{"id":2468,"date":"2018-08-17T11:35:42","date_gmt":"2018-08-17T15:35:42","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2468"},"modified":"2018-08-17T11:35:42","modified_gmt":"2018-08-17T15:35:42","slug":"things-ive-learned-from-my-patients","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/","title":{"rendered":"Things I’ve Learned from My Patients"},"content":{"rendered":"
\"\"<\/a>

Ellen Poulose Redger, MD, is a Chief Resident at Stony Brook University Hospital in Stony Brook, NY<\/p><\/div>\n

I recently completed my internal medicine residency training.\u00a0 Three years, thousands of hours, thousands of patients, thousands of decisions.\u00a0 I certainly learned a lot from the past\u00a03 years: everything from what \u201cHFrEF\u201d means and how to manage it, to treating recurrent C. difficile<\/em> colitis, to how to share decision-making with patients about whether or not to start anticoagulation in atrial fibrillation.\u00a0 Despite the multitude of lessons I have learned from my co-residents, my fellows, my attendings, the nurses, the pharmacists, and everyone else involved in my training, I think that the deepest lessons I\u2019ve learned are from my patients.<\/p>\n

Lesson 1:<\/h2>\n

\"\"<\/a>Earlier this year, a patient gave me a recipe for leg of lamb.\u00a0 He had been fighting a hematologic malignancy for years and had spent the better part of the past 6 months severely neutropenic \u2014 and then came in with invasive aspergillosis, which led to emergent and disfiguring surgery. At first, he could laugh about \u201cbeing a pirate for Halloween\u201d [this was months away from Halloween].\u00a0 Later, he refused to speak to the team when he realized just how seriously ill he was.\u00a0 There\u2019s nothing worse than watching someone decline like that \u2014 and so, I pulled up a chair to the bedside, let his wife have a well-deserved break from being in the room, and asked the patient what he liked to do.\u00a0 He eventually started talking about cooking, which is something I enjoy, too.\u00a0 Naturally, I had to ask him what his \u201csignature dish\u201d was.\u00a0 It was a leg of lamb.\u00a0 As he described how to remove the fascia from the meat, and how to properly spice it, and at what temperature he would roast it, he became more than \u201cthe patient with invasive aspergillosis.\u201d\u00a0 I saw a small glimpse of the man who had loved being the center of his family and celebrating with them.\u00a0 When the hours and stresses of residency add up, it\u2019s important to remember to spend time with those we love.<\/p>\n

Lesson 2:<\/h2>\n

\"doctor<\/a>Some of\u00a0the things I\u2019ve learned from my patients aren\u2019t as bittersweet.\u00a0 There was another patient, the victim of another drug overdose in the ongoing heroin epidemic, who came under my care last fall.\u00a0 Just as soon as she was remotely stable, she wanted to leave.\u00a0 That instant.\u00a0 So, I went in to talk to her, to see if I could convince her to stay at least a little longer.\u00a0 She had back pain, and if we couldn\u2019t give her pain medications, she was going to go back out on the street and find something that would work.\u00a0 Eventually, she agreed to stay and to try to get help for her addiction.\u00a0 After her estranged daughter showed up to see her, the patient opened up about what had happened to her \u2014 after a car accident, she had back pain and had gotten her first prescription for opioids.\u00a0 Years went by with monthly refills, until her physician abruptly cut her off, at which point she turned to the street to get pills, and later, heroin (N Engl J Med<\/span> 2016; 374:154<\/a>).\u00a0 Heroin was cheaper; surprisingly cheap, when I asked her how much it cost.\u00a0 Perhaps she was the victim of a well-intentioned effort trying to curb opioid use in this country.\u00a0 Now, though, she wanted to get clean \u2014 the condition her daughter set for being able to see her grandchildren.\u00a0 This patient taught me of the importance of looking beyond just \u201canother addict\u201d or \u201canother XYZ\u201d patient, because each of these patients is someone\u2019s parent, partner, child, or friend.<\/p>\n

Lesson 3:<\/h2>\n

\"cookies\"<\/a>Several of the things that I\u2019ve learned have been much lighter in nature, too.\u00a0 The retired jeweler in my clinic who gently chastised me for wearing my engagement ring while pulling gloves on and off in clinic.\u00a0 He didn\u2019t want me to accidentally throw away something that\u2019s priceless.\u00a0 The kind older bus driver who recommended places to go for vacation\u00a0(you were right \u2014\u00a0Austin was a really fun place to go for a long weekend).\u00a0 The patient who very much misunderstood what I was saying (\u201cI like Boston,\u201d in reference to his Red Sox shirt; not, \u201cI like boxing\u201d) and peppered me with questions about which weight class I liked.\u00a0 The lovely and very chatty patient with whom my attending once left me, as he\u00a0ducked out of the room, telling her that his resident (me) liked cookies, thus leaving me to debate the merits of thin and crispy vs. thick and chewy cookies for 20 minutes and prompting the patient\u2019s family to show up with bags of cookies for me the next day.\u00a0 These patients taught me to really listen to what people are saying, because these human connections are worth their weight in gold (and chocolate chip cookies).<\/p>\n

It can be very difficult when the hours are long, the learning curve is steep, and the patients are sick to remember to learn something every day.\u00a0 Reading books and journals and doing questions is important, but so is learning from our patients.\u00a0 And I am so glad they are willing to teach.<\/p>\n

 <\/p>\n

\"NEJM<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

I recently completed my internal medicine residency training.\u00a0 Three years, thousands of hours, thousands of patients, thousands of decisions.\u00a0 I certainly learned a lot from the past\u00a03 years: everything from what \u201cHFrEF\u201d means and how to manage it, to treating recurrent C. difficile colitis, to how to share decision-making with patients about whether or not […]<\/p>\n","protected":false},"author":1296,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[49,33,42],"class_list":["post-2468","post","type-post","status-publish","format-standard","hentry","category-about-residency","tag-art-of-medicine","tag-reflections","tag-thanks"],"yoast_head":"\nThings I've Learned from My Patients - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Ellen Poulose-Redger notes that many things one learns during medical training don't come from other clinicians \u2014 some are lessons from patients.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Things I've Learned from My Patients\" \/>\n<meta property=\"og:description\" content=\"Dr. Ellen Poulose-Redger notes that many things one learns during medical training don't come from other clinicians \u2014 some are lessons from patients.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2018-08-17T15:35:42+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2018\/07\/AU000_epouloseredger.jpg\" \/>\n<meta name=\"author\" content=\"Ellen Poulose-Redger, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Ellen Poulose-Redger, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/\",\"name\":\"Things I've Learned from My Patients - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2018-08-17T15:35:42+00:00\",\"dateModified\":\"2018-08-17T15:35:42+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/9582a49f225d70a7043e5aad25bfd855\"},\"description\":\"Dr. Ellen Poulose-Redger notes that many things one learns during medical training don't come from other clinicians \u2014 some are lessons from patients.\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2018\/08\/things-ive-learned-from-my-patients\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Things I’ve Learned from My Patients\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/9582a49f225d70a7043e5aad25bfd855\",\"name\":\"Ellen Poulose-Redger, MD\",\"description\":\"Ellen was born just outside Atlanta, Georgia, at the end of her father\u2019s second year of medical school. 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