Dr. Zaza takes empathy to a new level

Empathy is one of those things that is important for a doctor or a nurse to have. Empathy is putting yourself in someone else's shoes and feeling with them- understanding their suffering. It's important because if you are going to put a patient through a procedure that is painful, frightening, embarrassing or just plain uncomfortable, a little bit of sensitivity goes a long way. Apparently, the number one factor that distinguishes between doctors who get sued and doctors who don't get sued is whether or not the patient likes the doctor. In other words, I can be an incompetent idiot, but if my patients love me, I'll be fine.
Although it is something that comes naturally, I've always worked on cultivating empathy. When I was a nursing student learning how to give injections, I injected myself to see what it felt like. So now when I give a patient a needle I can truthfully tell them, this just feels like a little pinch, you'll hardly notice it at all. And then when I'm done they say, wow, I hardly felt that. It's kind of tough to put in your own IV, but when I was learning, I had a very accommodating friend Anna who let me practice on her in exchange for popping all the veins in both my arms. The next day when we walked around with matching bruises I could honestly say, getting an IV in is no walk in the park. But sometimes it has to be done.
I took my own blood pressure, I (attempted to!) suture my own wounds, and I let a classmate draw blood from me. But most recently, I took patient empathy to a whole new level. I intubated myself. Yes, that's right.
The other day at the hospital the Anesthetist was very nice and let me intubate two patients. He was using a special kind of tube called a laryngeal mask. It has a large rubber tongue-shaped piece attached to the end of the tube and it slides down the throat and seals off the entrance to the lungs and is hooked up to a machine that breathes for the patient. It isn't as difficult to put in as the tubes I'd tried before, and after I successfully got it in on the first try I was elated. Because of a very intense physiological gag reflex to having anything in one's lungs, it is necessary to have the patient unconscious first and lubricate the tube so it slides in. But this type of tube has less potential to damage the teeth or vocal cords. I told the anesthetist, if I'm ever operated on, that's the kind I want to have. He laughed, holding up a tube.
“I'd use one this size on you. Go ahead and try, haha!”
I guess he didn't know that I would take him seriously.
“I've always wondered what it felt like.” I said. “And if I'm going to do it to my patients maybe I should know what it's like.”
He looked at me like I was crazy.
“You must be kidding.”
“No, I'm not.” I took it from him and sat down on a chair to the side. There were a couple of nurses standing there and they all stared at me.
“Do you want some local spray to freeze the back of your throat?” The anesthetist asked dubiously, smearing lubricant over the tip of the tube.
“No thanks, I'll be fine.”
I did consider the fact that I might choke myself, but with an extremely experienced anesthetist standing in front of me and three surgical nurses watching, the chances of something going wrong seemed pretty slim. I put the tube in my mouth and began to advance it down my throat. I had to fight back the gag reflex and for a second I thought I couldn't do it. Then I just decided to go for it and I pushed it down and suddenly I was breathing through the tube. At that moment the surgeon and his surgical resident walked into the room. They just stopped in their tracks and I gagged up the tube and began to cough, tears pouring down my face.
“I'm fine!”
Everyone was laughing and patting me on the back. Later that day someone came up to me and told me that I had become legendary as the girl who had intubated herself. At least, I thought, I can truthfully tell my patients, this is one procedure that you will definitely want to be knocked out for. And it makes your throat sore after.
My dear readers, I wish I could tell you that was the extent of my empathy-inducing experiences. As a matter of fact, two days later, I decided that the intubation hadn't been too bad, but what I really wanted to know was how it felt to be catheterized. (A catheter is a tube that goes through your urethra into your bladder to carry urine out.) I've put catheters in patients before and I always tell them, this won't hurt, it'll only take a second. Well, I won't tell you all the details of that particular procedure, but I did indeed catheterize myself. And I can now truthfully tell my patients, this will hurt, for more than just a second. But it has to be done.
I stopped in at the bank the other day and was sitting across from the bank teller when he suddenly doubled over and began to clutch his chest.
“What's the matter?” I asked him. “Are you feeling okay?”
“I'm having a hard time breathing.” He said. “I think it must be allergies.”
“How long have you been experiencing this difficulty breathing?” I asked him.
“On and off for a couple of months.”
“Do you have any pain or tightness in your chest?”
“No, just a little pain in my neck and back.”
“Whereabouts is the pain?” I asked. “Does it radiate? Is it an achy, dull pain?”
“It just kind of aches here in my back and radiates down my left arm.” He said.
“Has anyone in your family had any heart attacks or other heart problems?” I asked him. “When was the last time you had your blood pressure checked?”
Right then and there I gave him a mini medical consultation. Then I told him as soon as he was finished cashing my check (hey, I'm not completely empathetic!), he was to go across the street to the clinic because it was quite possible he had something going on with his heart. Don't wait for tomorrow, I told him, go right now.
When I walked to my car I had a good feeling thinking I might have saved his life. Then as I drove away I pondered on whether he'd take my advice and go or just stay at work and have a heart attack and die. Then I turned on my ipod and thought about what was for dinner. Suddenly it hit me. I felt completely unemotional about that man. I honestly didn't care if he lived or died. What happened to empathy?
At times I've struggled because I've gotten too emotionally involved with my patients. Sometimes it is hard. I remember once treating a baby girl who was dying of cancer who was lying in her mother's arms in exactly the same way that my little sister had lain in my mother's arms when she died. After they left I had gone outside and leaned against the building and cried.
There has to be a balance, though. On the one hand if I don't learn to distance myself a little, I'll be even more of an emotional basket-case than I already am. On the other hand, if I distance myself too much, I won't be a likeable doctor and I'll end up getting sued. (That sounds trite, I know.) But I do care, deep down inside. I care very much which is why I try to cultivate empathy.
Although at this point I'm not sure which is worse, my sore throat, or my sore urethra. Either way I might just take a break from trying new procedures on myself.