We have a particularly difficult patient on our vascular surgery service who is a frequent flyer at the VA. He is a poorly compliant patient with some psych issues, in addition to be morbidly obese with very poor hygiene and even worse bowel/bladder control. None of the nurses or doctors like to take care of him and they don't do the best job of hiding that fact. He frequently becomes agitated with the staff for "not treating him like a vet." Last week he threatened to leave AMA (against medical advice) because he wasn't allowed to ride his motorized scooter to the canteen to buy tootsie pops. While most of the staff scoffed at his seemingly ridiculous request and were ready to get him out of their site, my surgery intern had a different approach. He bought our patient the tootsie pops and got him his scooter back, which lead to an immediate improvement in our patient's behavior. He saw that we were on his side and were not conspiring against him.
Although some of the staff members yelled at my intern for convincing this "terrible" patient to stay, my intern explained that he knew if the patient left, the infection in his foot would undoubtedly spread and he would likely need an amputation. He said that as a doctor you have to have enough perspective to look past the actions of your patients. That was one of the most sensitive things I have seen any resident do. I guess I was expecting the resident to have the same dismissive attitude as the rest of the staff, especially because he was supposed to be a typical surgeon who only really cares about cutting and suturing up the patient. His simple act reminded me that whatever field you go into, you can always avoid the negative stereotypes. You don't have to let the preconceived notions dictate your actions. You just have to stay true to your convictions and let them dictate the type of doctor you become.
