Wednesday, August 21, 2013

Why Do I Try So Hard?

It's always the same: It's the fifth hour of the procedure. As your ankles ache and the perspiration drips beneath your lead, you stand there wondering why you try so hard to fix this arrhythmia. You realize this is not cost effective. You're tying up the lab. The staff and anesthesiologist are getting restless. The music drones on. You feel you're not getting anywhere. "Then again, maybe if I just try this...," you think. And you try this and it fails. Meanwhile, the fluoroscopy clock ticks, your fight continues.

Then you remember the story: the syncope, the wife, the kids, the vocation. They're depending on you. Not a tech, not an anesthesiologist, not a nurse, not an administrator. You. So you keep going, just a bit longer.

And then, sometimes, miraculously, you win. It's all worth it. You've completely changed that person's life. You are the hero. You are the superstar.

But just as often, you have to quit. Your feet are too sore, the radiation dose too high, and the hour too late to safely continue. You have to face the family, the disappointed looks, the doubt about whether you were the right person to do this procedure, and the sad look on your patient's face when you break the news.

And you find yourself asking once again:

Why do I try so hard?




Anonymous said...

As I am learning since our entry into the world of cardiology, you just have to trust that the doc
you got is the one that will do the best he can. You read reviews, bios, pedigrees etc. online to try to decipher if this is, indeed, the one. Then you try to take a crash course in cardiology by reading JACC with great zeal, even taking the quizzes intended for the cardiologists who need to maintain license etc.
Then gradually you realize that pedigrees, bedside manners, titles etc.. in the end you just have to surrender, ask the questions you need to ask, and be grateful the loved one is still here albeit with a tricky heart rhythm. You learn trust and you learn that sometimes it is not so great an idea to throw the kitchen sink at the rhythm. And then you read a post such as your recent EKG du jour and the 29 post comments. It hits you. There is no way on earth you can absorb in 6 months what the doc has taken years to master. What triggered this comment was your sentence about
the looks of doubt in a family's eyes whether you are the best MD
available for them and whether they should doctor shop. I greatly appreciate your blog. It has helped me in so many ways...most especially to appreciate the art of cardiology if not the science.

DrWes said...

Anony 04:29 PM -

Thanks you.

As I reflect after writing this post, I suspect the reason all of us who chose this profession go 'above and beyond' in cases like these is because, win or lose, we learn. We learn what works and what doesn't; what we can tolerate and what we can't.

Medicine is like that: always teaching - sometimes quickly and sometimes in slow, painful ways. As a great professor of mine reminded me: "Good judgment comes from experience, and experience sometimes comes from bad judgment."

Ann or Tom said...

Thank God there are physicians like you who are willing to put yourself in a position of having to deliver good or bad news. As one who benefitted from 6+ hours of your efforts, and relieved good news, you have changed my life and for that I will be eternally grateful!

Anonymous said...

Thank God and God bless doctors like you who give their all, doctors who truly care--care about their work, the patient, the family... I can't say that I have personally experienced your care, but from what I know of you online, on Twitter, and this blog, I can see how good you are. Your personality and the fact that you still follow me are impressive. I see you more as a pretty cool tweet buddy. I could care less that you are a doctor but I am glad you are! You are obviously very good at what you do.