Lessons from a Patient

Lisa was a young woman in her 20s. I thought she might have had bipolar disorder. Early on, after offering my diagnosis, I seemed to have time for her. She received my counsel with appreciation. I listened with at least some attention as she described the horrors of her brief life, which, needless to say, had not been improved by her psychiatric diagnosis. Whenever a patient like Lisa shares with me her tale of misery, I experience the following arc, perhaps common to most doctors: first, horror at how cruel and harsh the world can be, then appreciation of the relatively insignificant hurts I have experienced in comparison, followed finally by compassion and a compunction to “make it all better.” Finally, once reality sets in, I realize that what I have to offer is very unlikely to help in the end. I often feel that I am simply not giving enough.

I am often driven to believe that I will be the doctor to look these patients in the eye and tell them how to fix their lives, limit their hurt, and restore order to the chaos swirling around them. In this way, Lisa and I connected. I looked forward to her visits and she genuinely seemed to enjoy my counsel. I did continually prescribe painkillers to her because she had an obviously painful and dramatic injury from an accident, but I felt sure that I couldn't be “played” by this young girl, that I would be able to rein it all in down the road. I had done this before and I was no pushover.

But she was always at least 1 step ahead of me, …