I recently left the clinic late one afternoon not really liking my job and wondering why I continue to toil in primary care. The final patient my resident and I cared for that day was a woman with poorly controlled diabetes who has neuropathy, chronic headaches, and an opiod addiction. This patient has been in our practice for years and is a bane of our practice. Attempts by multiple doctors to wean her off opioids have been unsuccessful.
My senior resident was totally frustrated with the patient. After 45 minutes of trying to address the patient’s poorly controlled diabetes, she gave up and came to find me. The resident walked into our conference room, irritated, saying we needed to address the patient’s diabetes but noted that she would focus only on the need for a higher dose of pain medication.
Not really wanting to (but knowing that I had to), I went back to see the patient with the resident. Thirty minutes later, I had not accomplished much more than the resident and left feeling drained, defeated, and inadequate. After some words of encouragement and thanking my senior resident for taking care of my difficult patient, I was slightly more hopeful. But I wondered how interactions such as this were affecting my resident’s ultimate career choice.
However, those were discussions for another day because I was leaving to attend a conference—a chance to rejuvenate and reflect on my academic practice and career. And, at the very least, I would not see any more difficult patients until the following Monday.
While I was walking from one talk to another at my conference, I heard someone call from behind me, “Dr Bass!” Turning around in the busy hallway, I did not see anyone I recognized, but I did see a young man walking toward me with an extended hand. I did not even have the unease that you get when you recognize someone and know you should know his or her name or relationship but do not.
Catching a glimpse of the young man’s name tag, I determined that he was a resident. But I did not know how I knew him or how he might know me. As we shook hands, he said, “I saw you and wanted to say thank you.” By this point, he sensed that I did not recognize him and he went on. . . . “You were my attending on an inpatient ward service and I ultimately chose internal medicine because of the experience I had on your team.”
I asked him where he was now and what he was doing. I was flabbergasted at what he said and embarrassed that I did not remember him.
The student didn’t realize it, but he had no idea how much joy he had brought me in that moment. The thought that I had helped him foster an interest in internal medicine that affected his career choice, given my clinic experience not 16 hours before, had a powerful impact on me.
Given my career choice in academic internal medicine and pediatrics, I have an opportunity to mold the future of individuals by having an impact on students’ views and understanding of medicine. As a teacher, I provide a lens through which students see medicine, and I impart skills to help them provide care for patients.
Very few professionals have a very unsatisfying experience on-the-job and then have the opportunity to see the fruits of their efforts in such a short time period. Students rarely see or know how much satisfaction teachers get from seeing them develop and maximize their skills, talents, and clinical acumen.
If you do not currently teach students, I suggest you look for an opportunity. Teaching is one of the most rewarding things I have done in my life.
I made a difference in a student’s life.