by Benjamin Moses, MD, MS, FCCM, FCCP
We all see the world through our own lens, colored by our experiences, our education, our family, our religion (for some), our friends, and so much more. And what we see is usually some slightly edited version of the world as it exists for everyone else.
Part of my journey has been trying to observe the ways in which my lens is tinted differently from other people’s, to take a step back and try to see a less edited version of the world around me. It’s an exercise that takes patience and understanding (both of which I find myself running low on sometimes, so it’s not always an easy task) and it’s one that may leave me exhausted. It turns out, not only is my edited version of the world dramatically different than most people’s version, my editing has changed over time so the world I see today through my own “tinted lenses” is different than the world I would have seen through my lenses of an earlier age.
I have been down many paths in my life, with twists and turns, forks and road blocks, with hazards and shortcuts, and landed where I am right now: a husband, a father, a doctor, an Army veteran, a dog dad, and now a business owner. Some of the experiences I had along the way changed me over extended periods of learning or growth, while others changed me in mere moments. It is these moments that I dwell on when I’m alone with my thoughts.
As an anesthesiologist and critical care physician I have taken care of thousands of people in dozens of health care environments, and not once have I met someone on their best day. I guess that’s part of the job – no one ever starts their day thinking “Oh, isn’t this a lovely day for me to get sick and go to the Intensive Care Unit” or “Gosh, I’m so excited about having an operation and I’m not nervous about it at all!” Thankfully, though, I trained for years and years to do what I do, so the people I care for get the benefit of my training and expertise, and that of my colleagues and coworkers, and they typically have a better day after I get involved. I listen to people. I ask questions carefully. I look people in the eye, and I’ve been known to hold a person’s hand sometimes. I do the very best I can think to do every day to keep the people under my care safe, feeling seen, heard, and understood, and comfortable to the best of my ability. I’m not G-d’s gift to critical care medicine or anesthesiology, but I know my strengths and I apply them the best I can.
But all of that goes out the window when I am the one that needs a doctor. To that point, I had just turned 40 when I became very ill and found myself needing emergency surgery. It was a Sunday in early December, and I was finishing a week of working in the ICU. I actually got up and went to work, feeling under the weather but not quite badly enough to stay home (boy how things have changed since the pandemic, but that’s a story for another time). By the time I got to the hospital I was feeling pretty awful, and made it into the ICU just long enough to ask a colleague to step in for me and let my team know that I was going to be taking my calls from home the rest of the day. I went straight home and back to bed, but over the next few hours I felt worse and worse. Thinking I may have a bad flu and wanting to get some help I drove myself to the nearest primary care clinic that takes walk-ins (my family was out of town until later that day). I got to the parking lot and couldn’t get out of the car. I flagged down someone walking by and asked for help – the staff from the clinic had to get me out of the car and into a wheelchair to get me inside and checked out. They very quickly determined I was suffering from acute cholecystitis (my gallbladder had turned on me), and sent me to the hospital.
Most people faced with this kind of situation are at the mercy of the system, shifted from point A to point B based on the diagnosis and the preferences of the treating physician or hospital. Once you have a diagnosis and a treatment plan in place it takes an act of Congress (or a severe complication) to diverge from the pre-ordained path. I, on the other hand, worked at a hospital, with surgeons I knew and trusted, and I had access. I called a general surgeon that’s a close friend and asked if he would get me into the hospital quickly without going through the ER and do the emergency operation I needed to remove my offending gallbladder – he did both. When it turned out I had pneumonia on top of everything, he admitted me and treated me with antibiotics, even getting specialists involved to ensure I was on the proper medications for the specific bacteria that infected me.
I had great care, and three days later I returned home. Two weeks later I was back to work, and a month later I was back to my usual exercise routine. When I got my hospital bill it was expensive, but the amount I paid out of pocket was only about a tenth of the overall charge – I didn’t get any special discounts, but thankfully my insurance covered most of it.
Since then, I have looked at the world differently, with a deeper appreciation for the care hospital nurses give, with a healthy distaste for the boredom and back pain of being in a hospital bed for days, and with a small amount of insight into the disruptive power acute illness can have on a person and their family. All of this happened after I had already been “in medicine” as a professional for over a dozen years, and it still radically changed me.
I’ve spent a lot of time wondering what would have been different for me if I wasn’t in medicine? What if I was a person of color? What if I didn’t speak English? What if I was a woman? What if I was trans? What if I was uninsured? What if I was schizophrenic or severely depressed? The list of what ifs stretches seemingly out to the horizon.
I had an unexpected encounter with the health care system, and I ended up just fine. I was prepared, but I was lucky. And looking back I know I was an outlier. How, I wonder, could I make my experience one that is the norm instead of the exception? What is it that sets people up for satisfying outcomes from unexpected encounters?
It’s trust. Trust that the people you ask for help can and will help you. Trust that your family will be there to support you. Trust that your doctor knows what you need to feel safe and heard. Trust that the system will see you as a person in need of care, not just a diagnosis and a treatment plan. Trust that the bill you get won’t destroy you and your loved ones.
And how do we build that trust? We start by demanding an audience with the health care system, so a person who needs help can say, “I am me. I need your help. And this is what that means for me.” And they listen.