Anonymous Doctor

"Having a good day, even though my patients are dying."

It's strange to realize that for just about everyone else, death is only something they see rarely, and it's a traumatic experience each and every time. No one in most other lines of work could ever claim to be having a good day when surrounded by death. And certainly no one in most other lines of work could ever admit to it. In fact, I'm not even sure I should feel okay admitting to it.

But I don't know how else to put it. I'm getting more and more comfortable doing this, the attending is getting to know me and I don't feel like he thinks I'm completely incompetent. I'm getting to know some of the residents and we have a good relationship. The days are still long, but there's a little more camaraderie, there's a little more of a team feeling, there's a little less fear I'm going to do something terrible and have no one to turn to. My pre-rounding goes faster, it takes less time to know what's going on with the patients, and I've had some patients for the whole time I've been here, so I've gotten to know them and feel more and more comfortable around them.

Yet even as I feel like I'm settling in, I can't deny the reality that my day may very well be going okay, but my patients are dying. And that's always going to be the case, at least in a hospital setting. I can't prevent it, I can't make them well, I can't do a whole lot but try not to make things worse. And I don't know how much sympathy is the right amount. How sad am I supposed to be, or at least to seem? Every one of these people has no quality of life remaining and pretty close to no quantity of life remaining. It's horribly sad, and sometimes it seems thoroughly unfathomable that this is what the end of life looks like all too often. And that we will all die, in some way or another, and everyone we love will die, and life is very, very short even if it's a hundred years long.

Am I allowed to call it a good day if a patient dies? If a patient gets sicker? If a patient is in pain? If not, what are the good days, especially in a hospital setting?

We don't do much. Maybe lawyers feel like this too, maybe teachers, maybe everyone. That to the outside it certainly seems like we're helping someone, like we're adding some great value to the world. But in most cases, we're just not doing much. We're following recommended drug protocols and we're hoping the patient responds. We're monitoring their test results. We're trying to ease their pain. But a lot of times there's just not much we can do, and not much difference we're making. Frustrating. Maybe. Or just the nature of the job.