Referencing a recent New York Times article “What Kids Wish Their Teachers Knew” got me thinking about both sides of the coin.  Physicians are human beings and sometimes this fact gets lost when a patient is angry or frustrated seeking help from the medical system.  Here is a primer on what I wish my patients knew. (This is a companion piece to “I wish my doctor knew.”)

I wish my patients knew … My children started vomiting at 4 a.m., and I am completely exhausted. This happened about a month ago.  My third child threw up all over my clothes as I was leaving the house to drive to work.  I ran inside and quickly changed.  I put on flip flops at some point during this process and forgot to take them off as I ran out the door.  All day I walked about looking like I planned to go to the beach instead of the office and felt ridiculous plus I think I smelled like vomit as well.

I wish my patients knew … How privileged I feel to be an integral part of their lives.  Ours is a relationship forged in give-and-take conversation and in the sharing of knowledge built over decades that is difficult to replicate in any other profession.  I have seen so many poignant moments over the years reminding me of how fragile the human condition can be.  It is truly an honor to know my patients and their parents intimately sharing in their triumphs and tribulations.

I wish my patients knew … I did not get paid this month.  At least once per week, a parent calls to ask if I could write off the cost of a procedure that was kicked over to deductible by their insurance.  Often they ask reasons a co-pay was charged with a well-child exam when they brought a list of 15 questions about asthma, night terrors, food allergies, or a variety of other conditions requiring a prescription.  I have never said this out loud but really wish they could understand that I use my income to pay my mortgage and buy food for my own children.  At least one month each year out of the last 5, I did not receive a paycheck.

I wish my patients knew … How frustrating working with insurance companies can be.  These third party payers control the entire system except for the part controlled by the government.  Calling to obtain prior authorizations from someone who knows nothing about the medication I have prescribed drives me insane.  There are many people wedged between me and my patient, yet I shoulder the responsibility for decisions over which I have no control.

I wish my patients knew … The greatest thing about being a pediatrician is seeing my patients become adults.  Watching these tiny newborn infants grow up to be healthy, well-adjusted, productive members of society are the stuff of which dreams are made.  Watching my patients become mothers themselves has truly been one of the most rewarding experiences of my life.

I wish my patients knew … How hard it is to make it through the day, week, and month when I have lost a patient unexpectedly.  A 12-year-old girl who I deeply cherished died last year due to Influenza A.  I attended her delivery and held her in my arms before either her mother or her father.  She, like many of my patients, was very special to me.  This young girl was the first person who “informed” me my third pregnancy was a girl, despite my being resigned to delivering yet another boy.  She just knew it in her heart, and she was right. I think of her every day, miss her smiling face and joyful demeanor, and occasionally catch myself hoping she will walk through my door.

I wish my patients knew … How hungry I am, how badly I need to urinate, or how much I need a moment to think.  There have definitely been days where I walk into the examination room and want to dive into the bag of chips or fruit snacks my pediatric patient is eating.  Sometimes, I ask for a bite or two when I know them well enough.  It might be all I have to eat that day.   A bladder can clearly be trained to withstand a great deal of pressure and if you ask any physician, they would concur with this awkward situation.  When a frustrated person yells and curses at me, it is difficult to put aside; it would be fantastic to have a few minutes to collect myself rather than having to move on to the next patient and pretend everything is normal.

I wish my patients knew … I am late because an infant stopped breathing in the next room and I had to call an ambulance after resuscitating him.  I am still shaking and about to burst into tears out of fear the child will not survive the 45-minute ambulance ride to the nearest hospital that admits pediatric patients.  Your time is valuable, and I mean no disrespect, but I am doing the very best that I can to stay on schedule.  That patient was in for a well-child exam.  The respiratory arrest was purely coincidental and unexpected.  Some of my patients can read my face so well.  They say “take some deep breaths doc, we can wait.” I love and appreciate the sincere compassion shown at times like these.

I wish my patients knew … It makes my day if you bring something.  Food is my favorite because it means I can eat while saying “thank you.”  Over the years there have been pictures, donuts, cards, coffee, flowers, farm fresh eggs, homemade jams, fruits, chocolate, music boxes and the list goes on.  It has nothing to do with monetary value; it is the sentiment I appreciate.  It tells me you understand I am giving my all, doing my best, and not holding back on your care and comfort.  It means the world to me.

I wish my patients knew … I would not change anything about my career choice.  Being a physician was my calling from the time I first entered a hospital nursery with my father at 5 years of age.  I knew it then as sure as I know it now.  Primary care comes with an unbelievable amount of responsibility, stress, exhaustion, and frustration; but there is also overwhelming joy, fulfillment, gratitude, freedom, and love.  I could not be more proud to be a physician, and there is no other profession in the world that is more rewarding than mine.

Niran S. Al-Agba is a pediatrician who blogs at MommyDoc.

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