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Vulnerable Healthcare Workers

It was the start of my third year of medical school. My first clinical rotation was on the inpatient psychiatry ward. I put on my white coat, filled my pockets with clinical guides, and donned my stethoscope. I recall feeling both excited and daunted.

At that time, it was the job of the student on the team to interview and examine new admissions before the resident and attending physician saw them. We students would then report our findings and write up a formal H&P, or history and physical exam.

During my first week, I was sent to interview a sixty-year-old male who was in the throes of a manic bipolar episode. The interview occurred in his room on the unit. His thoughts were disorganized and his speech was fast. About halfway through the H&P, he leaned in, grabbed my breasts, and said, “These are breasts just like my wife used to have.” He then pushed me down on the hospital bed—at which point my resident came into the room and pulled him off of me.

The resident finished the interview. After we left the room, he asked if I was OK. I said I was fine. I was embarrassed. This was not the kind of attention I wanted as a med student. I’d never heard of patients assaulting doctors or healthcare workers, and I assumed I must have done something wrong for this to occur.  

I tucked the experience into my subconscious and told myself it didn’t count as sexual assault because he was mentally ill. Life went on. I became a resident, then an attending in family medicine.

Last year, I was reminded of this event after learning of a hospital shooting in which a disgruntled patient killed a physician and three staff members. I thought about all the near-misses I’ve had with angry and psychotic patients over the past 20 years. I thought about the fact that we don’t have panic buttons in the hospital/clinic where I work, even though my family medicine colleagues and I provide the majority of the community’s mental health care. I thought about the fact that I always avoid wearing feminine clothing to work. I thought about the fact that our exam rooms tend to seat the patient between the doctor and the door. I thought about this event from my time in medical school and the ways in which my employers have left me vulnerable to harm. 

Jacqueline Redmer
Viroqua, Wisconsin

Comments

3 thoughts on “Vulnerable Healthcare Workers”

  1. Jacqueline, thank you for sharing these vulnerable, traumatic experiences and their impact. As you care for the trauma in others, please protect yourself and continue to heal in ways that resonate.

    Your last paragraph should seriously be used as a blueprint to redesign exam rooms!

  2. I was a psychologist dealing with seriously mentally ill patients for the bulk of my career and yes, too often, the patient between me and the door. You never know on a psychiatric unit when someone will blow. I was very lucky. I’m sorry you had to deal with that.

  3. Pamela Adelstein

    Jacqueline – I am so sorry you were assaulted. And that you endured the double trauma of needing to rationalize it away.
    In my clinic we are just getting panic buttons after a long while, we also are seated between a wall and the patient, and we also serve a vulnerable population – and patients’ tempers can flare, and many patients have mental illness and severe trauma in their histories. I am also a family doc.
    All those times we enter a room, close the door, alone with someone we never met, asking intimate questions – it is wildly precarious in concept.

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