By James M. Saucedo, MD, MBA

When I was invited to write about a challenging or enlightening patient, several went through my mind.

I considered the young man who injured his wrist in a terrible golf cart accident 6 months into my practice – someone who had one of the best attitudes I have ever encountered. Despite a post-op X-ray that gave me indigestion every time I saw it (I really did my best, but if only I knew then what I know now), he did surprisingly well, with nearly full and symmetric range of motion and only occasional discomfort. “Farts and moonbeams,” he and I would say to each other every time he followed up, a tongue-in-cheek reference to my description of the stability of his reduction and fixation. He taught me an important lesson and reinforced another: attitude can be everything, and we don’t treat X-rays.

Another patient came to mind, one less encouraging. She presented to me with hand pain, and after ruling out several potential causes, I finally decided to offer a steroid-lidocaine injection, both for diagnostic and therapeutic purposes. It was a busy clinic, but I did my best to give her my full attention and as much time as I thought I reasonably could. After several weeks passed, I found a blistering review online. While I try not to give myself more credit than I deserve, I had never seriously considered myself a “horrible doctor.” I was crushed. I felt defeated and questioned myself for days if not weeks. I even called the patient to apologize for missing the mark, which she appreciated. But the review remained, and I eventually had to come to grips with an important lesson: I am not perfect. I will not solve every problem. And I will not be everyone’s favorite. It still kind of stings.

And finally, I remember a single mother who crushed her finger while collapsing a stroller. She presented to me shortly after her injury. She had no wounds and minimal ecchymosis, normal X-rays, and no instability on exam. Except for some pain out of proportion to my findings, her exam was rather benign. I attempted to reassure the patient and encouraged her to move her finger to avoid getting stiff. But I still recall the feeling as my heart sunk into my stomach when she looked at me and said, “I just don’t feel like you’re listening to me.” I did my best to explain my logic and reassure her that everything appeared to be okay, but she was right. I wasn’t listening.  She had young children who relied on her, and she was concerned about being able to care for them. I had not considered that in my treatment plan. I saw a contused or sprained finger, but I had ignored the patient. Once I realized that, we were able to find a solution that worked for her.

There are so many other patients that have taught me important lessons over the years, but these are the ones that are most salient to me at this stage in my career. What a privilege we have to care for others, but how incredibly humbling it can be! I suppose the secret is to try our best and learn as much as we can along the way.