Humble myself. (Love / Provider)

Physicians actively delve into labeling and categorization but we are in danger of throwing humility to the wayside in the process. I’m a professional profiler, especially in primary care. When I hear hooves, I have to look for the common horses but still be on the lookout for the zebras, sometimes even the rainbow-striped sub-type. Common things happen commonly is the mantra. 

I would argue, however, that NOONE is common. All human beings are unique and have interesting backgrounds, skills and interests. Profiling patients based on their educational achievement, demographics (e.g. 42 yo white male or 83 yo black female), appearance (well-groomed or disheveled), employment status (employed, retired, unemployed, disabled, etc.) clinical presentation or even chief complaint is a seductive game that could falsely elevate the physician into a feeling of intellectual superiority or instill an unnecessary emotional distance that distracts and potentially degrades the interaction. The secret language and terminology we share inside the tribe separates us from the thems on the outside, especially when we do not make a connection and view the patient instead of the person.

You could be cast by a physician, in a negative light, as a high maintenance suburban housewife, a stubborn farmer, an ignorant white trash hick on government aid, a hard-working, but self-abusing blue color grunt, an angry, confused teenager, a know-it-all engineer, an undisciplined tween brat, a drug-addicted chronic pain patient, a misinformed academician, or, if you are me, a snobby, overeducated professional.

If you are offended by any of these terms, then you also need to look in the mirror and see your own hyperbolic self, building the caricature of the you who is seen superficially upon first blush by a pre-biased person. Realize, of course, this outer shell is not the deeper true you that you fail to reveal in most settings, even at your own doctor’s office. Don't blame yourself for not divulging these thoughts. The environment is not always safe for you to share those innermost worries, concerns or dreams anyway. Don’t be hatin’ is a common phrase used to seriously but jokingly call someone out for their depersonalizing and marginalizing comments.

The aforementioned descriptions may seem harsh but they are primal mechanisms of survival left over from a darker, evolutionary past. If I enter the clinical interaction without the awareness of pre-conceived notions and pigeon-holing, however, I cannot undo those projections unless I take the time to then search for the more meaningful, human side. Unfortunately, many busy clinicians don't like to take the time to draw out the multi-faceted aspects of our patients to see the whole.

The chain-smoking blue color line worker who works the midnight shift may also be taking care of his sick mother during the day, keeping her out of an otherwise expensive nursing home that would be a financial burden on his family and American taxpayers; he is a loving son, caregiver and steward of the healthcare dollar! The trailer trash mom is raising three adolescents at home, two of whom made the honor roll last semester; she is an inspired educator and mentor of at risk youth! The angry, confused teenager was recently recognized by her art teacher for a sculpture she made for her senior project; she is a budding, gifted sculptor and inspiration to her peers! The mild-mannered retiree with hypertension is the crew chief for his son’s nationally-recognized car racing team; he does something I could NEVER do! (Ask my family or wife about my mechanical prowess or lack thereof.) The academic who thinks he has an MD from the internet came up with a strange, obscure diagnosis that may actually explain his symptoms; he is HELPING me!

If I don’t take the time to humble myself and acknowledge the expertise and skills that my patients have (especially the ones that I don’t), I am denying a piece of them and falling back on a critical, discriminating but dehumanizing component of my own human nature. In fact, I will return to my profile of the mechanic. What if my corner gas station service specialist berated me for holding on to a dirty oil filter that should have been changed out 2,000 miles ago? I wouldn’t go back to him again. What are we doing as physicians to embrace our patients and keep them coming back to us in a humble and respectful way?

SECRET WORDS/PHRASES: "Humility needed." (Brevity phrase) OR “Please talk to me like a fellow human being.” OR “I’m not prioritizing my healthcare goals because I have other priorities in my life right now.”