Caring for Family and Friends in the Medical Field
Today I got together with my uncle. We talked about a lot of things - my cousins, his recent travels, his cottage. And then we talked about his exercise habits, blood pressure, and other standard medical screening questions. Yes, he was in my office for a physical.
Oddly, I read an article in a medical journal just a couple days ago outlining why doctors should not care for friends and family. The "Facebook Revolution" has again brought to light the relationship between personal and professional - this time in regards to medicine. The consensus is, "don't go there." Honestly, I used to lean this way, but the more seasoned I have become in my profession, the more I've changed my opinion.
Bringing It Home
I remember exactly when my views began to change. It was 10 years ago last month. I visited my grandmother in the hospital after testing for some episodes of confusion had revealed a one-centimeter growth on the lining of her brain, just under the skull. It had all the appearances of something benign-- just make a window in the skull and pluck it out-- no big deal.
She was extremely healthy, in her ninth decade of life. She looked at me directly. I remember her gray-blue eyes and her words ask me outright as the medical professional in the family, "Do you think that I should I get this thing out?" I was honest and direct, "Yes I do." She went to surgery, ushering in one of the most painful chapters in my life.
During her post-operative course, she was mistakenly given her roommate's Lasix, a potent diuretic. I watched as the staff chased their tails hydrating her with IV fluids to prevent kidney damage and replaced the electrolytes leached out of her body by the Lasix. Later, her condition deteriorated further after an infection developed where the surgery was performed on her brain. Weeks later, we watched her take her last breath in a nursing home. The matriarch of our family was gone. Something meant to help had rendered harm.
Do you have a relative or friend who is a mechanic or a plumber? How about one who sells cars or is involved in some sort of retail? Wouldn't you call them if you needed some advice in their realm of specialty? Of course you would. The question of trust and "top shelf" treatment wouldn't even be an issue. In a world of medical errors, poor communication and a paucity of honest caring, people would tend toward desperation when faced with one of their most precious possessions - their health. I was forced to think this through when I had the first person in my circle of friends/family call, asking me to be their doctor.
This week, I also bumped into a former colleague of mine who has become disabled. She lamented how disappointing it has been to be on the other side of things. Further, she spends a significant amount of her time accompanying family and friends to their medical appointments to serve as an advocate and "medical interpreter," making sure that things get done, that they get done correctly, and that her loved ones understand what is being done and why. We further bemoaned that medical care, like a trek in a treacherous jungle fraught with pitfalls and dangers, should require a guide.
So, after crossing that line that doctors are cautioned about, I can say that it has been all good so far. I feel like I can be that guide and make sure that excellent care is given. While I do play advocate for my close family members, such as my parents or kids, I am too close to provide unbiased care personally. For those friends and family I do care for, an understanding exists that any sensitive issues can be taken up with my partners or a specialist. The social time where paths may cross has been respected to the utmost.
I understand that most doctors don't feel the way I do, but, for me, medicine is more than a job; it's a calling, and I am a doctor not only when I go to work, but during all other times of my life. It's not a switch that I can just shut off.
To sum it up, I don't necessarily agree that doctors should never care for friends or family. Maybe if the waters of medicine weren't so treacherous I would feel differently. This is a sad fact, but a fact nonetheless. It further hits home in the ways I treat my "typical" patients who often ask, "What would you tell me if I was your family?" Having experienced this a bit, I can readily transfer this level of care to all of my patients.