Now that I have all of the new graduates and eager med students here, I first want to say congratulations! You’ve worked hard to get to this point. Your futures are bright, and I truly hope you find the medical field to be a rewarding place.
I am not a medical professional, but I’ve spent far too many hours in specialist offices and hospital rooms. See, I’m young and at the beginning of my career like you- but I’m disabled with numerous chronic illnesses. The places you work at have become a source of trauma and anxiety for me because of the professionals who came before you. While I’m sure those professionals never meant any harm, they did. And my story is all too common among the disabled/chronically ill community-to the point where being treated with decency is a surprise. So, I hope that I can offer you some advice from disabled person to medical professional.
How a patient looks doesn’t determine how sick they are
I feel like I shouldn’t have to say this in 2024, but a patient’s appearance doesn’t determine their illness. I’ve known people who dress up and do a full face of makeup before an appointment because it helps their anxiety, while I know people who come in sweatpants so a medical professional will believe they’re sick. I’ve momentarily stopped breathing and had to be taken to the ER only to have it recorded that because of my PJs I appeared unkempt and my symptoms were a product of mental illness. Meanwhile, I’ve done my eyeliner and worn a dress only to be told that because I could look nice I wasn’t that sick. I’m not going to unpack the racism, ableism, classism, and transphobia that goes into those assumptions, nor wade into the health disparities of various minority groups because that’s your job to do, not mine. But I hope you recognize that by holding the assumption that a sick person has to look a certain way, you’re wading into dangerous, bigoted waters. So if you hold those assumptions (and even if you don’t) you should be working on actively unpacking your biases and researching those health disparities. Your bias can always can always show up in discrete ways you may not recognize. (Also, fyi if you’ve been living under a racist rock, black people feel pain.)
Here’s some research:
Implicit racial bias among healthcare professionals
Healthcare biases experienced by BIPOC and LGBTQ+ patients
Addressing unintentional gender bias in healthcare
Your education should never stop
I know you just went through an ungodly amount of schooling and your dreams are probably still filled with deadlines and essay anxiety. However, hate to break it to you, but the greatest doctors never stop learning. Every week I come across new research studies for my chronic illnesses. You probably know that there are constantly new techniques, treatments, and illnesses. It may seem impossible to stay on top of it all. So when I say you should keep learning and stay up to date, I recognize that it’s near impossible to read every study or attend every conference. It’s more so about doing your best to stay knowledgeable, recognizing that you are practicing medicine, and to never get too complacent. It also helps if you’re open to your patients discussing the research they’ve done. A patient doing research doesn’t undermine your formal education, nor does it make them a doctor. It makes them someone who you can collaborate with. Because, once you start insisting that you know something, but the last time you checked your knowledge was twenty years ago, that’s when the problems start.
On that note…
You don’t need to know everything
You’re human. You simply can’t know everything about medicine. Most people are understanding of that fact. It’s your reaction to not knowing something that separates a mediocre professional from a great one. As a patient, I don’t really care if you don’t know how to diagnose or treat me. I actually have a great respect for the professionals who have told me they don’t know the answers. What I do care about is that you admit it, and then you do something about it. Because, at the end of the day, this isn’t school, and my illnesses aren’t about you. You don’t fail if you don’t have an answer. I don’t get on my knees in worship if you insist you’re the end-all be-all, and if you don’t know the answer no one else will. So, instead of saying you don’t know and leaving me hanging-or worse, saying I’m faking-send me to someone who might know. Do some research. Ask your colleagues. Trial medications. And if you truly have no other options or ideas, for the love of god, be honest that you’re out of your depths and don’t know what to do. It’s okay if you are. Your patient may be upset because they’re no closer to answers, but their feelings aren’t personal. They won’t think less of you.
Your belief in us means as much as an answer
Anyone who has had their symptoms dismissed will know that there is such a raw desperation to be believed. Many of us are just as desperate to be listened to as we are for answers. In general, it only benefits you to believe your patient is experiencing the symptoms they describe. I realize that there are some people faking illness out there, and that sucks, but the vast majority of people don’t want to be in this situation. They don’t like being sick and they don’t like the attention that it brings. So much gaslighting occurs within medical settings that we just want to be told our symptoms are real and you believe something is going on as opposed to “it’s just anxiety” or “you’re doing it for attention.” I promise, if you’re willing to believe us, you’re going to do just fine.
Your ego will be the death of you
The field of medicine has no place for your ego. You’re meant to help people, and you have enormous power over people’s lives. You can quite literally determine whether someone lives or dies. So, if you’re someone who insists you’re right every time regardless of evidence, and you refuse to listen to other ideas, change careers. Get the fuck out of this field if you care more about your reputation, being “right,” or your paycheck than your patients. This isn’t a t.v show where you can have as many redos as you need. I’m sick of showing up to doctors who care more about being at the top than the fact my symptoms are taking away my life. And by the way, if you don’t have a crumb of respect for others, no one will like you-no matter how much you know. Patients will stop coming and your coworkers won’t make your life any easier. If this little reality check hits too close to home, consider why.
