I have good days and bad.  Some days I am content, connected, focused, and motivated.  On those days I enjoy my job, I enjoy the people I’m with, I am willing to be inconvenienced by interruptions.

On other days, not so much.  I wake up as grumpy Rob and (despite multiple cups of coffee) the old codger doesn’t leave me alone.  I keep score of all the ways in which life has conspired to make the day difficult.  Too many red lights.  Too windy.  Clearly terrible things going on.  I am not patient with people, and am distracted by little things.

Like I said: I am normal.  I do my best to not let these things stand in the way of the care I give, and I try to hide my emotions from my patients.  It’s a necessary part of the job.  But there are still days I’m better at it than others.

Yesterday a patient came to the office to pick up prescriptions.  He spotted me in my office and asked if he could have a few minutes of my time.  Yesterday was a grumpy day, so I immediately felt a little miffed at this interruption of … whatever I was doing, but I quickly stuffed that down and told him to come on in.

“Are you OK, doc?” He asked as he sat on the couch.

“Yeah I’m fine,” I replied, obviously not hiding grumpy Rob as well as I thought.  “I’m just tired.”

He proceeded to ask me several questions: one about guitars (we both play) and one about medications related to a certain problem.  I banished grumpy Rob and did my best to answer his questions.

He stood up to leave and then grew serious.  “I really appreciate you and your office.”

“Thanks,” I said.  We get that a lot since I switched to direct care.  People appreciate the personal attention we can give.

He grew more intense.  “I’m serious, doc.  I don’t know what I’d do without you.  You saved my life twice, you know.”

“Twice?” I asked.  “I remember when you were on death’s door with diverticulitis and didn’t want to go to the hospital.”  He came very close to developing peritonitis, so it wasn’t an exaggeration that I saved that time.  “What was the other time?”

He made a gun with his fingers and pointed into his mouth.

“Back when things were so bad, a few years ago, I was ready to end it all.  I even bought a rope.  It was you who saved me.  Things you said gave me hope.”  He teared up as he spoke.

I remembered.  His life was falling apart: his wife abandoned him, he lost his job, he didn’t have a place to live, and he had a very painful orthopedic condition.  I recall getting him on medication, helping him find a place to live, pointed him toward agencies that could help him, and just gave him moral support.  I also remember that we didn’t pay much attention to whether or not he could pay us.

“Thanks,” I said, recovering the ability to speak.  “It’s nice to hear I make a difference.  I’m just doing my job, but it means a lot to hear that.”

I walked over to him and gave him a hug.  “I really appreciate you and your staff.  You mean so much to me.  I love you, doc.”  He wiped at his eyes and nose as he walked out.

As I sat back at my desk, the weight of what he said crashed down on me.  Recognizing someone who is critically ill with diverticulitis is easy.  I take minimal pride diagnosing the obvious, even if it is life-threatening.  Even if grumpy Rob is in the room.

But this …

This isn’t about diagnostic skill.  This isn’t about intelligence, problem-solving, or clinical experience.  This is about caring.  And caring can vary based on attitude.  What if I was tired and didn’t pay as much attention?  What if I said to myself, “I’ll deal with that next time?”  What if I didn’t take the time, look him in the eye, try to do the extra thing?

I don’t feel pride about this; I feel gratitude.  I am grateful I have a job in which I can make a difference.  I am grateful to have Jenn and Jamie, who are willing to go the extra distance for people.  I’m grateful to have a practice in which I can take extra time with people (and to discount the care if I want).  I am grateful grumpy Rob was on vacation when I saw this patient.

But I am also sobered by this.  It’s not just in the exam room where words make such a difference.  It could be a text from a friend or an email from family members.  It could be on a good or a bad day.  I have to be ready to help when the next opportunity arises, regardless of how I feel.  I’m fortunate to have incredible role models in my parents, who have always lived their lives with the intent to leave people in their wake who are better off than the would’ve been. I can only strive to do so as well as they have.

There’s a lot of crappy stuff in this world.  There are a lot of things pushing people down as they struggle to survive.  While I can’t fix what’s wrong in the world, I’ve always got opportunities to put good in the balance and tip the scales back up.

Even grumpy Rob can do that.

Rob Lamberts is an internal medicine-pediatrics physician who blogs at Musings of a Distractible Mind.

Image credit: Shutterstock.com