“I’m so sorry.” The attending says with a sheepish smile as he hands me the chart.
I should have seen it coming, although I had heard attendings and residents say worse about patients with shorter past medical histories and medication lists. So I smile cautiously and head into the room.
The minute I walk in I know it’s not going to be good. I open with my usually cheery greeting (focusing on smiling so I don’t scare my patients away with my RBF) “Hello, I’m Tessa the student doctor working with ____ (insert attending’s name) today, how are you doing?”
She responds with a skeptical glare before reluctantly taking my outstretched hand.
“What are you doing here?” She snaps at me.
“I’m a medical student working with your primary doctor today, so I am here to talk to you first before the attending comes in.” I respond, trying to be as patient and pleasant as possible. “So what brings you in today?” I try and move on with the conversation.
“I don’t feel like doing this.” She states and stares at me blankly.
“I’m sorry?” I genuinely don’t understand what she means by this statement. She clarifies for me:
“I don’t feel like doing this with YOU.”
This takes me aback. Not that there haven’t been patients that hadn’t wanted to see the medical student before. But they had never met me, they just told the LVN they weren’t interested in being seen by a student. It didn’t feel personal or mean spirited. I always just assumed that if that had actually met me my charm and wit would have totally won them over.
This however, felt VERY personal. This woman met me, assessed me, and was now sitting in front of me saying that she was too important to waste her time with me.
My gut reaction? I was pissed as. Who was she to think her time was more valuable than mine? As it she was doing me some favor by talking to me. I had plenty of other things I could have been doing instead of being there trying to HELP her. I had SOAP notes to write, exams to study for, clinical guidelines to learn and plenty of other patients I could have been spending my time with.
So what do I do? I stand up, smile my sweet plastic smile, say “Alright, that’s ok,” and walk out the door.
As a people pleaser, this was pretty much my worst possible scenario. If you are also a person bound to the cruel world of requiring others to like you, then you understand my plight. So when I walked out of that room to the knowing looks of the LVNs and Residents who then tried to reassure me by saying “Don’t worry, it happens all the time”… that really did NOT make me feel better (although I appreciate their efforts to console me). Being a professional also makes dealing with rejection like this more challenging – because I’m not allowed to get angry. I’m not allowed to deflect my hurt feelings into rage and superiority (As you can tell by my earlier gut reaction, is my typical cooping mechanism).
So it is my conclusion that for people like me, being a professional and surviving in this world of medicine requires developing a bit of a split personality. The residents are right, this is going to happen over and over again as a student and even once I become a physician. Some patients are going to ask to switch doctors because they don’t like that I am a woman, or that I am blonde, or maybe because I smiled at them the wrong way. And I won’t survive if every time this happens I am reduced to a sad little puppy dog sitting in the rain wondering “why won’t they love me?”
The key (which I have in no way mastered at all btw) is to realize that they are not rejecting Tessa – they are simply going in a different direction than Student Doctor Tessa.
And Student Doctor Tessa is NOT the same thing as Tessa. I mean, that’s pretty much the reason I started writing this blog, so I could remember this very fact. But man, even with all the good intentions I had in the beginning to keep myself separate – I failed hardcore, as was evidence by the fact that I definitely shed a few tears after this encounter.
So, I guess it’s time to remind myself of this fact again. Sometimes people will reject parts of us, and I am going to have to learn to be ok with that.
Here’s the intention/instagram post I made the night before I started this rotation – apparently I should have added something about my patients hating me… we live and we learn. Anyhow, it’s time for a refresher on this personal promise: