Why I wear the badge holder

I don’t wear my hospital insignia on my badge holder, that ubiquitous piece of plastic that medical folks use to display their allegiance – sports teams, hospitals, folk art IV bottle tops.  I wear her hospital’s.  

The one where I learned what it meant to be on the other side of the bed. 

I spotted it today as I looked at my watch.  Overdue for an appointment with a resident – the prognosis of an unprompted “Dr. Z, do you have a minute to talk” is at least 30 minutes in my office, with a 50% chance of cathartic emotional breakdown.

And so I looked back at the cracked, abused plastic of the rolling stool in the half-lit, curtained room.  Thought about the 3 “I’m sorry”s my patient had already laid on me during our brief discussion of their disabling, unfair and very chronic condition. 

Text to the Resident: My own “I’m sorry”. A plea to catch up before I go home. 

Mentally move two projects from “2-4:30 PM” to “after bedtime”. 

The diagnosis that hangs over both of us in that room is one dear to my heart.  One I witnessed not as a physician but as a friend – holding a hand and watching as symptoms derailed plans.  I remember her “I’m sorry”s as well – she also was great at simultaneously cracking jokes/apologizing to her medical team, trying to lighten the somber tone in her own cramped ER rooms.  

And there it was, the catharsis.  The moment I plunked down, dropped the doctor demeanor and agreed. 

This Sucks.  Capital S. 

The fear, the resentment of everyone living a “normal” life and hitting the socially accepted milestones that seem less attainable with every ER visit.   An admission of anger – the natural progression of pain, left to mature in an environment of alienation and frustration.  Followed by of course, “I’m sorry”

I don’t talk about this stuff to people. 

And there it is.  This patient doesn’t need a House MD.  Doesn’t need the TV version of the outlandishly attractive and intelligent doctor coming in with The Answer That Will Magically Solve All Their Problems.  (Spoiler Alert: those are few and far between in the real world.  We have, at best partial solutions, and long recoveries achieved through hard work done by dedicated people) 

They needed someone safe, and quiet.  A dimly lit room to air out what’s been festering inside, what they’re terrified is going to make them into a “Difficult Patient”.  Ironic that one of our patient’s greatest fears is that they will get Labeled as “Demanding” or “Seeking” by the system that is supposed to help them.   Knowing that my system is broken, that I’m not going to un-fracture their care I can only sit and hold a hand and try to make them feel Heard.

And because the mark of a good Doctor is to shuck off emotional trauma like we ditch isolation gowns and gloves as we come out of rooms, me sprinting back up to my office, wondering if I have the energy left to navigate catharsis #2. 

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