Dec 9, 2009

The Family Doctor

Every physician is a family doctor. I don't mean to say that they all specialize in family practice. On the contrast, the majority of physicians now enter subspecialties. My point is that every physician, no matter their specialty, ends up being "the doctor" in their family. Sometimes this is okay. There's not a holiday that goes by the someone doesn't want a mole looked at, a consult on pain or bleeding or GI trouble...whatever ails them. Usually I don't mind taking a look and giving an opinion, although sometimes it is tiresome. What I'm struggling with is where and how to draw the line between family and patient. I think the real issue is that there is no line to draw within myself. I am not a doctor from 9-5 (or 7-11, more realistically), and a daughter, a granddaughter, a niece, a wife on all the other hours. I've said it before, you are never "off call" as a doctor. It is a casualty of the training. You think and observe medically, every moment, without thinking about it.

This duality is something I haven't learned to balance yet. It can be hard both ways: for a doctor-daughter to be a family member while entrusting her parents' care to other people, and for a daughter-doctor experiencing human grief whilst being expected to care for and relay medical information to the rest of the family.

My dear friend lost her young fiance last weekend, after he collapsed during a half marathon. She said he had a massive brain hemorrhage. My friend heart breaks for her, while my doctor-friend mind wonders if he had an arteriovenous malformation, if the increased heart rate and blood pressure probably triggered the rupture of the aneurysm. There is no separation between these two thought processes for me.

So, I am learning to manage this new addition to myself. It is easier to go to the hospital and just flip through the chart, rather than pestering a relative for information that they don't have. On the other hand, if I find something abnormal, I feel compelled to do something about it, and maybe miss out on the richness of caring for someone simply as their granddaughter, their friend. It's hard as a doctor to trust the care of someone you love to another doctor. But you have to, otherwise you'll be exhausted of patients before you even step foot in your own office.

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