One of my teenage patients once sat in my office, with their arms crossed, looking down and reluctant to engage. This patient told me, “I don’t matter, you’re never going to remember me”. It took some building of what we call a therapeutic relationship (the relationship between patient and treatment provider) before this patient eventually came around, accepted treatment and did a lot better.
But the belief that patient’s experiences and lives do not have an impact on the treatment provider is false. Upon entering medical school, I was geared towards a future career in cardiology, oncology or even ophthalmology. I mean, these were “prominent specialties” that I had been exposed to within my life both personally and academically prior to medical school.
However, my first clinical rotation as a third year medical student was in child psychiatry. I will never forget the encounter of seeing the sensitivity, time and care my supervisor had in working with a child. There was a young boy who had been labeled “oppositional or behavioral”, who would cause problems and not listen to any authority figures. Yet in the room, with the doctor, his mom, and myself, it was revealed how this child would purposely act out and draw “negative” attention to himself because this was how he knew that he could protect his siblings from being placed in a neglectful and potentially abusive environment. By the end, certainly he and his mother were in tears while I was trying hard to hold my own emotions back.
This, I can say, was the patient who changed my life. This patient has always been at the back of my mind when I was at the cross roads of making decisions on where my training and career would go. Not only did I enter psychiatry, but then sub specialized in treating children and adolescents in my final years of training. This young boy, and the many other patients I have treated over the years, has taught me to not judge other’s actions or behaviors. For what superficially may appear to be a problematic or negative behavior, could be driven from a place with good intentions.
July 31, 2017