Thread by @medicalaxioms

If you set your mind to it, and you really want to hate your job and the patients you care for, you can blame almost every patient who comes in the hospital for making your day worse by making you work hard to take care of them. 1/10

If you want to get burned out and quit in disgust, look hard for patients who
- don’t take their medicines
- make bad life choices
- engage in high risk behaviors
- don’t invest the time and effort to exercise
- take dangerous jobs
- run with dangerous crowds 2/

If you want to be sad and hurt at the end of the day, think of all the hard work you put into people who “won’t put the work into caring for themselves.” 3/

Don’t think about the pain and suffering of the sick person.

Think only if your own pain and suffering. Focus on it. Dwell on it. Let your resentment build until you can’t stand to walk into the hospital another day.

On that day you will be ready for this message: 4/

If you want to succeed, know your purpose, be happy in your work, and enjoy the honor and privilege of being a healer, you must understand your role and scope. 5/

You are not here to judge the decisions your patients make. 6/

You are not here to live people lives for them. You do not go home and tell people what to eat, how much to drink, when to go on a brisk 20 minute walk.

These are tasks left to free will. You merely make suggestions. 7/

Your task is to find people when they are sick, build a therapeutic alliance, and as far as you can be convincing, guide each patient toward treatment and prevention to improve quality and/or quality of life. 8/

If you get angry when patients don’t follow your recommendations, you have failed. 9/

Few patients have ever adhered to a treatment plan because of an angry doctor. 10/

If it hurts your feelings when someone doesn’t follow your recommendations you are doomed to failure.

You are going to hate your job. Your patients are going to hate you too. You are meddling. Paternalistic. Overstepping you boundaries. 11/

Here’s what works for me (and I love my job): 12/

Forget about the outcome. It’s beyond you control. It’s the award ceremony on the podium, not the game in the field.

Focus on the bond. The bond is where the joy is.

The bond is where you can teach, advise, guide a person from sickness to health. 13/

The bond is where is where you get back more than you put in. You leave work feeling better than you arrived.

The bond is a safe place where you hear honest words and you get to speak them. 14/

It’s not a friendship. You are getting paid and they are sick and scared. It’s not an equal connection. It is doctor-patient for you, patient-doctor for them. 15/

In these last few lines, I will teach you how to make this bond, fast.

1. When you first meet, ignore every single difference between you. Age, gender, ethnicity religion, background, nationality, criminal record, political affiliation. Everything. 16/

While you hear the story and examine the body, search for as many things as possible you have in common.

- love a local sports team
- hate your ex-spouse
- hate hospitals
- love chocolate cake
- recovering from addiction
- had a long day
- grew up in an abusive household 17/

You only need one. A shared interest.

I once built a very strong bond with an incarcerated fellow over prison tats. The artists, their techniques, regional styles.

I got to know so much about his life, priorities, treatment goals, hopes & dreams just by talking about tats. 18/

I happen to like art and he was covered in it. By exploring, I found a common interest. In other ways we were quite different. I don’t care about the differences.

I’m not in the differences game.

I’m in the bonding game. I build therapeutic alliances. It’s my job. 19/19

“Rather than noticing the differences between herself and others, she trains herself to notice the similarities. She centers her attention on those factors that are universal to all life… leading to feelings of kinship rather than estrangement.”
—Mindfulness in Plain English