During my first uncertain steps towards becoming a physician, I unconsciously searched for role models and mentors to emulate. First, as a nursing assistant and later, as a medical student and trainee, I had plenty of opportunities to observe doctors in their natural habitat. It was not always pretty.
Once, during my days as a nursing assistant, an older physician came to the hospital Outpatient Department accompanied by a woman with a small facial cyst. “Lie down!” he growled. She looked worried, but complied. I didn’t notice any attempt at informed consent.
He glowered at me, “Get me a set of instruments.” I got out what he would need and began to wash up her forehead. “Where’s the razor?” He shaved a wide swath well up into her hairline. “Gimme the local!” Without warning, he jabbed her several times, infiltrating the burning anesthetic into her forehead, completely oblivious to her discomfort.
He clumsily draped her head, leaving towels covering her mouth and nose. She tried to move the drapes so she could breathe. “Don’t touch that! It’s sterile!” he yelled. Her hand dropped submissively to her side.
As he made an incision, she withdrew. “Yeouch!” she cried. Blood dripped down the side of her scalp.
“Hold still!” he ordered. He made no attempt to add more anesthetic. Despite the small size of the cyst, the procedure took a painfully long while. After the cyst was removed, he placed a few thick, uneven sutures. “Don’t get it wet AT ALL for five days! Meet me here next week and I will take out the stitches!” I tried to clean up the blood, but she shot off of the bed and bolted for the door without saying a word. I doubt she came back.
Albert Schweitzer once noted, “Example is not the main thing in influencing others. It is the only thing.” I admit that at least a part of my career was heavily influenced by a cranky, old general practitioner on that day almost 35 years ago.
The following is feedback received for this blog:
Wow! I have always found talking to patients as a great way to distract them from the uncomfortable things we sometimes have to do to them (i.e. needle injections to place the local, etc).
- RL Bates
I encountered a doctor--and I use the word with a wince--who was like that, 20 years ago. Brought the needle tip to my eye, as I laid there, and fiercely demanded that I not blink. (I had a squamous-celled growth on the inside of my eyelid.) Thank you for learning from your own encounter not to ever be that kind of a doctor. Thank you for being a compassionate one.
- Alison Hyde