As I sit home spending Christmas with my family this year, I look back on the past few years of my practicing medicine and realize how much of a luxury this is. While most jobs allow employees time off for particular holidays, health care is a profession where we are called on numerous occasions to sacrifice our time in order to care for others. Frequent are the calls we make to our loved ones letting them know that we have to miss a family gathering due to our schedules at the hospital. Many times have we had to reschedule lunches and dinners with friends due to a patient becoming unstable at the hospital. We make plans with people, but in our mind, each plan is with a large asterisk, a caveat that things may change suddenly if one of our patients requires extra care at a particular moment. At times, it can create a particular discomfort, a constant feeling that as much as we try to have control of our time, our time is not our own. It is not something that should surprise us; we signed up for a career where we are trained to handle emergencies that will take up our time at various moments.
But as much as health care providers are affected by this, I am realizing more that this concept of uncontrolled time also affects our patients. Most of our patients do not choose to come to the hospital, and they do not choose to have a particular illness occur at an inopportune time in their lives. Once they become hospitalized, they are at the whim of the hospital schedule. As they try to get comfortable sleeping in a hospital bed, they are awakened early in the morning for blood draws. Timing of their meals and medications may be different from what they are accustomed to. They try to have a moment of privacy in their rooms, only to have it interrupted by a group of physicians coming in to ask them how things are going. And sometimes, a particular diagnosis that they want delivered in a timely fashion may be delayed because it takes time to access all of the necessary information. This sensed lack of control can be frustrating to patients, and it is something we should keep in mind as we discuss their concerns.
As long as emergencies exist, time will be interrupted, and both patients and doctors will be at the whim of uncontrolled time. By its nature, an emergency occurs unexpectedly, causing a substantial deviation from the planned course of a day. But rather than lament the fact that another portion of our planned time is taken away, it is important to enter into the new time created with those moments. Though it is not something that many of us would be willing to choose once it becomes a reality, there is little that can be done to change the circumstances. A realization has to occur that, for such a time as this, we have the capability to deliver care to a patient whose time has also been interrupted, care that could potentially change their lives for the better. The more this realization is made and successfully carried out, the more likely that patients and health care providers will grow to appreciate the time they have and to make the most of it, since we do not know when next we will be reminded that at times, our time is not our own.
Chiduzie Madubata is an internal medicine physician.
