Page 182 – Pulse

A Doctor Confesses: I Screwed Up

Marc D. Wager

When I was in medical school, more than thirty years ago, I felt I received pretty good training on how to communicate clearly and effectively with patients and families. I even remember the name of the fictitious character we had to practice telling about his wife’s demise: “Mr. Gottrocks, I’m afraid that your wife has taken a turn for the worse; I think you should come to the ICU right now.” As a pediatrician, more recently, I’ve been trained to discuss vaccines in a nonjudgmental way with parents who, contrary to my wishes, decide not to vaccinate their children.

Despite all of this training, though, and despite many articles on the merits of doctors admitting their wrongdoing, nobody ever taught me how to say, “I’m sorry, I think I screwed up.”

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Friendships Across Barriers

Leave a Comment / Across Borders and Cultures / Lindsey Johnson

At my university I am involved with a program (OMA, or Opening Minds Through Art) that has exposed me to men and woman who have inspired and empowered me. Many have become my friends. The catch is, these people happen to be four times my age and have been diagnosed with different stages of dementia.

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Expectations

Leave a Comment / Stress and Burnout / Annamarie Nocera

Before the start of every school year, from the time I was nine up through middle school, I would make the same school-year resolution: to become shy.

I have always been too enthusiastic. Out of all my classmates, I sang the loudest at birthdays, I laughed the longest at jokes and I asked more questions than anyone else. In fifth grade, a firefighter visited my class; after I’d asked my third question about how fire suits actually work, I remember hearing some classmates groan and seeing my friend Thom lift his arms up and, in mock agony, flop down on his desk. I tried to be shy, really. I would go for a few days sitting on my hands during lessons, but, inevitably exhausted by my inauthenticity, I would soon find my excitement uncontainable once more.

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Choices

Leave a Comment / Stress and Burnout / Mary Grace Heyrosa

My current life as a locum tenens–a doctor who travels around to fill in for vacationing or ill physicians–is lonely. I spend endless days in hotel rooms, away from my family. But I chose this existence as an antidote to the professional exhaustion that threatened to end my surgical career. Regular panic attacks, maladaptive coping behaviors and compassion fatigue had turned me into a person I did not like or recognize.

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Reverse Burnout

Leave a Comment / Stress and Burnout / David Coulter

I have a long commute to the hospital where I work. I’ve been doing this for a long time and have thought about retirement. So when I’m stuck on the turnpike in morning rush-hour traffic, when it takes me 60 to 90 minutes to get in to work, I often say to myslf, “Why am I doing this? Why not just quit, retire and enjoy life at home? I don’t need this aggravation.”

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A May-December Friendship

20 Comments / Stories / Hanan Rimawi

Hanan Rimawi

Ms. Connie was known, to her delight, as the Jackie Kennedy of Our Sanctuary nursing home. A tall, eighty-something woman who tucked splashy flowers into her voluminous curls, she’d strike up a conversation with anyone she encountered.

These chats were never a half-hearted “How are you?” tossed off before zipping away in her wheelchair. She’d ask an aide if her ailing daughter was feeling better, or check whether the receptionist’s son had heard from his dream college–“I’m keeping my fingers crossed for him!”

Ms. Connie shared a suite with Ms. Alice, a woman who was in her nineties. Ms. Alice was more reserved, but equally good-natured. Morning and evening, you’d find her sitting in her room, absorbed in a book. Despite their contrasting personalities, the two were close friends.

We met when I was fourteen, two years after I’d started volunteering at Our Sanctuary.

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Building Site

Leave a Comment / visuals / Justin Sanders

Justin Sanders

About the artist:

Justin Sanders is a palliative-care physician in Boston. From today, he is the former visuals editor of Pulse. “I’m going to miss this job, and miss combing through the wonderful images sent by our readers. Fortunately, I have lots to keep my hands full, including a new baby.” He still loves reading the New Yorker and cooking pizza at home.

About the artwork:

“With the arrival last week of a second child, the corralling of the first, the pressures of building a career, and my ambivalence about passing on the responsibilities of editing this wonderful part of Pulse, it was helpful to come across this scene. Despite the seeming chaos of building a life, of saying hello to new things and goodbye to others, it’s helpful to remember that life goes one way: forward.”

Visuals editor:

Sara Kohrt

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My Puzzled Self

Leave a Comment / Stress and Burnout / Donna Doyle

“It is no measure of health to be well-adjusted to a profoundly sick society.” -Jiddu Krishnamurti

How many times have I tried to begin writing about my experience of stress and burnout?

I’ve lost count.

Each time I begin to write, detachment renders me into pieces like a jigsaw puzzle. Where are the straight edges? Where is the frame? What is supposed to be where all of these empty spaces are? Where is the box lid with a picture to guide me?

A few years ago the medical library where I had worked for six years relocated from a building outside the hospital to a space inside the busiest area of a busy hospital. Prior to the relocation, I rarely entered the hospital or did so only when my energy felt sufficient to handle whatever I might see, hear or smell. It helped that I worked an evening schedule. After 5:00 p.m. the hospital was almost unpopulated.

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The First

Leave a Comment / Crying / Teresa VanCauwenberg

I have wanted to work in geriatrics, specifically with people with dementia, since I was in high school. Over the past year, I have been able to volunteer with a program called Opening Minds Through Art (OMA). I have worked at the same site as both a volunteer and a leader and therefore have gotten to know many elders on a personal level.

A woman I volunteered with and hold most dear had a twin sister. Recently, during one of our sessions, I found out that her sister was headed for hospice; the next day, she began the active stages of dying.

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Care in Airplane Mode

Leave a Comment / Across Borders and Cultures / William Sperduto

Airplane mode disables me from using Wi-Fi and enables me to provide distraction-free care to the patients in front of me. Truly disconnecting is difficult, but being in rural Honduras allows me to switch my phone settings with ease. My otoscope and ophthalmoscope cannot see texts and emails. My stethoscope cannot hear incoming calls. My hands cannot feel my IPhone screen. I am in tune with my body, my senses and my patient.

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Confessions of a Recovering Insurance Addict

Leave a Comment / Stress and Burnout / Brian Forrest

When I hear other physicians talk about burnout, I often feel a little guilty. Sometimes I sit in meetings of physician associations where they are discussing ways to help physicians deal with the stress of the job and the increasingly complicated demands for documentation and billing. I think to myself, “Don’t physicians always talk about prevention being better than treatment?” Yet most of what I hear about are measures to deal with the aftermath of burnout.

Seventeen years ago, I was in an environment seeing thirty patients per day, spending more time on documentation than patient care, and longing to focus on just spending time with my patients. I hated the rushed appointments, the endless coding and the administrative burdens. I interviewed practice managers, read a lot of practice managment magazines, and interviewed a lot of physicians. One thing was clear: 99% of the frustrations came from filing insurance.

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Weary and Wishful

Leave a Comment / Stress and Burnout / Ronna L. Edelstein

I was living just two blocks away from my parents, but I spent more time at their condo than I did at my apartment. I shopped for them and cooked, cleaned, and did laundry for them. I took them to appointments. I tried to help them lead lives of quality. Every night I went home feeling tired–after all, I was in my sixties–but also feeling glad that I could support them after all the years they had supported me.

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