The Beautiful People
People talk about burn out all the time in this field. I know I’m only two years into this, but I’m pretty sure it’s not the job that burns people out, its the asshole patients. Those people that are just unkind, cruel, self centered. I fully admit, that I have positively loathed some of my patients.
“Hey there, I’m Dr. X, how can I help you?” ”Fuck you, fix my arm” Ohhhhh kayyyy then.
But these people aren’t anything new. They exist in every ED. They suck your good will out and just pour it down the drain. But fine, whatever, I’ll deal. But everyone once in a while…. you get that one guy….
There is this guy that comes into our hospitals about every two months. Always an overdose of his calcium channel blocker, usually a half assed suicide attempt, always goes to the ICU, gets tuned up, set up for out patient support, psychiatric follow up, never goes, comes back two months later, rinse and repeat. The thing is though, he is the most racist, sexist human being I have ever met, or even heard of for that matter. Once he comes to, wakes up, he runs his mouth constantly, spewing forth the most vile things you’ve ever heard. When I was in the unit with him one time, he had this kind, sweet nurse, one of the good ones, whom he quickly sent out of the room by calling her a “cunt nigger”.
Everybody hates this man, loathes him, wishes one of these times he would just get it right and come in as a code blue. How horrible is that, to think that, and then having to perform life saving medicine on him. That’s what burns the docs and nurses out, that’s what eats at the fiber of your soul. It takes 50 happy, kind, thankful patients to replace one of the scars left by these horrible people.
I wish more than anything, we didn’t have to put up with it. I’ll treat you, quite happily, but only when you act like a human being. Fine, I’ll come back in 20 minutes and you can try telling me about your arm again. But nope, not allowed to do that, cause door to dispo times matter more. We have to take it, to the let the patient smear all their vile feces all over our faces, while we stand there and take it. THAT’s where the burnout comes from, not from the long hours, not from the over crowding, lack of resources, or what ever other factor experts say makes us burn out.
It IS a problem though, even in residency. A poster that was presented at ACEP showed that 50% of EM residents experience mild burnout, 25% of them have SEVERE burnout (Ironically, 50% of participants failed to respond to the follow up survey)
And deep breath. I’m not saying I am in any way burned out. Far from it. I am a little angry about it, but beyond that….well, just keep doctoring on, and doing my best to not stab these patients in the eye with a angio cath, at least for the time being. There are days when that is a distinct possibility. And I think I’m better than most at keeping my cool. One of my other residents almost came to blows, patient telling the resident “GIRL I WILL FUCK YOU UP IF YOU DON”T GIVE ME A SCRIPT FOR PAIN MEDS” and her in response… getting right in the patients face and going all calm and quiet Clint Eastwood like…. “Go ahead, hit me, I dare you”….. Yup, let’s just keep packin’ powder into that keg.
I’m not sure what I’m going to do about, other then just vent about it anonymously for the time being. And a good vent always helps. Ahhhh, much better.