my medical experience, and was a distinct blip on the radar of an otherwise positive recovery.
In retrospect, it is clear to me that situations like this are very difficult for doctors. Patients do, at times, have outrageous requests, or make claims and promises that are false. But from my perspective as the patient, the doctor who was about to place a piece of titanium inside my body came across as rude, unmoving, and generally unkind. But then again, how important is doctor behavior, and the relationship between the physician and the patient? My negative memories may persist, but so does the metal plate that has allowed me to regain full use of my ankle. Should society care about how patients feel emotionally, provided that they do recover physically? And where is the line between physical and emotional well-being? I clearly do not have the answers. I’m just asking you to take a walk out of my shoes, and think about it.