Dear Future Patient...

Dear future patient,

First off, let me say that it will be a privilege to take care of you. There are a lot of folks in long white coats out there with a jumble of letters after their names, and I am honored that you will one day allow me the privilege of being your doctor. It's something that I am working very hard at, and will continue to do so for the rest of my career.

Because this relationship you and I will have, of patient and physician, is based on honesty, there is something you should know. I did not score exceptionally well on my licensing exams. In fact, like 50% of the other physicians out there, I did not even score in the top 50th percentile. So, if you're looking for that doc who knocked their licensing exams out of the park, I know several and I will get you their contact information and a referral, no charge. :)

You see, reading information out of a medical text book and regurgitating it onto a scantron is not my forte, and never has been. Those questions are two dimensional and more often than not, all they really test is a person's ability to recognize a word they've seen before and match it with another word they've seen before. The exams don't always test how well the examinee understands a concept, just how good they are at a matching game with really big science words. Your disease process, like you, is a multi-dimensional ever-changing entity. So when it comes time to treat you and tailor your care to the unique and complex individual you are, the ability to correctly pick "B" on a multiple choice test doesn't really seem all that helpful, don't you agree?

So, yes, knowing the science behind your ailments and injuries is the foundation of this thing we call medicine. And as I move forward in my training I will continue to learn and strengthen my understanding of the diseases that will one day bring you into my office. But, there is more to providing good quality patient centered care than high exam scores. For example...

While I'm learning about the various kinds of anemias and how they will make you feel like crap, I'm also learning to put you at ease when you tell me about what hurts. And while I need to know what neurological exams to perform if you present to me with stroke-like symptoms, I'm also learning to make asking questions about your bowel movements more funny and less awkward. Should you get admitted to the hospital for acute atrial fibrillation, I'm learning about the medications  I need to give you to make your heart stop racing like its chasing after the Sprint Cup. I am also learning how to keep you in the discussion and remember that you are the center of treatment, not your disease. When your concerned wife drags you into my office because you've been coughing up blood for the past week and have a history of unintentional weight loss, I'm learning how to explain the diagnostic exams I want to run to see if it is cancer in a way that empowers and not terrifies you. And one day, when you aren't really you anymore and your body is old and simply no longer capable of doing this "life thing," I am learning how to prepare the people you love and walk them through the difficult process of letting you go.

So no, I did not pass my board exams with flying rainbow colors. I passed them and moved on to learning how to practice medicine. I scored what I needed to so that I could continue to learn how take the very best care of you.  Because that has always been my goal - to be an amazing doctor, not an amazing test taker.

Thanks for letting me be honest with you, dear patient. It will still be a few years before we meet, and I promise until we do to continue to to bust my butt and learn the things I need to know to provide you with phenomenal care, the same kind of care I would wish for myself, and those that I love.

See you soon,
Future Dr. Day

P.S. Stop smoking, try to get 30 minutes of exercise at least three times a week, and don't be afraid of those leafy greens. :)

Lo siento

"Hey, have you ever heard of benzos causing GI bleeding?" I quietly asked one of the first year interns on my team during rounds this morning.

"No. Why?"

"Dr. X. just said patients on ativan are at high risk for GI bleeds."

"Are you sure he didn't say aspirin?"

"Yeah, he definitely said ativan."

"Hm. Yeah I've never heard of that. He really didn't say aspirin? He has a pretty thick accent. Maybe you misunderstood him."

"Oh no, I'm from AZ and am totally used to listening to people with thick accents," I said, half joking.

Full of third year confidence, I grabbed my phone and opened epocrates to check the adverse effects of ativan.

Later, during a lull in the morning activities, I mustered the courage to ask the attending about this baffling correlation between ativan and GI bleeds. He looked at me, puzzled and said, "no, aspirin. Aspirin causes GI bleeds."

Blank stare. Internal scream. Morgan, you arrogant ass.

"Oh. I must have misunderstood."

I caught a smile creep across the intern's face out of the the corner of my eye, just as our attending began pimping me on aspirin, and other drug classes, that are known to cause GI bleeds. Woo.

Happy Monday, folks! And, if you too were served a tasty slice of humble pie today, I hope you at least learned something from it. :)