Thank you for being a good doctor.

So apparently it works.

Two days after I posted my last post on trying to maintain compassion, empathy, and respect no matter how difficult some patient encounters were, I received a positive encouragement that this was indeed a worthy goal to achieve on every shift.

I was finishing up another tiring shift, hiding in a corner as I usually do trying desperately to finish my charts while avoiding any further eye-contact with any living creature, when a familiar voice came from just around the corner.

I looked. A scruffy-looking man with messy hair and worn down face stared down at me.

"Oh by the way, sorry to bother you, but I just want to say thank you for being a good doctor to me yesterday. I know I was being difficult, but thank you for looking after me...".

My heart melted. My defensive posture gone.

"Nono, I'm glad to see you doing better. How are you feeling?"

"Oh a lot better now, thank you doctor..."

I smiled. And broke up eye contact soon after and briskly returned to my charts. But I felt happy.

He was indeed very difficult the day before. Had it not been for my earlier reminder for myself to be nice against all odds, I very well could have casted him aside. Even had I treated him correctly medically, I would have given him the cold shoulder. He was loud, obnoxious, demanding. He was moaning and calling out such that the entire department could hear him. Sure he might have been in pain, but so many more tamed souls would have simply suffered in silence, or at least asked for help in a more respectable manner. He wasn't even from our region. I was working in Maple Ridge; he was from Surrey. His "relatives" merely decided to drive him here and simply dropped him off. The night before, apparently he was at a different hospital at New Westminster, likely in a similar unpleasant manner, and likely somewhat deserving so that he got the cold shoulder from other ER docs there and left without getting much attention. Today, he was coughing, he was complainting of nausea, he was retching badly and kept calling out for pain meds or other requests. Yes those might have been legitimate request, but comparatively he really wasn't that ill to demand that much vocalization. He has a history of substance use, which no doubt contributed to his difficult character. All my nurses hated dealing with him. Most were dead set on not having me admit him to hospital under any circumstances. Had it not been my worry about his vomiting potentially causing an esophageal injury and that he likely won't be very compliant with any outpatient treatment I bestow on him, I also might have leaned towards discharging him. But I softened. Objectively, he deserved a stay. So I kept him, and quickly apologized to all my nurses for leaving them with most likely an evening of endless demands and moans.

Obviously, in this case, I guess I made the right call.

Lately I have been feeling rather blessed. I had recently got a new condo in an area I've been longing to move into. I've been excited at the prospect of a new home, and new furnitures, and a new living style. While I continue to live a very very modest lifestyle, I have no doubt numerous luxuries easily among my reach. I choose to live somewhat under my means merely as a form of discipline, and because I continue to practice sound financial judgements and planning. But, sometimes, by allowing myself to enjoy a certain luxury, I also allow myself to remember how blessed that I am. Sure, my job is tough, and I honestly feel that every dollar I earn is by trading a little bit of my health and livelihood (there has been many studies on the negative health effects of doing shift work as well as working in a high risk environment such as the ER). But, simply being in the position to work for this type of living is a tremendous privilege. And the more I am aware of my comfortable lifestyle, the more I can see the vast contrast in many of the patients whom I see every day.

As I mentioned in my last entry, in the ER we treat many of the most vulnerable people in our region. Most of these are unpleasant characters that, one could argue, might have found themselves in those situation by their own doing. However, in our society, very often once you are down, no matter the reason, it is very difficult to get back up. These people are difficult for us to treat, and often their actions don't make it any easier. But I try to remember, that no matter how challenging the interaction might be, they are the one who are in need, and I am the one who gets to get into my car and drive back to the comforts of my home at the end of my shift. No matter what, I am the one who has more to give than they do, and it is my job to do so.

I will not be perfect. There is no way I can keep up this positive attitude through out my working career. It is likely that within the first 30 minutes of my next shift I will lose all this perspective. But I will try to remember it as much I can. And the look on the face of that despicable man, as he was thanking me, would serve as a very clear reminder that it is all worth trying.