One More Quotation

On the heels of a post with humorous (and often concerning) quotes from throughout the year, I wanted to add one last statement that really made an impression on me. Obviously the core clinical clerkships are not all fun and games. As many of our preceptors say, the third year of medical school is probably the time in our lives when the greatest amount of learning happens. Perhaps even more than as an intern in residency, this year encompasses a vast expanse of knowledge that we are expected to acquire. Thus, it is important for me to reflect also on some of the other lessons learned since last July.

There were many sage words spoken by the great physicians we worked with, but we only remember about 5% of what we learn throughout the day (and I probably am remembering that quote incorrectly as well - and 47% of all statistics are made up on the spot). So, as I look back, there is one specific piece of advise that I will hold onto for the rest of my career. During one of our psychiatry didactics, we were discussing suicide and patients with suicide risk. One of my cohorts stated that (s)he was greatly worried about a patient because, even though there was no reason to commit the patient to inpatient therapy, (s)he was concerned that this patient might end their life. This is a sentiment I have often referred to in this blog, one of helplessness. It is something we have all felt throughout the year, but with suicide, the stakes are often higher. Our preceptor acknowledged this concern, but also tried to add some perspective...

"My goal as a provider is not to make sure that no one commits suicide."

This really struck me as a unique way of looking at our roles as clinicians. For me, it helps contain the feeling of helplessness that many of us hold. I can't go to a patient's house and make sure she takes her blood pressure medicine. I can't make my patients exercise. And, I can't hold a patient down and make sure he doesn't harm himself. This statement addresses one of the fallacies of the goals of medicine. We often think we should be able to "fix" everything and everyone, but in reality, that's not our job. Our job is not to make sure that no one commits suicide; our job is to try to make each day in the lives of our patients a little bit better. Whether that means prescribing an SSRI, taking out a gallbladder, or even by just sitting and listening. Sometimes we can prevent a suicide from occurring. Sometimes we can't.

Now this may not be the lesson that our preceptor was attempting to provide, but I think priorities are very important in the medical profession. Understanding one's goals, and accepting one's limitations is imperative. We are all human, and we are all going to make mistakes. We are going to succeed, and we are going to fail. However, we must define "failure." Success and failure are not about how many patients are cured and how many patients die. I'm not sure I know what those two terms mean in the context of medicine, but I'm sure I will experience both throughout my career. For now, I'll keep concentrating on each patient in each moment.

Did I make my patient's day better?