Surprise! It’s Patient Appreciation Day →

On random Fridays, clients are showered with extra affection to celebrate “Patient Appreciation Day.” I surprise the unsuspecting visitors with dark-chocolate hearts and Mylar heart-shaped balloons as they enter the office. This is in addition to the gifts many receive for meeting their health goals.

Sitting on the couch next to her balloon, treats piled high in her lap, a woman bursts out, “This is like going to Grandma’s!” Kids and adults alike enjoy the unexpected attention and gifts.

It’s especially exciting to surprise new patients, the ones who choose me at random from a preferred provider list given to them by their health insurance company. After receiving a door prize and an initial hour-long appointment, one woman exclaims, “I feel like I hit the lottery!”

Actually, I’m the one who hit the lottery. After all, I couldn’t be a doctor without such awesome patients! Here are a few of the people I appreciated and celebrated this week:

Mariah loves her balloons!

Benjamin and his balloons

Kimmy takes a balloon for her son.

Dick and Sheri share a loving moment before the end of their visit.

Pamela Wible, M.D. is a family physician in Eugene, Oregon. She is author of Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind.

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Should You Be Intimate with Your Doctor? →

Pamela Wible

A new patient calls for an appointment. I ask, “What would you like to come in for?”

“Depression. Two weeks ago my doctor put me on antidepressants.”

“Why don’t you see your current doctor?” I ask.

“I feel weird discussing my emotions with someone who doesn’t have any.”

When doctors are fully present, vulnerable—even emotional, patients are more likely to be honest, transparent, and open. Sexual intimacy is, of course, inappropriate between patients and physicians, but emotional intimacy is essential in any healing relationship.

What patients really need is a human being who is being human, a whole person who sees the patient as a whole person. On her way out, a new patient says, “I feel like I just got a physical, met with a marriage counselor, and had a spiritual awakening.” We could all have comprehensive, personalized care, but here’s the paradox: We resist what we most desire: Intimacy. Intimacy means “in-to-me-see.” It’s when we see so deeply into another, that we find our own reflections and discover ourselves.

Beatrice, an elderly woman calls for a Prozac refill. I remind her of my office policy: no refills between appointments. She screams, “None of my other doctors made me come in. What’s wrong with you?” Upon arrival for her appointment, she’s fuming. After thirty minutes, Beatrice breaks down and shares how difficult it has been since her husband died last month. She feels isolated and scared. With tears in her eyes, she hugs me and then thanks me for getting her out of the house.

It’s Friday night when Christie calls for an antidepressant. I pick up on the second ring. “Hello, how can I help you?”

“This is the doctor? It’s almost midnight and you answered the phone!” Frazzled, Christie tries to explain herself. “Things are kind of tough right now, Pamela. I was just calling so you could prescribe me some antidepressants.”

We talk about her mother’s death and the challenges of raising her autistic child.

“Christie, I’m happy to see you Saturday morning.”

“I just can’t believe you answered the phone. I’m so excited, I don’t feel depressed anymore.”

Being emotionally available and accessible is healing. Sometimes I think maybe I am the antidepressant.

Pamela Wible, M.D. is a family physician in Eugene, Oregon. She is author of Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind.  Photo credit: GeVe

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How to Eat a Triple Bacon Cheeseburger with Your Doctor →

Joe just had open-heart surgery. A triple bypass. When he left the hospital last month, he promised he’d follow a healthy diet and quit smoking for good. I call to review his cholesterol results. He picks up on the second ring.

“Hold on a minute,” he says.

The reception is poor, but I can make out a few people talking. I hear the muffled voice of a woman.

“Okay, so you want a combo meal, sir? That’s a BK Bacon Triple Cheeseburger, large fries, and a large Coke. Anything else, sir?”

“Can you change that to a Diet Coke?”

“Okay. That will be $7.29 at the window.”

“Sorry, who is this again?” he asks.

“It’s Dr. Wible.”

“Oh my God. Oh no. Oh no. Oh my God. I can’t believe it. I promise this is the first burger since the bypass. It’s just a treat. It’s the first time, I promise. I’ve been eating more salads. I was even vegetarian for a few days. I can’t believe it’s you. I can’t believe you’re calling now. Oh my God.”

“Joe, your cholesterol is still high. You better stay on your statin. In fact, let’s triple the dose. You know, the drive-thru is just a shortcut to the Pearly Gates.”

This is PART 2. Read PART 1.

Chapter 79  from Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind.   ** R.I.P. Joe 12/10/13 **

 

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How to Smoke a Cigarette with Your Doctor →

Joe has smoked two packs per day since his teens. He knows better. I don’t need to lecture him on the dangers of smoking.

“I was a respiratory therapist back in Brooklyn,” Joe says in his thick New York accent.

“And you smoked?”

“Yep. All the respiratory therapists smoked, Doc.”

“Reminds me of cardiologists who order bacon and eggs in the hospital cafeteria, but then tell patients to eat low-cholesterol diets.”

Joe continues, “It’s my anxiety. That’s why I smoke. I moved to Oregon a few years ago for the quiet life. I’m gonna turn my life around. You’ll see, Doc.”

Today we’re celebrating. Joe hasn’t had a cigarette since he went into the hospital last month with pneumonia.

“I feel terrific!” he says. “I’ve turned the corner, Doc.”

The next day I’m bicycling through town. I turn at the corner of Sixth Avenue. To my right, I see a man smoking a cigarette. I have a feeling it’s Joe. He’s standing next to an apartment complex. I get closer. Oblivious, he has headphones on and he’s tapping his left hand on his thigh. So I speed up and then stop suddenly right in front of his face. The high-pitched squeal from my brake pads startles him.

He does a tough guy pose and tries to stare me down. “What’s your problem?” he says.

I lean my bicycle against the door to his apartment.

“Who are you?” he demands as he closes in on me.

We’re in a standoff. He takes off his headphones. I take off my bike helmet. He removes the cigarette from his mouth. I remove the sunglasses from my face.

Then he slinks back against the building and almost cries, “Oh my God. Oh no. Oh no. Oh my God. I can’t believe it. I promise this is the first cigarette. I just picked it up just now. It’s the first one. I mean the last one. I promise I’m going to quit, Doc. I’ll quit now, tonight, as soon as you leave. It’s the last one. I promise. I can’t believe it’s you. What is this? Why are you here? What are you, an angel?”

I put my hand on top of Joe’s balding head, look straight into his eyes, and I bless him: “Your life has been spared one more day.”

Then I ride off into the sunset.

This is PART 1. Read PART 2.

Chapter 78 from Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind.   ** R.I.P. Joe 12/10/13 **

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Why I Kiss My Patients →

I started kissing patients in med school. And I haven’t stopped.

During my third year pediatric rotation, I used to stay up late at night in the hospital, holding sick and dying children. I’d lift them from their cribs, kiss them, and sing to them, rocking them back and forth until they fell asleep. One day the head of the department pulled me aside. He said that I was a doctor when my patients needed a doctor and a mother when they needed a mother.

Twenty years later, I’m still mothering my patients.

I’m a family physician born into a family of physicians. My parents warned me not to pursue medicine. They worried that big government would kill the small-town physician. But I love being a family doctor. And I love my patients. I hug them and kiss them, and I do housecalls. And most patients call me Pamela or sweetie, or honey. They all have my home phone number. I’m on call 24/7, but I never feel like I’m working.

I’m not good with boundaries. I’m never sure when work ends and play begins. It all feels the same to me. Many of my patients are friends. I do their physicals and eat over at their homes for dinner.

I’m not a fan of professional distance. But I’ve been trained to maintain distance from patients. How can I remain distant when I’m looking deep inside people in places nobody has been before? How can I remain detached when delivering a mother’s first baby, saving a brother’s sister, or helping a child’s grandfather die?

Apparently, maintaining a safe distance from patients will help my objectivity, limit favoritism, maintain clear sexual boundaries, and prevent exploitation. But patients today don’t want professional distance; they want professional closeness with a doctor who has a big heart and a great love for people and service in a clinic where people feel warm, nurtured, loved and important.

And I want to be that kind of doctor.

The truth is: I can’t always stop patients with heart attacks from eating bacon double cheeseburgers. I can’t always stop smokers from smoking. I can’t always stop little kids from dying.

I can’t always cure, but I can always care—and kiss my patients.

Pamela Wible, M.D. is a family physician in Eugene, Oregon. She is author of Pet Goats & Pap Smears: 101 Medical Adventures to Open Your Heart & Mind.

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