Patients are not sheep
I attended the local county fair a couple of weeks ago. Since we have two Shetland Sheepdogs who love to herd things (mostly kids), I wanted to watch the sheepdog trials. There is nothing like seeing these wonderfully-trained dogs at work. The dogs stare down the sheep and strategically move them in unison from one place to the other. The sheep are visibly intimidated, although many are big enough to kick this dog's butt, if they were so inclined. This demonstration is not unlike some people's experiences at their doctor's office or in the hospital.
The medical provider is the strong-eyed, intimidating sheepdog (of course). The patients are the sheep (sorry). The doctor/sheepdog enters the examination room with regal confidence and determination; chart in hand; stethoscope over the neck.
The patient/sheep is passively sitting (naked/sheared under a paper gown) on the examination table. After a brief introduction to make sure the patient knows this is the doctor, the herding begins. The patient may be herded to the lab, then on to x-ray. They are then herded to the pharmacy, where a different breed of strong-eyed professionals, supply you with various elixirs and nostrums. The patient may then be herded on to specialists, where the dance continues.
At some point, the sheep will either (a) complete their herding journey, or (b) leave the herd and run away in frustration. The sheepdog is not that concerned about runaways. There are plenty of other sheep. The wolves can have a few. (I will let you guess who those wolves might be. Hint: They quack instead of howl.)
When patients (people) are treated like sheep, they tend to ACT like sheep. They relinquish all care and responsibility to their medical providers. They passively sit there, naked, and accept piss-poor treatment instead of working in partnership with their medical provider. As a medical provider and a reluctant patient, I have been on both sides of this equation. Even when my own doctor knows that I am a medical provider, they still treat me like crap sometimes. As soon as my white coat and stethoscope comes off, I am no longer a member of their club.
My most recent heath challenge was a kidney stone, discussed in an archived Blog a few months ago. The ER provided me with surprisingly wonderful care (this time); but my urologist was terrible (I hope he reads this).
During my three visits to his office, he never ONCE examined me! I am still mind-boggled. He also never wrote any notes (I can get in my own chart quite easily). I was curious what he would write about his "examination". He certainly didn't fudge and write a fraudulent examination. He didn't write anything! I spend hours typing charts. I didn't know we could just "not chart". Obviously, that was the last time I would see him as a patient; and of course, the last referral he would ever get from me. There are plenty of other sheep, apparently, since he still has an active practice.
Doctors and other medical providers should have periodic "secret shoppers". Someone needs to challenge some of these arrogant sheepdogs. When I was in family practice, I would often hear my colleagues bitch about a sick patient showing up without an appointment. Those sons-a-bitches! How dare they seek medical care when they are sick! Who do they think they are? I have to go to lunch. When did the word "care" leave "medical care"? I must have missed that announcement.
Yes, some sheepdogs are definitely problematic, but what about the sheep? Don't they have a role in this? You bet they do.
Patients need to stop being sheep. Medical professionals, no matter how intimidating and strong-eyed they are, are really not in charge of your life's journey. Ewe are in charge. Unless people take an active role in their own health care, and the health care of families, this mindless herding will continue. In order to be equal partners with your medical provider, you are going to have to be more strong-eyed and assertive, too. - Don't accept substandard care for a high-cost visit.
- Do your homework, both before and after your visit. Don't leave without knowing your diagnosis and the medical provider's rationale for making that diagnosis.
- Then, go home, get on the Internet, and see if you agree.
- Got questions? Call your medical provider. They don't call you back. Call again...and, again.
If they fail at their professional role in providing you with answers and explanations, or at least the courtesy of returning your call in a timely manner, then walk. See a different medical provider. Medicine is much too complex to do it alone. Unless you partner-up with your doctor, and are accepted as a respected member of the care team, then leave the herd.
Maybe I am angry today. I called my mother's nursing home doctor for the third time in the last five days and I am still waiting for a call-back. If she ever calls, she is going to be informed that her services are no longer needed.
On the WebMD Ear Disorders Board, I am sometimes asked to answer a question that should have been addressed by the patient's medical provider. People sometimes post within an hour of their empty medical visit. Sure, medical providers walk in with a hurried demeanor, but that does not mean your visit should be short-changed. If you had an appointment, then you deserve to have a productive visit. Besides, the medical provider is not doing this for free, you know. Someone, either you or your insurance company, is writing them a check.
Try this: "I know you are busy, Doctor, but it is very important that you answer my questions. If you can't do it now, when can I expect a call?" You must be prepared to stare 'em down, in a respectfully assertive manner, of course.
Next time you are sitting in the examination room hearing the bleating of others while waiting for your medical provider to arrive, I want you to repeat this mantra, "I am not a sheep. I am not a sheep."
Related Topics: Language Barrier Affecting Health Care, Healing the Doctor-Patient Relationship (WebMD Video)
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23 Comments:
LOVED THIS POST! One of my friends had the perfect word for doctors suffering from arrogance; he called them MDeities. I've been fortunate in most cases to have wonderful doctors who don't fit that profile -- but I knew what he meant!
Your posting also reminded me of an endocrinologist I used to see for my thyroid problems, and the time that I wasn't a "sheep" anymore. His nurse always insisted that I strip to the waist and put on an open-front paper shirt for the examination, which was always just of my throat. (The nurses had explained in the past that they required this for all patients so he could process them more quickly, and it was just in CASE he needed to do a more in-depth examination.) I didn't understand the need in my case, felt like an item on an assembly line, and had some issues with this doctor's overly intimate bedside manner. I hated that too-small, too-thin paper blouse and how naked I felt in it.
The last time I went to that doctor, I politely told the nurse that I would not be undressing. She sputtered, and I added that if the doctor needed to do a more extensive exam, I would change quickly. When she protested again, I said I would change clothes as requested for his speed and convenience -- if he would just provide a paper or cloth blouse of adequate size. (The paper blouse wouldn't even pull closed over my chest.) She shook her head andleft me alone.
When the doctor came in, he frowned at my street clothes and asked if his nurse had failed to ask me to disrobe. I quietly said it was just my preference. He said it was required. I had anticipated an argument and had a prepared response: "Think of it from my point of view. Over the years, you've never examined my chest or explained that it might be necessary. The covering you provide for me is also inadequate. So you've given me NO reason to see this as anything other than a waste of my time and an unnecessary indignity. How would you feel if you went to the doctor for a chronic stomach ache and he told you to disrobe from the waist down JUST IN CASE he MIGHT need to do a thorough examination, and his nurse cheerfully gave you just a teensy little Dixie cup to cover your genitals? Would you feel all comfy and dignified then?"
The discussion went downhill from there. *sigh*
I also loved this post. I am very happy with my doctors that I have. It took me 5 years to find a doctor who would listen to me, but those five years were worth it. My doctor will also call me back within an hour of calling her and leaving a message.
Carolyn....I love YOUR post. What a wonderful and appropriate story. You are to be commended for your assertiveness.
The medical profession often depersonalizes patients...they become the back pain in room #3, rather than the PERSON with back pain in room #3. No one likes to be robbed of their dignity, of feel they are only being undressed because the doctor is some kind of a voyoeur.
For the last five or so years, my practice is exclusively children and teenagers. I only have the unrobe IF the exam warrants it, and I do so with age-appropriate modesty in mind. Some of my patients run around naked, innocent to the world, while others are embarrassed if I look at their tummies.
Clothing can be a barrier to a good exam, but there are times when the shirt needs to stay on! Just like the patient that said she hates to get naked in front of her doctor....she is definitely going to get a different dentist.
I thought this post was great and I agree 100%. Personally I'd never run into an arrogant doc until I visited my first allergist last fall. He really took the cake. Not only did he waste my appointment time talking about his personal matters, but he didn't educate me at all about my allergies. He took a shortcut on an allergy test that made the test invalid, even after I told him we should not do it. He didn't listen to my input and acted affronted when I asked questions about medications. The final straw was in May when I'm sure he believed I was lying about my symptoms. I'm sure, because in the chart (which I have a copy of), he put "patient's report of symptoms cresting are hard to understand." It was only hard to understand if you don't believe the patient!
After that I was so mad, not only did I walk to another allergist, but I filed a quality complaint against the first guy with his clinic and with the health insurer whose network he was part of. The clinic sent me a letter saying "sorry" 4 times, refunding my money for 2 clinic visits and some inconvenience money. The health insurer couldn't disclose what happened, due to state confidential peer-review laws, but I'm glad they at least reviewed his practice of giving allergy tests to patients taking antihistamines, and corrected him.
Doctors like that shouldn't deal with patients, they should do research or something that doesn't involve human interaction. But we patients have to speak up, and sometimes loudly, you're absolutely right.
Some clinics and labs ARE being secret shopped. Not enough, but some. HMO's could arrange for secret shoppers if they chose, but private docs won't be doing it, because someone has to pay for it and why should they? Either a physician cares about his patients as human beings or not.
Didn't WebMD used to have a spot where patients could comment on what they liked or disliked about their physicians? I know someone did. I don't know where that went. I suppose it's asking for slander to happen when you allow individuals to post, but it could be really helpful if you got multiple comments from rational people.
I was looking for a blog to vent about my doctors. One I have seen for over twenty years and he can barely conceal his lack of interest and opinion that my medical problems are all based on hypochondria. Another is a "specialist" he sent me to about 7 months ago. He has made so many mistakes with not charting medicines, not following up with
the other doctor, and not having my chart when he calls me so that we can conduct an intelligent discussion, that I doubt his abilities. Another scheduled 3 people for every 15 minutes. It was not unusual for me to wait 45 minutes to 1 hour in the outside waiting room and another 30 to 45 minutes in the exam room. The last time this happened, I went to the nurses desk and asked for my chart. She handed it to me without a question. The doctor never called to apologize or ask what happened. Then there was the doctor who came into the exam room and said he had looked at my X rays and everything looked fine. He had never read the letter from my other doctor or my 7 page form that HIS office had me fill out that said that I was in severe pain and on morphine. He quickly tried to schedule surgery for the next week. I found another doctor. There is also the dermatologist who has never checked an inch of my body for melanomas because this doctor practices from the door of the exam room. How about the psychotherapist who got his kicks off of getting all the details of a past relationship of mine. I wondered why he kept bringing it up in our discussions. I found out later that the two people involved are friends of his.
Makes you wonder if there are any good doctors. I'm going to email this article to my godson who is in medschool. I don't want him to treat his patients like sheep!
Many medical schools conduct exercises so that medical student can experience what it FEELS to be a "patient"...vulnerable, naked, and frightened.
It can also be a humbling exerience when doctors become patients.....
As a medical writer who writes continuing medical education programs for physicians, PAs, NPs, other nurses, and pharmacists, I work with lots of physicians. The physicians I work with are mostly VERY BIG names -- "thought leaders," as the pharmaceutical industry calls them -- well published, frequently seen on TV, etc. I am astounded by how very uncontrolled and demanding some of their egos are, and yet some of the very biggest names are humble, approachable. This isn't limited to physicians, either, as I have also run into more than a few PAs and pharmacists with very outsized opinions of themselves! It all depends on the person him- or herself. As a patient, only you can insist on some sort of a semblance of a compassionate/respectful/listening bedside manner. And if as a patient you can't get your fatheaded doctor to treat you right, don't worry, we medical writers are very good at taking them down a peg or two. They need us, but only the humble ones will admit it. But guess what? They need patients, too.
. . . actually, as a patient (rather than medical writer), the biggest problem I have is not with my physicians (who all respect me), but with their office staffs. They ALL talk down to me, treat me like just-another-stupid-patient, and do everything possible to keep me away from the doctor. What can be done about these poorly paid, apathetic, often uneducated people who see their main role in life as being a barrier between you and your doctor?
It is funny you say that Michelle-as I sit here more than 1 week-post my first phone call to my neuro's office. I suffer from severe headaches that have never had a diagnosis in 11.5 years. There have been times in the past-much like currently-where I have been admitted into the nearest hospital for the basic *knock out* for a few days to quell the pain.
I have spent many an hour between my first phone call Monday of last week, and today-trying to decide if I wanted to be a "pest" until I read this article. I was promised a phone call back and TODAY I will get it. Thank you all foryour inspiration
had a renogram, it took 17 days to get the results in spite of many phone calls from me [the technitian said it would take no more than 2 days to get the results]. finally had an angiogram to stent the kidney artery, but it was to late. couldnt open the artery and i have lost the kidney. the doctor said "its no big deal to lose one kidney" well, it is a big deal to me.
I totaly agree with you. I learned through the illiness of my husband and my self, I am in charge this is my body, my money, and my responsibility to ask questions til I get answers I need and want. My husband had to go on dyalsis and they wanted to put him on the machines to clean his blood. No. He was put on peritoneal, 4 years later Dr. said he needed a trandsplant asap. I told him you are the Dr you have the position so do what you have to do and we prayed, put our faith in God and after going on the list he received a kidney in two weeks. A miracle. Oh i was told during this ordeal that I read to much! He is doing fine but we have to watch the medicine to make sure it is the right one. We have more trouble with the staff than the Drs. They are not trained professional most of the time. This was in 1994-1997. Then in 2001 he had to have heart by-pass surgery. I told them no morphine after surgery he couldn't handle it. They gave it to him anyway. I ripped them out, demanded no more and to get me a sprite and soda crackers and get him up in a chair. He was out of it. I worked with him for about 3 hours he started coming arround they moved us up from critical care to a room. The next day the Dr. came in and sayed they would never have believed he was the same man down stairs yesterday. I told him I new him better than they and took over, we have been married over 40 years and let me take care of him. The dr. said well you sure proved your point to them. TO ALL: DON'T BE INTIMADATED BY ANY DR. THEY PUT THEIR PANTS ON THE SAME AS YOU. IT IS YOUR BODY. TAKE CHARGE AND KEEP FAITH IN THE GOOD LORD.
Thank You for giving me insight on how to deal with dead-end doctors and often times nurses as well. I had a very bad encounter at Cleveland Clinic Hospital (Colorectal Dept). The doctor was great but his nurse Renata treated me as though I forgot to pay her, or worse yet as if I stole her joy! I didn't stop though, I had to go to the Ombudsman' Office and file a formal complaint. I later received the service I requested, and hopefully the future request...which was that Renata be terminated for her mistreatment of patients. Unreal!!!
Again, the post was highly informative and thought-provoking..THANK YOU !! (k.l. Beachwood, Ohio)
20 years ago I went to a dr with symptoms of what I knew was a severe kidney infection, having had one before. He told me I had a muscle infection. Several days later, knowing how ill I was I went to a different dr and got the correct diagnosis and felt better within 24 hrs.
A worse experience was when I was losing vision in my left eye. My dr said he was getting a referral to a specialist for me, as this is what my insurance company required. I waited 6 weeks, calling every few days to the dr and the insurance company to see what was happening. It turns out the dr never lifted a finger to get a referral. I went to an optometrist who recognized the problem immediately and I got my referral. I know the dr was a quack because he went through the motions of doing "tests" by putting some kid of weight on my eye....he didn't know what he was doing. I hope he has lost his license by now as I lost some of the vision in that eye.
I have also had drs who tell me to come back in ten days. I go back in ten days and they ask me why I am there. They can't be bothered to turn the page back and read my recent history. I can't be bothered to pay them.
Maybe it's wisdom that comes with age but I don't tolerate negligence anymore.
I agree with most of everything you had to offer in "Patients are not Sheep". I do object to your language used. In professional literature I do not accept seeing the words "piss-poor" nor "crap" in an article. I find this lowers your credibility and sence of decency.
Not anyone's Sheep...
VALIDATION!!!!! THANK YOU SO MUCH FOR YOUR POST. MY HMO HAS BEEN VERY BAD FOR SOMETIME, AND THE MORE ASSERTIVE I BECAME, THE MORE RESPECT I AM GETTING. RECENTLY, IT TOOK 4 MD's TO DIAGNOSE A SIDE EFFECT OF LISINIPRIL (Prinivil). The side effect was "COUGH". It was massive inflamation of the sinuses, which resulted in a cough that led to coughing so hard I coughed a naval hernia. The 4th woman doctor realized the problem. Even the Emergency Room Doctor who pushed the hernia back in missed the side effect. Made an official complaint with the HMO. There are other mistakes, but am very assertive NOW, and do not let them GET AWAY WITH ANYTHING.
Sometimes it not the doctors in as much as it's the nurses, med-tech and PA's that are the problem. Earlier this week my husband began feeling the same pain and pressure in his right chest area, that he had felt back in March that landed him in the ER. After some discussion and several phone calls he decided to go to the ER at the Heart Hospital we have in our area. The ER team was great and the 5 hrs spent there seemed to move along quickly. Not only were we actually treated like people, but they did an awesome job of keeping us informed and telling him all his options.... It took two nitro pills to take care of the pain, and get his BP under control.
It was after the second nitro pill that it was decided to keep him overnight, put him on a nitro drip, and do an angioplasty today. For the most part the day shift and early evening shift were patient and as accomodating as possible.....he's a smoker and despite his best efforts to avoid having one, he could hold off any longer....The nurses, may not have approved, but they've come to understand an addiction is just that, an addiction. One nurse even tracked him down to just draw some blood without acting all put out to have to go find him...we were on our way back.....
Things started to go downhill after 8:00 - the night shift nurse couldn't verify the time for the procedure until after 9:00 pm, not sure what the hold up was other than the person she was trying to get ahold of was available, or didn't have the info handy.....
I'll give her credit for not wanting to go against, what she thought was, dr's orders when he wanted one more before bed....all they wanted to do was prescribed Xantax....Don't know if it would have helped or not, he's already taking a ton of pills as it is. At any rate he had to push to get that...sounds trivial and it is compared to today.....
He was woke up at 5 am and pre-prepped for the procedure which he was originally supposed to go down for around 9 am. I arrived just prior to that and he was told at that time it would be closer to 10:30...I could understand if a patient taken in just before needed more attention, however when the day shift nurse came back 7 minutes after being paged to tell him she didn't have any idea when they were coming to get him, he began to loose the rest of his patience.....
It wasn't so much that she didn't know, but more to the fact that she presented an indiffernt attitude...because it's Saturday it seems that they are only there to push pills, take temps and complain about how busy they are....wasn't a whole lot visibly going one. Needless to say my husband left AMA, he's still kicking and finally got to eat something for the first time since 8 last night...he was worried that if he had a snack to close to midnight it would cause problems since his stomach was already worked up. If the nurse would not have presented her indifferent attitude and used her position to inform the prescribing doctor of the patients concerns about going into this procedure unknown as to the whys and what-ifs, my husband would probably still be there having this done.
Once we got home he was able to talk to one of his primary doctors team members who did concur that something was left undone, or uncommunicated.....
I do feel that as patients we have to be kept completely in the loop, and not treated like a nuisance to their day....All medical professionals have obligations to treat their patients in a respectable manner, even when the patient is cranky, which is how most patients in pain will be......I've not seen too many that are in pain and smile like there's nothing wrong....
All I can say is that procedures need to be thouroughly expalined, patients and family members need to be treated with absolute respect....if there is a problem causing a delay in treatment the patient or family member needs to be informed right away, but most importantly, if you don't like working with living patients then go apply for the job in the morgue where no one complains anymore.
Thank you so much for the post. I only wish this type of information would get out to so many people who do not have the use of computers. My horrors have included being diagnosed with an STD when infact my visit was for an injured knee. My father was told to stop all meds (diabetes & heart) because he was being scheduled for surgery, I called his primary who got very angry and said that I should not be questioning the decision made by the urologist. Due to her behavior I decided to get a second opinion and found out that subjecting my eighty year old father through surgery would have killed him and the best news was that he did not have prostate cancer. He had a swelling in the testicles due to a severe infection and severe scar tissue from previous infections. I paid out of pocket $$600 for a visit to a specialist who had the nurse returning my calls to her regarding a medication that was not working. I kept telling the nurse that the medication was a prep for surgery which if it was not working I should not be scheduled for surgery. I did not show up for surgery and paid for a second opinion and found out that my rpoblems were due to peri-menopause and that I should have a sono done to make sure everything was okay. If I did not have the money to pay for all these out of network second opinions we would have been subjected to bogus surgeries and perhaps even dead.
Loved these posts! A couple of years ago I had uncontrollable pain in a very general and moving area, my abdomen. Since my urine was dark and I've suffered from kidney infections, urinary tract infections, and bladder infections my whole life (I'm only 35), I figured this may be my first kidney stone that I was warned may eventually happen. FIVE visits to the Sentara ER and was told it was in my head. This was because urinalysis showed nothing and one attending ER dr asked me to touch my toes. I could. He said an ultrasound was unnecessary and unwarranted simply because if I could touch my toes, I couldn't possibly have kidney stones!!! The real reason was at that point in my life, I had no health ins. I informed the dr that I was a former 4year full ride scholarship recipient for a university gymnastics team...and even though I was much older, I was still very flexible. This made no difference to him. A happenstance referral (the 5th I received and only one I took out of sheer desperation) turned up a miracle. My current urologist found my bladder "holds" urine, probably from a hence "unrelated" birth defect in my hip. It was literally poisoning me, and yes, I had over ten small kidney stones!!! Thank god I have excellent health ins now and WILL NEVER FEEL LIKE A SHEEP AGAIN!!
Wow I am dumb founded. This article written by one of the only caring Physicians I've ever had the pleasure to encounter.
This article is priceless and it needed to be posted in every care facility there is. I've had the same Dr for 10.5 yrs now and just this week was talked down to as tho I don't know my own body as well as he does. For the past five yrs(since a fundiplication surgery) he's refused to give me anything for pain due to the instance of a reaction, didn't deem it necessary for me. I was diagnosed in Sept 05 with Fibro and since that time I've had a bad time with it. The pain is the worst. Now couple that with 12 surgeries total and all of the side effects to them. I mentioned wanting to get legalized for the use of marijuana and he just flatly refused. Basically telling me he wouldn't help me. Didn't even want to discuss it. He blantantly said No Exceptions. Little does he know I've been smoking it for many yrs and it's the only reason why I've never gone to him and demanded something for pain. Don't get me wrong I am not promoting the use of it I am simply wanting to be legal while enduring my pain. It doesn't diminish the pain it just makes it so I am not so focused on it. It's also the only way I would eat. Since the fundiplication I can't tell when I'm hungry or full so I just never eat. That's not good for me as I also don't have a thyroid gland and am constantly fighting with him about that. So now I am faced with having to find a new Dr. because I refuse to see someone that doesn't give a crap about my health and what's best for me. Just because my TSH is below the low end of normal he wants to up my meds. Never mind I am feeling better than I have for yrs. I told him No we are leaving my Thyroxine at the dosage it is cause I feel better. What did he do he upped it when he wrote out the prescription. Regardless I will find someone that will care for me and want to be the Dr everyone wishes they had. I'm all for lining the pockets of the Dr's out there IF they are doing exactly what it is that their patient needs....!
God has truly blessed this doctor with a RARE form of understanding what a patient has to endure 90% of the time. The doctors make you feel as if they are paying the patient instead of it being vice-versa. This man is the second doctor who gets my tremendous award for belonging in an very small, elite, group of blessed doctors. Wish we had more of you.
Doctors don't need secret shoppers. What they ought to get is feedback from every single patients they see. If things went well, the positive feedback can be used to further encourage great care. If there's negative comments, then the physician knows what they need to do to make things better. And that only helps the doctor do what they want to do most: give their patients great medical care.
I started one of the online physician rating websites, www.DrScore.com. Part of the idea was to let patients rate doctors and look up doctor ratings for free. But the important flip side was to give doctors feedback from patients. Hundreds of doctors currently use DrScore to give their patients an easy, anonymous way to give the practice feedback.
I am a RN in a very busy ER in Virginia. In 2007 alone, our 43 bed ER treated 280,000 patients. There are many good points in your article...my favorite part being:
"Patients need to stop being sheep. Medical professionals, no matter how intimidating and strong-eyed they are, are really not in charge of your life's journey. Ewe are in charge. Unless people take an active role in their own health care, and the health care of families, this mindless herding will continue. In order to be equal partners with your medical provider, you are going to have to be more strong-eyed and assertive, too."
IF ONLY THE MAJORITY OF PEOPLE WOULD TAKE AN ACTIVE ROLE IN THEIR OWN HEALTH CARE! You have NO idea how many patients I care for on a daily basis that can not tell me what medications they take or what chronic health problems they have. Most of them don't have primary care physicians, and abuse the ER to recieve care for colds, sore throats, etc., then COMPLAIN about the wait time! If it would occur to them that if they used a primary doctor, not only would they pay less money and save time, but also would free up our time to care for someone who...oh I don't know...is having a stroke? Can't breathe? I could go on and on.
One last thought. While you are bashing us for referring to patients as 'The back pain in room 2', we also use this as a coping mechanism to seperate ourselves from the stress of our profession in more difficult situations. The majority of us, including myself, LOVE taking care of people for our profession. But physically and emotionally I cannot take it all home with me. The first time I did CPR on a child, it was a 14 year old boy who dropped dead in the street while skateboarding with his friends. He died, and it nearly killed me. I almost couldn't take it...I cried daily for weeks, and eventually taught myself not to carry my work home with me. So next time you hear one of us refer to a patient as 'the back pain in room 2' think of that and you will know why.
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