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When doctors get sick; it ain’t pretty

December 20, 2009

For healthcare professionals – especially doctors – it is challenging to be a good patient. As experts in health, we are sometimes considered to be role models for healthy living, so you’d think we would eat right, exercise as we recommend, see our own doctors regularly, and take medications always and only as prescribed. However, there are unique challenges for doctors to achieve health.We don’t always take care of ourselves, often feel guilty about taking time off to heal ourselves, and know too much about medicine.

1. We don’t take care of ourselves:

We work ridiculous hours, prioritizing paperwork over an after-clinic jog.  If I’m on call on Monday night, when I usually play hockey, I have to miss my game. But do I do something instead to make up for the missed exercise? No. Sometimes, it’s more convenient to eat that deep-friend-who-knows-what in the hospital cafeteria than  to plan ahead and pack a healthy lunch, even when you know better.

2. We don’t want to miss work:

If we are sick, we are reluctant to take a day off. Maybe it’s a sense of duty to care for our patients or maybe we have inflated egos and assume that the people depending on us will not make due without us. There’s also the fact that we will lose our fee-for-service income and some might reckon that our colleagues/staff/patients will think us less god-like if we bail out when it’s not a case of life or limb. I know. Sadistic. Doctors are – for lack of a more persuasive non-colloquialism -“hardcore.” What better job for type “A” OCDers? If we are contagious, our deep need to protect the vulnerable might persuade us to go home, but only after 7 nurses suggest that maybe it would be a good idea for the doctor to heal herself. I’m a little less self-destructive than the average doctor; with debilitating migraines on a regular basis, I’ve learned to make the sheepish call into the office when I just can’t shake one. There was a time when I tried to stay at work, but when a medical office assistant (MOA) told me  “you look, uhm . . . green,” I started trying to take better care of my nauseated, photophobic self.

3. For a doctor to see their doctor, it’s like… I don’t know what it’s like. I haven’t been for a while.

Whether we take that sick day when we are acutely ill or not, we are loathe to see our doctors. We might not even have made the time to locate and meet a GP. If we have one, we might have a difficult time deciding when it’s appropriate to see him, not wanting to waste his time with trivial things, but not wanting to ignore something that could become serious. One would hate to be suffering as in the Man Flu:

Self-diagnoses is impossible to avoid. There is a phenomenon in medical school, in which students diagnose themselves with all sorts of ailments as they read them. Tired, cold, weight gain? Must be hypothyroidism! (Okay, actually, many medical students are sleep deprived and gain weight from not having time to exercise or eating hospital cafeteria food). Medical-studentitis is common. It can make you feel pathetic, though the condition, also known as medical student syndrome, doesn’t fully meet diagnostic criteria for hypochondria.

My right big toe was numb for several days. As in a tale of Oliver Sacks, I found it distressing to have this thing attached to me that didn’t fully seem to belong to me. The sensation was bothersome, but so was the confusion as to why it had occurred. I figured it would go away but a tiny part of me (perhaps a big toe’s worth!) was genuinely worried. I only half-jokingly informed my friend whose house I was staying at – “if I die, tell them I had a numb toe” – and continued on with my day. I knew it was probably nothing. But what if it was Guillain-Barre? Ischemia? Oh, it was nothing.

There ware other times where we might think “ahhhhh, it’s nothing, it’ll go away; if it we my patient, I’d reassure them and send them straight home without passing Pharmacy or collecting $200 dollars worth of treatments.” If we simply suck it up every time, we might miss the occasion in which things are serious.

4. We use medical language when we talk to our doctors

A patient’s choice of words distinctly shapes the way we approach their problem. Often patients in the office will hand their doctor the diagnosis on a silver platter. “Gee doc, I’ve had this terrible chest pain. It’s exactly like before when I had my heart attack . . . ” but we can also be lead astray. “I’ve got gout” doesn’t necessarily mean that you have positively birifringent uric acid crystals collecting in your joint capsule; you might mean that you have a red, swollen, and painful toe. If I had pain in my chest with deep breathing, coughing, and movement, I’d tell my doctor “it’s pleuritic.” My vocabulary is already tainted with the flavour of diagnosis. If what I say is very narrow, it can close my physician’s mind to wider possibilities.

5. We might be afraid to share, or we might think we know better

I’ve written before about the difficulty of finding a doctor for doctors. In a smaller community, your GP is also your colleague. It’s hard to reveal things to your doctor if you have to pass him in the hallway every morning on rounds; to tell him something that might in another context make one feel stigmatized, it can be an impossible thing, unless you have complete trust in his ability to keep it confidential and to not allow it to affect how he treats you as a colleague. In some cases, doctors do like to share their experiences with being on the other side of the scalpel or stethoscope. But, even if we are good at sharing, we might not trust the opinion of our doctor, thinking that our own is more valuable or accurate in some way. It is difficult to let go sometimes, but to be healed

It’s a whole different story when it comes to caring for an ill doctor or being a doctor and having an ill family member. For a start, check out What Do You Do When Your Loved One is Ill.

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