Sex and patients

We has a lecture the other day that informed us that TEN PERCENT OF PHYSICIANS HAD HAD SEXUAL RELATIONSHIPS WITH A PATIENT.

Ten. Percent.

So, the study is from almost 20 years ago, BUT. That was an astonishing number. In my mind it is never okay to have sex with a patient... unless they are really really hot!

But seriously, unless you're a rural physician who is the only game in town so everyone in town is essentially your patient, that is not cool. And never okay if you're a psychiatrist.

I guess I should wait and see what happens when my first ridiculously good looking patient hits on me.

Personal v. Professional Life

Last night I went out with friends, as we have been quite a bit recently. As THE MATCH looms, coming up in a week and a half, we find ourselves with little to do other than begrudgingly go to class in the mornings and drink our normal quota of calories in alcohol. But as we transition from students to "real doctors," the line between our own selves and our doctor selves starts to dissolve. How would you feel if you saw your physician drinking a glass of wine? Probably the vast majority of people would be okay with that. But what if they are noticeably drunk? Or what if they only have one glass of wine and there is a very small (but very real) possibility they might get called into the hospital?

Legally, physicians need to report any law breaking (specifically salient to this conversation would be any arrest for drunk driving) when they yearly register with the licensing committee. But there is a whole range of other behaviors that don't result in legal action that reflect poorly on the profession and the individual. As much as we live in a society that celebrates and respects individual responsibility, I also believe that when we signed up to go to medical school, we also signed up to hold ourselves to a higher standard. It has been fascinating to rubberneck during Charlie Sheen's very public manic episode. There have been all kinds of discussions about what his professional obligations are as an actor... imagine what would have happened if it were a physician (other than the obvious fact that no physician is cool enough to get over 1 million twitter followers in 24 hours)?

I certainly am not innocent of behavior unbecoming a future doctor. And I will likely continue to occasionally indulge in that kind of behavior. I know many doctors do. In some ways, it is an unhealthy way of dealing with the stresses and pressures of the job. Last night I ran into a group of interns from the hospital!

But I also know that I am much more aware of the risks that I take every time I make those decisions.

Gallows Humor

This week's NYTimes "The Ethicist" article was about medical students posting pictures of patients on facebook along with "gallows" humor comments. One of the most difficult things about being a medical student is relaying to friends and family who are not in medicine that when we make jokes about our patients, it usually starts out less as a statement about the individual patient, and more about our discomfort, fear, or sadness about a particular circumstance. However, Randy Cohen is absolutely correct that what initially begins as a defense mechanism to prevent burnout can quickly turn into a systematic way of dehumanizing patients. To avoid falling into that trap, it takes a lot of consistent and conscientious evaluation of how one laughs about patients. As someone who loves to laugh and appreciate the absurdities of life, it has been a line (even as a 4th year medical student) I have sometimes struggled with. Often, the way that I see I have crossed the line is to relay a joke to a non-medical friend (or often, my brother), who's reaction is as appalled as the writer into "The Ethicist." These reactions, while at the (hopefully temporary) expense of my image in that person's eyes, help me define and redefine and redefine where my own humanity is, so I can focus on the humanity of my patient.

I am currently reading "House of God" for the second time (the first was during first year of med school), and I am struck with how much more hilarious, relatable, and tragic it is after I have had so many similar experiences of my own over the past year and a half. I would definitely recommend it to get a sense of what it can be like to be in the world of medicine... minus the frequent in-house sex parties. The acting out I see with my friends and colleagues is much more of the inappropriate facebook behavior variety.