This is what transpired in my daughter's orbit last week. True story:
On Friday, she stubbed her toe. That would have been painful enough, but she'd dropped the lid from cast iron pot on the same foot several weeks earlier, and it was still bothering her. She was optimistic it would eventually take care of itself, but it was still painful and swollen. Then, BAM! The toe!
By Saturday morning, it was apparent the toe was broken so she agreed to go to one of the nearby orthopedic walk-in clinics to have it checked out. When she got to the first one, it was closed. No problem. She made her way to the second one, a little farther away. It, too, was locked up tight...even though both websites indicated they were open for business.
She ended up at an urgent care clinic which, she conceded, was better than nothing. There, she explained that she'd experienced two injuries--one to the top of her foot and one to her toe. She showed the radiology tech where the pain and bruising were. The initial reading on her X-rays suggested no fracture, so she came home with nothing. No boot, no crutches, and no diagnosis...until hours later when the radiologist read her films and identified the fracture at the base of her toe. They had failed, however, to include films of the dorsum of her foot, so the nature of that injury will forever remain a mystery.
They invited her to come back so they could apply a post-op boot, but by then something else was developing at home. Something urgent. Her older dog had picked up a mild case of kennel cough from his younger sibling, and all afternoon he was becoming more and more short of breath. He was anxious and lethargic. He wouldn't eat or drink. He clearly needed help. So at 9:30 that night she bundled him off to the nearest emergency vet clinic. When she got there, she was told that they were "at capacity," meaning they weren't seeing any more animals that night. They told her that the next closest clinic was also at capacity, which meant a 30 minute drive to an animal hospital in another town. In another state. In the middle of the night.
There, she explained her pet's symptoms. She told the vet that her other dog was being treated for kennel cough but so far, nothing was helping. She'd already been on two antibiotics and it sounded like her cough was getting worse. Now her older dog was clearly in distress. It's no wonder she was upset when the vet neglected to get an X-ray to r/o pneumonia. When he prescribed the same antibiotic that failed to help her younger dog, and he refused to explain why. Then he became defensive because she asked questions in an effort to understand how this was expected to work...and what she should watch for over the weekend if it didn't help. She left feeling frustrated, angry, and disrespected.
To be perfectly honest, the vet was probably justified in foregoing the chest x-ray. Clinically, the pup didn't require IV hydration or oxygen at that point in his illness so he didn't need to be hospitalized. And he did prescribe a widely accepted broad-spectrum antibiotic for the infection. I'm sure the vet was confident everything would be fine, even though he failed to communicate that to my daughter. He didn't answer her questions, or address her fears. Similarly, earlier in the day at the urgent care center, her concerns about her foot were not heard, and the full extent of her injury was overlooked.
This story is intended to convey the healing power of a patient, gentle, and compassionate relationship between the physician and the patient (or, in this case, the patient's caregiver)…when everything else is foreign and frightening. It speaks to the importance of trust and confidence in the healer’s character and expertise. It should remind us to treat every patient with the same respect, kindness, and care we would extend to our best friend, to our own family members, and even our beloved pets.
Unfortunately, we've watched medicine change over time. How sad it is that the physician/patient relationship is no longer what it used to be. How little time we have with our patients. How continuity of care has been sacrificed in favor of efficiency. How the drive for corporate profit outweighs the compassionate care of our patients.
Even when care is appropriate and thorough, it may not be good enough. We can do better. The patient's or the caregiver's fears must be allayed, his questions answered, and trust established before healing can begin. There is always room at the bedside for gentleness, patience, and compassion.
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