Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

I will go on treating patients, because that is what I know

Greg Smith, MD
Physician
July 21, 2016
Share
Tweet
Share

You’ve all heard it. Those ads about that wonderful product that will change your life. The new kind of mattress that will finally give you a good night’s sleep every night. The new electric car. The superfood. They go on about them for thirty seconds or a minute, you are enthralled, and you dream of going right out and purchasing. Ah, marketing, how powerful you are. How much we want to be swayed.

Then they say the last little bit. Very fast. Almost an afterthought. We hear it, but we don’t think about it.

Terms and conditions apply.

That new medication that will fix your aches and pains does seem wonderful, miraculous even, but it has its downsides. It happens to be toxic to your liver, even at therapeutic doses.

That relationship with the perfect guy seems like one you waited for your whole life. He’s handsome, rich, has a good job, and everybody loves him. You do too. The problem is, he drinks way too much, and when he does, he hits you.

The author you have always loved to read, the one who used to write just one more book because, in all honesty, he needed the money, the one whose bucolic, breezy salt in the air prose you craved, finally tried to get himself fit. He tried to eat right, exercise a little bit, and decrease his girth to fit the national standards. He was headed in the right direction when suddenly, quietly, the pain in his gut sent him to the doctor. Three weeks later, he was dead. Cancer is no fan of good fiction. “Healthy living will kill you,” he quipped, joking to the end.

The singer was only fifty-seven. A medical emergency, shadowed details. The end was the same. He left no spouse, no children, no living parents. His fortune will most likely  be in the hundreds of millions of dollars. He has songs that have not even been released yet. Someone will make the tough decisions for him. Someone will process the wealth, the leavings of life. Is that sad, really? Not for him. He has no need of gold any longer.

He sometimes knows who you are, but most days he doesn’t remember you any more. He is still reasonably healthy, loves to eat, to sneak sweet snacks like a little child. He can be irritable, irascible, demanding,  aggressive. She is getting tired, worn out by it all. You watch, you help. You love. It is a terrible, tragic, unnecessary disease, all the more difficult because of its slowness, its insidious march towards madness and loss of all connection with life as we know it, love it, need it.

I am told how to practice now, many days. In spite of good training and better experience through three decades of practicing my craft, someone with less formal education, less real world patient time will look at a script, a series of numbers, an outcome paradigm and will say yes or no to my treatment plan. But this works, I tell myself, tell them. I’ve seen it work a thousand times. Doesn’t matter, they say. It’s not evidence based. It’s too expensive. It takes time. We won’t pay for it.

And that’s that.

You will bear the pain.

You will stay with him, because he’s the best guy you’d ever want to meet when he’s sober.

I will re-read Prince of Tides and South of Broad and travel to the Lowcounty and remember him.

Every time it rains, it will be purple.

Your daddy will be here until he is not. You will go on helping your mama, because that’s who you are. Someone will love you all the more for your compassion and your strength.

I will go on treating patients, because that is what I know.

ADVERTISEMENT

That is what I love.

That is what I do.

Terms and conditions apply.

Greg Smith is a psychiatrist who blogs at gregsmithmd.

Image credit: Shutterstock.com

Prev

The art of taking an excellent medical history

July 21, 2016 Kevin 4
…
Next

The day a young patient took charge and grew up

July 21, 2016 Kevin 1
…

Tagged as: Primary Care

Post navigation

< Previous Post
The art of taking an excellent medical history
Next Post >
The day a young patient took charge and grew up

ADVERTISEMENT

More by Greg Smith, MD

  • Finding peace after years of abuse: a journey through grief

    Greg Smith, MD
  • What would you save if your house was on fire?

    Greg Smith, MD
  • Lessons learned in psychiatry: How experience shapes your career

    Greg Smith, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • Here’s how your attitude affects patients

    Lauren Feltz, MHSc
  • Treating the patient’s body is not synonymous with treating the patient

    Steven Zhang, MD
  • Is physician shadowing immoral?

    David Penner

More in Physician

  • How tragedy shaped a medical career

    Ronald L. Lindsay, MD
  • A doctor’s guide to preparing for your death

    Joseph Pepe, MD
  • How policy and stigma block addiction treatment

    Mariana Ndrio, MD
  • Why don’t women in medicine support each other?

    Jessie Mahoney, MD
  • IMGs are the future of U.S. primary care

    Adam Brandon Bondoc, MD
  • The high cost of gender inequity in medicine

    Kolleen Dougherty, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • Healing from medical training by learning to trust your body again [PODCAST]

      The Podcast by KevinMD | Podcast
    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • From nurse practitioner to leader in quality improvement [PODCAST]

      The Podcast by KevinMD | Podcast
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
  • Recent Posts

    • Healing from medical training by learning to trust your body again [PODCAST]

      The Podcast by KevinMD | Podcast
    • How tragedy shaped a medical career

      Ronald L. Lindsay, MD | Physician
    • A doctor’s guide to preparing for your death

      Joseph Pepe, MD | Physician
    • Coconut oil’s role in Alzheimer’s and depression

      Marc Arginteanu, MD | Conditions
    • How policy and stigma block addiction treatment

      Mariana Ndrio, MD | Physician
    • Unused IV catheters cost U.S. hospitals billions

      Piyush Pillarisetti | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...