Compassion

The course of this week has been much different than the last.  This week I have been challenged on a different scale.  I have enjoyed the rigors of the surgical service as much if not more, and we have had some very interesting cases.  But this week has presented me with an interesting opportunity - an opportunity to take a step back and try to remain objective about the practice of medicine.

I have noticed that it's easy to get caught up in the practice of medicine under a preceptor (or, more appropriately, learning to practice medicine).  In the process of simply learning the art of medicine, it is easy to become influenced in many ways - and often it is important to let oneself become influenced - by our preceptors.  But this week I have had the opportunity to evaluate the attitude that both my preceptor and I take into the patients' rooms.  I have noticed that my attitude is different, notably more naive, but at the core is this desire to have compassion no matter what the patient's condition or complaint.  My preceptor has a more realistic view, a more seasoned view, one that includes compassion for hard plights but a more comprehensive understanding of the human element that plays into how we practice medicine.  My preceptor is efficient and cuts through the fluff surrounding a patient's history.  I can understand how this might come off as indifference to the patient's problems, but this week I have had the opportunity to see an excellent surgeon take on some difficult cases and difficult patients and their families.  There is a difference between what is perceived and what must really occur behind the scenes from the provider's point of view.  This week has been an exercise for me in not taking the surgeon's reactions on face value but rather I have had to try and understand the experience that has gone into my preceptor's approach.  At times it is difficult to avoid disagreeing with that approach, but I am the student.  I am the young one - the inexperienced one.  I have much to learn and this is an experience I can use to gain insight into the practice of medicine in the real world.

I don't defend mindlessly adopting the attitudes of anyone who instructs us.  But in this situation the options are to accept, reject, or make the most of what could be perceived as a cynical attitude toward certain situations.  I think that this week has taught me to take a step back from being enmeshed in dealing with patients to evaluate as objectively as possible the attitude with which I do it.  Will I have blind compassion for the patient and pour out my utmost for each and every one?  Will I approach each individual with the idea that they are simply gaming the system?  Or will I figure out now in some small way the difference between those who truly need compassion and those who should not be taken at face value?  Experience builds this ability the most, but my hope (and the opportunity that this week has presented) is that I will take from this rotation at least a step toward knowing the difference.