Megan McCreery - Patient-centered Ethics: Pathography

Jul 16, 2022 at 03:54 pm by pj

I suppose after enough time we can all become jaded in our respective spaces. Monotony of dealing with certain circumstances, or types of patients, can change the way we perceive the circumstance, or patient, the subsequent times. In the Emergency Department (ED), waves of people crash through the doors daily. Some are memorable, some prove to be another notch in the belt. Some teach us something new, while others solidify skills we already have. An unfortunate side effect of working in the ED for extensive periods of time seems to be decreased empathy and understanding of the foundational concept that we are all fighting our own battles and are hoping others don’t notice our insecurities.

Psych patients especially seem to cause an almost in-unison “sigh” to the nurses and doctors of the ED. There is an overarching view that psych patients are difficult and troublemakers. Early on a Tuesday morning I entered the ED and saw her. She was 15 and baker acted. The nurses told me that nothing was wrong with her, and she just flicked them off and told them where to go. Obviously, this kind of behavior doesn’t encourage others to help you, but I still like the challenge of getting through to someone. In fact, I have discovered it is one of my greatest joys. The nurses had no information and just rolled their eyes at the task of caring for her until medically cleared to go to HBS. I slid the glass door open that she was intently watching me through. I could feel her attitude surround me in the air. I said hello and asked if I could pull up a chair and talk with her. Apprehensively, she agreed.

It was slow at first. She asked me why I cared and what any of our conversation would do with her care prior to going to HBS. I honestly told her likely nothing would matter. But I was an ear to listen and someone who genuinely hoped to learn at least one thing about her that I could carry with me as I train to become a psychiatrist. She barely let me have a glimpse of her smile. It was beautiful and drew me in. I gathered information regarding her necessary medical clearance, advised her on how to manage her chronic constipation of two years, and asked her about her life at home. Her demeanor changed. Her family is in turmoil. Her brother is having his first schizophrenic break. Her parents are separated. And she admits to knowing she has anger issues that she doesn’t know how to deal with. We dove a bit further and discussed possible treatment options after her stay at HBS.

She was medically cleared and was being escorted out of the hospital by the police officer. As she turned the final corner, she looked back at me, gave a soft smile, mouthed “thank you” and waved good-bye. Not necessarily a life-changing day for either of us, but I hope our interaction made a positive impact on her life. For me, it was another lesson in being an empathetic human being. It reminded me that she has struggles too and needs support, even with her unresolved anger issued. It was another experience that reminded me of my life-motto, words of my grandfather, “If you can be a sport for a nickel, be a sport.” It means that whenever you can do or say something to someone, or just go slightly out of your way to make a positive impact on someone’s life: Do it. Share a smile, a compliment, a listening ear, a meal. Attempt to make another’s day better, even if it is just for a moment.