Patient love is messy...

today, a patient was admitted under my service.  under normal circumstances, this should have made me happy.  excited even.  this would have given me the opportunity to practice my clinical prowess, exercise my mind, give a chance to be good and help humankind.

problem was i hated her.  i didn’t want to admit her under my service.  it was the weekend and i just wanted to do plans forma.  she was shrewd to the point that in the clinic yesterday, i charged her nothing because she wouldn’t take my medical opinion and i didn’t want to see her again because she kept on ranting about finances.  yes, i understand that finances play a major role in a place where insurance was not the mainstay of health care, but the patient would not accept the alternative of being admitted under a service hospital either.  talk about being payish.

after i sent her on her way (hoping that she would indeed go her way which would be OUT OF MY WAY), she called back my clinic (after my secretary and i had left), seemingly as an afterthought and did decide to follow my advice.  even with no clinic schedule on a weekend, i told her i would be willing to see her in the morning given that i had activities lined up in the afternoon.  she had the gall to say that she could not come, and the even bigger gall to ask to be admitted under my service and NOT go through the ER.  

trying to perform my Christian duty, i called the hospital and dictated admitting orders, respectfully asking the staff to give the orders to her.  after it was all done and complete, patient then decides to admit herself the next day.  saturday.  afternoon.  when i had my activities planned.

i prayed to the highest heavens for her to find another doctor.  i prayed for her not to cross my path because i felt that my kindness was being abused by her shrewdness.  

as circumstances would have it, she did admit herself under my service.  i went to the hospital even if i feigned being out of town to step out of her way.  only to find out that she had herself referred to another doctor.  and as such, i was the third wheel.  i believe her exact words were “paano yan doc, eh di dalawa na kayoing babayaran ko?”  

i couldn’t believe hearing those words after i went out of my way.  so i said with raising temper that i could just take out my entry from the chart and prevent nothing happened.  and she said “eh paano yan doc, kayo ang naiintindihan ko.”  

in pure exasperation, i headed out of the room “hmmping” away, muttering “discout sa PF”.  i felt smoke coming out of my ears and my face turning red in pure anger.

my thoughts were: i shouldn’t have sunk to her level and been rude.  but, i am just human.  however, i shouldn’t have done it.  but she deserved it.  she was so disrespectful (would that be the english translation of BASTOS?).  i should have understood her because she was sick.  but she was admitted under me and she did not follow any of my advice.  but that is the exact thing doctors give.  advice.  and i, as a doctor, could not compel anyone to do what i think should be done.  

it was a good thing things would solve itself.  i get a phone call from the head nurse where the patient requested that she only be seen by the other doctor.  i was ecstatic to be able to get out of the way.  i signed out of the service and charged nothing.

one would think that i should be happy.  but i was not. mainly because i sank so low.  i should have kept my cool.  shown my doctorly love. but the alta in me couldn’t do so. 

how do you balance being kind (and prone to abuse) versus being right (and being prone to complaints for misconduct)?    

Epilogue…

well, too late to do anything else now.  at least i got out of it.  at least, i got a reflection paper out of it.  at least, i got my point across (i think, or did i?).  i just hope that this lapse on my part will have no repercussions for my conduct and my referral base in the future.  but if it does, maybe this is not the place for me. 

only time will tell.