There's a myth in medicine, somewhat of a noble lie perpetrated by the industry so to speak, which has a profound impact. This myth is that everything in medicine is tolerable, anything goes in terms of patients' behavior or speech because they come first. This myth was promulgated in my training and while it is a notion I cling to, I know that it is an ideal towards which we strive, not an absolute truth. Indeed, we should strive to be those practitioners who put our patients' needs and wants first, and who accept and endure the lesser and outright bad behavior we see, simply because medicine is a higher calling and when people - and their families - are trying to cope with illness they theoretically know not what they do.
But there is another side, a side we don't talk about, a side where we see the worse of human nature, the scamming, scheming, the abuse, and are expected to grin and bear it. A bit ago, as a smaller example, a demanding family whose loved one we had taken superb - and I mean superb - care of, told us accusatorily that if we "failed to" treat his silent aspiration of decline with an antibiotic, we "would be contributing to his death." After all we had done - nuanced, tailored management of medications and whole body care which had kept him very vital despite his serious illnesses - this was their gratitude; accusing us of killing him if we did not comply and treat as they wanted? This family's expectations and behavior were the result of an imbalanced medical system which fostered skewed relationships: in our case, we had given and given and given, and they had taken and taken and taken, all without a notion of ever showing true appreciation to understand what we were doing and trying to accomplish.
Kindness is a double-edged sword. It can be dangerous when it is overly ideal without boundaries. Any exchange between two individuals should be as mutually beneficial as possible and even if a patient is too infirm to give of themselves, fairness and gratitude from the patient or family can go a long way towards making health care workers feel appreciated and motivated to keep going. What patients and their families need to understand is that health care workers are human with often superhuman values and that with the real daily burden of ingratitude, burnout of compassion (the fuel for good care) is real.
The kindness we need to espouse should not be an irrational one; it should be a deeply compassionate but firm and disciplined kindness that helps all of us to help ourselves and others deal better with the vicissitudes of life. Selfless giving should really make everyone feel better.
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