When Doctor’s are in the Sick Role
By Lauren Willis-Wood, MD
By Lauren Willis-Wood, MD "I'm so sorry you're here at 3 AM", I say for the millionth time and smile sympathetically at…fammedvitalsigns.wordpress.com
“I’m so sorry you’re here at 3 AM”, I say for the millionth time and smile sympathetically at parents sitting with their irritable, stuffy and feverish baby in the ER room. In the midst of respiratory season and in the middle of my month rotating in the Pediatric ER, this scene is commonplace. I have gotten used to quickly assessing which kids look sicker, may warrant admission or need suction to help them breathe better, eat better, get better. Strung-out parents getting by on a couple hours of sleep yawn their gracious “thank-you’s” as they take their kids home for a few more sleepless nights. Most of these kids will perk up in a couple of days and be back to business as usual. Just need a little time. As a physician, I know this.
So, when I find myself in the ER on a Friday at 3 in the morning with my 7-month old daughter I feel silly. She’s not that sick. She definitely wouldn’t be one of the kids I would think about admitting if I were on the other side of the situation. I find myself apologizing and explaining that “I know she’s okay, just some suction would help” over and over. I feel embarrassed for being there. My clarity clouded by the fact that I am the strung-out parent who has been up all night with a baby that can’t breathe, can’t eat, can’t feel better. It feels hard to be a doctor and a patient.
This discomfort is not new or unique for health care providers, it has been described time and time again. There is an internal struggle when doctors are in the sick role. Whether it relates to expecting certain things related to our care, putting our usual role into the hands of others or feeling as though we are seeking care unnecessarily, the role reversal can be a challenge. Residency can further complicate the picture, as finding time to tend to our own health amidst wildly fluctuating schedules with little wiggle room proves difficult.
During my last rotation, this issue came up in conversation with some of the other residents. We shared stories of coming to work despite stomach bugs, never-ending coughs, and extreme sleep deprivation. I recalled being a medical student and hearing one of the residents I was working with telling about getting IV fluids in the workroom while toughing out gastroenteritis, because she didn’t feel like she could miss a shift. While there are very appropriate systems in place to allow sick time, the same mentality that keeps doctors from yielding to the patient role often prevents us from accessing these safety nets when we need them. Fortunately — I suppose — for my daughter and me, her bronchiolitis was worst while I was on vacation, allowing time to rest and recover during the day.
As the sky begins to lighten, we head home from the ER to climb back into bed for a few more hours of restless sleep. And although she is fine, the suction does help. The ibuprofen quells her fever and she seems to feel better. We struggle through a few more sleepless nights and then, as I tell other parents in the same boat, she’s back to normal and none the worse for wear. I’m a doctor again and, for now, not a patient. But I’m left with a deeper knowledge of how it feels to be vulnerable, worried and needing to trust another with the health of my loved ones. While difficult in the moment, better understanding the patient role through personal experience has proved valuable in providing more empathetic care for my own patients.
Lauren Willis Wood, MD is a second year Family Medicine Resident in the Department of Family & Preventive Medicine at the University of Utah School of Medicine.