A PHYSICIAN’S BILL OF RIGHTS
I opened an email from a friend during my shift in the Emergency Department that rightfully imparted some words of wisdom:
YOU ARE ALLOWED TO TERMINATE TOXIC RELATIONSHIPS
YOU ARE YOU ARE ALLOWED TO WALK AWAY FROM PEOPLE WHO HURT YOU
YOU ARE ALLOWED TO BE ANGRY AND SELFISH AND UNFORGIVING
YOU DON’T OWE ANYONE AN EXPLANATION FOR TAKING CARE OF YOURSELF
Exasperated by attending to an alcoholic with who had tweaked her chronic back pain, I walked out of the room and remarked to the nurse, “It is difficult to have a rational conversation with an unreasonable patient.” In retrospect, I also walked out of two other rooms without “an explanation.” One involved a woman who insisted she was not supposed to experience any abdominal pain because she had a high pain tolerance. When I handed her the CT report that clearly stated why she was having pain along with an internet blurb explaining the condition and the treatment, she responded by tossing the pages aside in an unforgiving manner. Perhaps she might consider high stress to be impinging on her tolerance for pain. After another woman with high anxiety and simple gastritis failed to respond to an anti-emetic and antacid, I walked out of the room and had the nurse start an IV and draw labs. When I returned, the woman remarked, “What were you looking for in the labs?” In more polite words, I simply implied her anxiety drove me to look for things I did not expect to find.
Toxic situations and toxic relationships abound when our mortality is at stake. While we could choose to fight fire with fire and being unreasonable with being nonsensical, this would not support our mortal character. Our armament for taking care of ourselves is self-explanatory, but it does not have to reflect upon us as being unreasonable. I believe we have a natural temperament (mortal) that is served by a higher power (character) which is apt to become irrational when anger is fueled by anxiety. Underlying this anxiety is the fear of death which can potentially poison the relationship with the doctor who is supposed to save us from dying and any undying pain; without necessarily hastening our death. Intellectually, our mortal character knows this all could be unreasonable and can remind us not to be superheroes in the need to take care of ourselves in toxic, anxiety-provoking situations. The Physician’s Bill of Rights can allow for physicians to take care of patients by infusing and charging them with some mortal character to take care of themselves; perhaps respecting personal hurdles as personal along with guaranteeing physicians the right to walk away.