Thursday, October 1, 2009

When I Grow Up...

“Something mystical happens when we stop forcing our way through life and surrender to each moment.”

I had a great conversation with an old friend tonight. She just headed back to school for the first time in years, works a full time job, and still ponders the age old question, “What do I want to be when I grow up?” I often consult Google with difficult questions such as these, so I searched, "what do I want to be when I grow up?" and  got 54.6 MILLION results, which included one inspiring song.

Our conversation reminded me of an interesting, and somewhat uncomfortable, experience with a patient this week. His chief concern was hypertenstion, hyperlipidemia and weight gain. I was observing the interaction between him and the supervising physician as she explained what he needed to do in order to make the necessary lifestyle and nutritional changes to successfully address the problem. His resistance and anger was evident throughout the visit (especially when he yelled at the doctor!) and no matter how the treatment plan was described-- the message just was not getting through. We later learned that his father was dying of cancer, work is slow and he is not making much money, and he hates his job. He stated that he didn’t know how he got to this place; it was not what he planned for and now felt trapped by his life. As a listener, it was easy to see a change he could make to start with-- he needed a new job or to change his job somehow so that it was enjoyable for him. He clearly didn’t know what he wanted to be when he grew up, or somehow his current situation wasn’t fitting his vision for life.

This man could not see the dots. He just saw himself frustrated and alone with his problems. People, places, circumstances, and things are put into our lives often for unknown reasons until we can look back and see the dots connecting. At some point, the dots line up and we realize we have what we wanted. Did it take growing up? Did it take trying on different hats to find out what to "be"? Showing up and being present for life? In the case of my frustrated patient, his limiting thoughts and anger made it hard for him to be present to deal with this difficult time and constructively make change.

This experience exemplified my belief that the doctor must always meet the patient where they are. For this man, no amount of diet and exercise counseling was going to make a difference at this visit and frankly, it wasn't important. What he needed was to vent his frustration. He needed to shed a tear, get angry, argue and resist any suggestions we offered. He needed to be in a place where he would be listened to, not judged, and be given empathy. When I grow up and am officially a doctor, I will remember that a listening ear is often the best and only therapy a patient needs; because to truly be heard is something that is often complicated and difficult to find.

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