The True Face of Medicine

I grew up listening to stories about how great physicians are.

In every instance I can recall, people would always have the utmost utter respect for any healthcare provider, focusing their praises on the selfless service those providers delivered day in and day out. That praise was integral in the formation of the image in my mind of how great healthcare workers are. Ultimately, it sparked my interest in the medical field.

But was all of that praise deserved?

Are healthcare workers really selfless as my young mind came to believe?

In my experiences shadowing both physicians and nurses in several healthcare settings, I have been exposed to the true face of healthcare, and at times, a side of healthcare providers’ feelings towards their patients that I had not before been exposed to.

My first negative experience with healthcare workers’ feelings towards their patients came when I was doing my clinical rotations to complete my EMT certification.

My job for the night was to shadow the E.R. staff of a large public urban hospital, and my first interaction of the night came with a nurse on duty. She was extremely nice to me, warmly introducing herself and welcoming me to the new setting. Immediately, all of my preconceptions were supported. “This night shift is going to be a breeze,” I thought. As we walked into the first patient’s room, the nurse put on an enormous smile.

“How is everyone doing tonight?” she exclaimed, looking first at the child sitting in the patient’s bed and then around the room at the two parents. She went about her medical duties professionally and, once completed, made her way out of the room as I followed quietly.

Quickly, her bright smile faded. “Glad that’s over,” she said. As we headed back to the nurses’ station, she began talking with another nurse.

“Can you believe they’re back again!?” she said, approaching the station. “Maybe they wouldn’t come back so often if they actually took their child to a primary care physician instead of the ER, which is full of all of this bacteria. They’re making their own child sick!”

I continued to listen quietly, bouncing the scenario around in my own mind. “Maybe what they’re saying is true,” I thought. The child was probably at risk for more illnesses coming to the E.R. than if they had been brought to a primary care health provider. While all of this may have been true, however, something still bothered me: the way they went about discussing the patients they were supposed to be caring for.

A short while later, we once again the same room and, once again, the nurse entered very enthusiastically. When she came back out, however, she once again began gossiping about them to her coworkers.

“Maybe she is just concerned about the child,” I thought.

As the night went on, we visited another patient. This time, it was an elderly man wearing raggedy clothes. The same big smile was back on the nurse’s face. When we exited the room, the nurse went straight back to the nurses’ station to discuss her opinion of this other patient. This time, a physician joined in.

“You know,” the physician said, “these homeless people only check in to the E.R. to have a warm place to stay and eat some snacks. It would be much easier for them if they just pick up a job!”

With that, my heart dropped.

Everything I thought I knew about healthcare workers was in question.

I was hesitant to speak up, as I was only a student on rotations and these healthcare workers were my “teachers,” but as their conversation continued -- delving into economics and our political healthcare system -- I began to feel like they were more concerned about their tax dollars than the patients they were there to care for.

Could there statements have been based in fact? Sure, I thought. But why were they approaching these concerns with such apathy? Why were these problems being used as fuel for water-cooler conversations? The fact that healthcare providers were gossiping about patients put a very large dent in their professionalism.

After this rotation, I began thinking: “Do health care providers even really care about their patients? Is this just a job to them?”

I entered my next rotation, in another public urban hospital, with this very question. Thankfully, I left with an answer.

Not all health care providers are like this.

The nurse I shadowed in my second rotation was everything I’d envisioned a healthcare practitioner to be and more. She was extremely compassionate. She was passionate about her work. She took my learning experience seriously and would ask the patients for permission before taking me into their rooms. And, most of all, she cared about those she served, and she displayed that caring every second of every shift.

Through my first experience, however, I still had reservations.

“Maybe this nurse is more compassionate because she’s serving a different social class of patients,” I thought, wrestling around with my newly formed preconceptions. Quickly, however, this doubt was disproven. I looked around this E.R., and it was much busier than the other one; so busy, in fact, that some beds were brought out and set in the hallways to accommodate the sheer number of patients.

The nurse explained the prevalence of homeless patients that come to the E.R. as well. But she did so empathetically, taking their perspectives and experiences and using them to support each statement she made.

What made this nurse so different than the other nurse and physician at the other hospital?

My curiosity led me to asking a close family physician what his opinion was on this matter. His description was concise but explained a lot.

“Burn out is real,” he said.

From this explanation and further extensive research, I came to learn that a portion of healthcare workers start their careers with the goal of truly helping people. Over time, however, they begin questioning the political nature of the healthcare industry. They feel the burden of overwork, and grow tired of a perceived lack of appreciation. These factors, over time, often contribute to the slow progression of apathy towards patients.

Each patient becomes another part of the healthcare worker’s job. Nothing more. Nothing less.

So how is it that some healthcare workers are able to maintain empathy after years of working in the field?

This can be due to several factors. Some are able to maintain their empathy through stress relief and maintaining a healthy lifestyle, both physically and mentally. Others try to avoid thinking too deeply about the reasons behind patients’ motives to visiting a hospital or clinic, focusing instead on treating the patients in order to not burnout their empathy. But the biggest reason, and perhaps the most revered reason of all, is that some people are just born with an innately unlimited amount of empathy.

No matter what happens in life, they continue to care for each patient as one in the same. They continue striving to help the people they serve, and come to work every day prepared to fight anything standing between them and the health of the individuals they care for. They see their patients as individuals and not just numbers. Their job is not just a “job,” but a calling. And they respond to that call every day, despite all of the challenges that come along with it.

In the end, I have come to learn that these are the healthcare workers that I came to respect as a child. These are the individuals who represent all of the selfless qualities I strive to emulate. They are the people who all of those stories are about, and they are the people that change the world for the better.

Es-Haq Hassanin

Osteopathic Medical Student - 2nd Year (OMS II)
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences