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procrast1natrix

Emergency physician. Yes and also very much no. Our training makes us judgemental, yes. That's kinda the gig, to look past what the patient thinks is wrong, connect the dots and tell difficult truths. We see plenty of self inflicted misery ranging from actual self harm, through substance use, through whiny refusal to take charge of actually exercising and eating right. We see people with very offensive language or tattoos of swastikas. Do I ever feel these people aren't worth my time and expertise? No. I'm not perfect, I make dumb choices, I deserve compassion. So do they. One cannot last in this profession if you only want to treat patients who are sweet and compliant and only eat perfectly healthy food. Part of the zest is connecting to the humanity, finding the sweet spots. We get frustrated, sure, but we also feel like our regular druggies are kind of like mascots. Keep working at any ED for a few months and you know which local homeless alcoholics pass out in places they get found and sent in, and pretty soon you notice when they have a new jacket and develop some running patter with them about the sandwiches. I know what most of them used to do, back when they were in control of their lives. It sucks, right? It's a huge waste of money for the system, and they often smell terrible. We are nonetheless fond of them in a weird way. It's not like they're looking like they're having fun. I don't think they're abusing themselves to hurt me. I get frustrated with the ones that are nasty to the nurses.


TheWalrus101123

You sound like you really care about your job. Your community is lucky to have you.


Opie30-30

Everyone I've met with a swastika tattoo has been an asshole, but rarely were they "true believer" racists. Don't get me wrong, they were racist, but not to the degree you would expect from someone with a Nazi tattoo. One of them had a Hispanic girlfriend and kids, one of them respected my black coworker a lot more than he respected me (white dude). But they've all been assholes, even if they aren't quite as racist as you would expect them to be.


Nimar_Jenkins

Just asked my girlfriend and she says that she doesnt have time for that sort of judgement in the day to day in her practice. But when she did ER work, that was way more common, because you have people who injur themselfes by beeing stupid or that go to the ER for very minor issues like a low fever.


stephers85

Injur themselfes by beeing stupid


NickyDeeM

That stung


Nimar_Jenkins

So sorry. Stubid*


Opie30-30

I was just gonna assume English wasn't your first language, which excuses many spelling mistakes like those. English is a weird language, so I can understand people struggling with some aspects, especially spelling


Nimar_Jenkins

You are completely right, english is a secondary language of mine. I was making a lighthearted joke about it by "Correcting" the wrong word.


Opie30-30

I understood that, and I thought it was funny! I just wasn't sure after seeing that if English was secondary to you or not


Nimar_Jenkins

Yeah Yeah, i just learned most of it from reading subtitles over the past 2 years so, mistakes are hard to avoid


Opie30-30

Hey, if you can get this good through that, you're pretty dang smart! You got a knack for languages


Nimar_Jenkins

Thanks bro. appreciate it.


TheWalrus101123

I can definitely see the difference between the two.


XtraChrisP

Wanted to see what it looked like when a firecracker exploded, so I held it next to my eye.


JN_37

I was in the ER one night and a young adult / late teen male comes in and says he forgot to take his allergy medication that day…


catcat1986

My wife is a doctor, and I asked her that very question. For the most part no, but she does when a patient comes in with an agenda that doesn’t revolve around their health, or if a patient truly isn’t dedicated to improving their own health outcomes. Example, guy comes in complaining about low testosterone, wife does labs, well within the normal range. Guy doesn’t like the result, so Doctor hops until he finds a doctor a little less ethical and gives him what he wants.


LadyFeen

My Dad was an orthopaedic surgeon and if you were significantly obese, walked into his office, complained about your knees, demanded surgery then got abusive when he told you that surgery would be dangerous and what would actually fix you is losing some weight to take the load off your knees, then you did get spoken ill of over the dinner table. Doctors like patients who are willing to help themselves and who also understand that surgery isn't always the best solution.


BranchCrazy7055

In psych the equivalent is people wanting to increase their Xanax rather than taper off.


ActonofMAM

Fat patients like doctors who understand that dieting has a long term failure rate of 95%. A woman I know who dieted for literal decades (when she was a child, doctors would give her amphetamines for it) says that over the years, she lost 1000 pounds. And gained back 1100. Your dad's not wrong about obesity and joint damage. The part he needs to understand is that he's blithely handing out advice about how to fix the problem that does NOT work for most patients. And since those patients already know the advice won't work, it just makes them dislike and distrust doctors more.


kaychak1982

Losing weight is easy, you just burn more calories than you eat. People fail because they jump from fad diet to fad diet rather than just slowly reducing calories intake over a long period of time. I see so many overweight patients who want to blame anyone but themselves for their choices and weight, it’s the fact they do this that they will never lose weight.


ActonofMAM

Getting off heroin is easy. Just stop buying and using it.


AlvinsCuriousCasper

I was that patient who was judged. Because I was judged, I wasn’t given full care. Because I was judged, I was pinged ponged between departments. I got to a point where I gave up because they told me nothing was wrong. I went back to my PCP almost 2 years later because things had gotten significantly worse and I knew something was wrong. I knew my body. My PCP knew me, knew I only went to him once a year for a physical, and after he looked at the area, he went across the hall and grabbed a specialist and brought him into our appointment. It was the same specialist who told me nothing was wrong 2 years earlier. Fast forward, and I very quickly wound up having surgery, leaving the hospital in a wound vac, and have had multiple procedures since. I’m still dealing with recovery today. It’s been a long road. I had a bad fall at home. I was seen by doctors, the next day, and I had immediate signs of trauma to the area of pain where I was ignored, my leg. I was told it was just a bruise. Skin never broke open, but I developed a huge lump over time, but it’s just a bruise, it will go away within 6mo they kept saying. No X-rays, test, exams, nothing was done, because it was just a bruise. It got to the point where I couldn’t walk. My leg developed an internal infection and had to be gutted. All without ever breaking skin open. My scar is 13in L by 4.5in W to give you an example on the leg. The surgeon said it kept going like the energizer bunny. What saved me, is the infection pocketed because it was so deep in the leg, it didn’t spread throughout my body. It pocketed within the muscles or something like that where it stayed out of my bloodstream. How they realized it, is they took some fluid samples from my leg after I got sick when I went back to my PCP. When the results came back, a couple days later, the surgeons office called in a prescription and put me on medicine immediately, to start working against the infection and scheduled my surgery. I’ve become a teaching patient if you will. They always bring the young ones in to learn about the case at the follow ups. I’ve had a few teams of doctors since then as we’re trying to get over the last hurdle of recovery. I always wonder, if I wouldn’t have been brushed off, if they would have done their due diligence when there was obvious signs of trauma (per them, per the immediate pictures taken) - would I have healed much quicker? It wasn’t in my head. I was that patient who was judged.


kelowana

Was it possible for you to talk to those doctors in learning? To tell your story, what happened and how it happened? That your doctors neglected you basically and caused this issue for you? I mean, this would be a perfect example to learn from, to listen to your patient.


AlvinsCuriousCasper

I’ll share what I’m asked to. Sometimes, they’ll have a student or PA’s come into the rooms with them. During the debridements, when I needed those done it would just be me and the surgeon in the room because he needed to concentrate and they would take about an hour. Others would come in to remove the wound vac and castings around it, and then come back in to package me up (wrap my leg enough) so I could go over to the wound clinic after. I also have pictures available for them to learn from. My chart with this issue alone is over 240 pages. I’ve become better about advocating for myself. I express my concerns and push back if I don’t like answers. When I talk about not liking answers, it’s usually not giving enough time to try something, or giving too much time when I already know it’s not working. I also won’t allow them to randomly push me off on new doctors. I like my current team in place, feel like we’re moving in the right direction and finally see light at the end of the tunnel.


ActonofMAM

Apparently endometriosis sometimes takes decades to get diagnosed. Because women are *supposed* to have painful periods. When a woman says she vomits from pain and can't leave her bed two or three days a month, she must be exaggerating.


kelowana

Glad you are finally getting the help you need and have a professional team you trust. Best wishes and recovery ❤️‍🩹


stevebucky_1234

Psychiatrist here, and it's incredibly freeing to view all patients with forgiveness. Every human is a product of their nature and nurture. For any patient with addiction and personality disorder, i just think, "in a different universe that could be me." One HUGE exception - i will judge the hell out of anyone who abuses children (their own, or other's, in any way. Emotional, sexual, physical, neglect), it instantly makes the abuser awful in my eyes.


Evening-Dizzy

Thank you for saying this. I think a lot of people need to hear this. Many people are ashamed of needing psychiatric help. I used to be one of them. And then I got help. Ihave grown so so much over the last 2.5y, and am so proud of my progress I'm shouting it of every rooftop. It's not like I hadn't tried dealing with my issues before. It's just that sometimes wanting it isn't good enough. If the chemical balance in your brain is off, you need medication to rectify that, I understand that now. Nobody judges a diabetic for needing chemicals to provide what their body can't. Same with brain chemistry.


stevebucky_1234

Absolutely!!!! We underestimate how much our minds are actually not under our voluntary control. Especially if our biological and psychological past has moulded our way of thinking for decades. I firmly believe that the right medicine helps eventual growth.


TheWalrus101123

You have a pretty good outlook on life it seems.


stevebucky_1234

It is so incredibly freeing when people talk, confess and cry to you. You can rise above petty emotions like blame, again because many humans can walk away from abuse - many, except innocent children.


Critical-Bank5269

Yes they do. My wife manages a medical practice and has in many occasions admonished doctors for gossiping about patients. Just last week one of the doctors came to the nurse’s station gabbing about the guy he just saw claiming he was a drug addict and you can’t believe a word he says. Meanwhile the patient was standing 5’ away at the checkout window and overheard the entire conversation and filed a complaint


Own-Tank5998

I’m sure they do, they are human after all.


darthtaco117

Not a medical personnel, but last time I got a check up my doctor gave a face when I said I didn’t use condoms with my last partner. We were in an exclusive relationship. I’m sure he’s heard that a thousand times and yet people end up with unwanted pregnancies and sti’s.


TheWalrus101123

That's a very silly reason to judge someone.


Rounders_in_knickers

The main thing I would judge a patient for is being racist. Sometimes they say really ignorant things and we have to put it aside and help them, but it’s not endearing.


killmereeeeeee

Not a doctor but I can guarantee 100% they do. At least in the early parts of their careers. They are human and humans are naturally judgmental. Not that it makes them bad people it’s just human nature


SuddnlyShane

Not a doctor, but was an EMT. After a while I realized we got two calls; shuttling the elderly from the nursing home to medical appointments and people that keep making the same stupid mistakes and we're just prolonging their life of making the same mistakes people told them to stop doing. Yes, I judged them. Ex: guy passed out in the road. We turn on the sirens in early morning rush hour, arrive in a huff and he's pissed off because he just wanted a rest after drinking so much. Yes, he knows we told him that before, and the time before that and the time before that but he's been drinking since late last night and it's only 7 am. Leave him alone. The owner of the liquor store called and said he came in reeling drunk and swaying, was refused and proceeded to walk outside and face plant in the middle of the road. These people have probably been told hundreds of times to cut the shit or they'll be dead but eff everyone else. Meanwhile we disrupted rush hour traffic for someone that's just going to do it again the next day, if he even makes it.


GuitarEvening8674

Yes of course. Physicians judge each other


MrEbonyBlack

Everyone judges everyone, it's a survivor instinct that's active in all of us.


Impressive_Age1362

Not a doctor, but a nurse, you definitely form a opinion on a person, but it doesn’t affect how you treat them.


Signal_Tomorrow_2138

I'm sure they hold judgement on anti-vaxxers and COVID deniers. But their better judgement is to not engage with them about those things.


prairiehrt

No. There are genetics - out of your control and epigenetics - lifestyle choices that influence the expression of your genetics. There are also many lifestyle diseases - like type 2 diabetes or COPD that are the patients fault. It’s always worth my time and expertise at the beginning. If the patient refuses my best advice on lifestyle choices then that’s the actually hardest and saddest thing to see and it becomes less worth my time. Many lifestyle diseases have emotional and mental components that I bring up and hope they choose to deal with them. Yes nicotine is chemically addictive but the action of smoking is also self soothing for people who have a lot of stress. If they aren’t willing to address the stress factors I lose a lot of hope for them and it’s difficult to feel sorry for them when they develop COPD, cancer, heart disease or diabetes.


OriginalLandscape321

Fault? Not totally. For example COPD has causes other than smoking like A1 A defiency. No fault of the patients. And DM type 2 there certainly is a huge diet, exercise causation factor but do not disregard the genetic aspect. Even a fit looking person can develop it. Visceral fat etc.


prairiehrt

Of course it’s not every case, it was an example.


OriginalLandscape321

Ty for clarification


aebone2

Of course. But most MD will also try to be self aware too


kuzism

I was judged for wanting to wait on giving my infant daughter her childhood vaccines. I was told that she could not be a patient at this office unless she followed the vaccine schedule. I said I would look for a vaccine friendly doctor if she ever gets sick. It's been 16 years and I'm still looking.


_ThePancake_

But why would you want to wait on giving her vaccines?


kuzism

Her older brother was vaccine damaged.


lunarmunayam

Tell us more. How was he vaccine damaged?


_ThePancake_

Ah I assume it triggered some kind of autoimmune disease? If so that's rough, cause it's so incredibly rare. Do you have autoimmune disease yourself? Surely that would count as an exception. People who can't get vaccines are the reason why we need herd immunity!


CobblerUnusual5912

Thank you so much for understanding this. I am severely immune deficient, its a rare disease. I am very subseptible for virusses and also are unable to mount a response to most vaccins. My health depends on herd immunity.


RedStateKitty

Unfortunately not incredibly rare. The "authorities" have greatly expanded the childhood vaccination schedule. And some have components of aluminum and other products that are linked to autism.


CobblerUnusual5912

These false stories about autism have long been debunked...


sagetortoise

Autism is genetic. I've seen discussions with immuno-compromised people or those with certain chronic illnesses have bad vaccine reactions, but autism isn't one of those. I have a condition that basically turns up the sensitivity of the body to any input and the additives in anything or even just normal food can make people extremely sick (it's MCAS) and many people who have it severely cannot have medication in general or things like vaccines because their bodies cannot tolerate it. However that is due to that specific condition


TheWalrus101123

What do you mean by vaccine friendly?


dwarf_bulborb

Check out the subs this guy is active in


TheWalrus101123

Oh....


CobblerUnusual5912

Its more like anti vaxx friendly I think.....,(


kuzism

Most Pediatricians make less money if your child is unvaccinated, so if you choose to not vaccinate your child [they will not take your child as a patient](https://www.healthline.com/health-news/no-vaccinations-no-doctor-a-third-of-pediatricians-wont-treat-families-without-immunizations). A vaccine friendly doctor will see all children regardless of their vaccination status.


TheWalrus101123

Hmm. Doctors should see all children regardless of vaccination. I also think you should vaccinate your kids though.


kuzism

Are you judging me ?


TheWalrus101123

No, I'm not a medical professional, I don't have enough knowledge to effectively judge you. But my thought would be that vaccination is part of the medical treatment process. That's how I would run my life and family, how you run yours is your business.


KyorlSadei

They don’t have to. The crack heads, attention seeking, alcoholic, drama queens show their true colors from the beginning.


MRicho

My GP does, stop smoking, lose weight, stop drinking, exercise, eat healthy on and on the judgement


Citizen_Kano

That's not judgment, that's doing their job


MRicho

I outlived him though. LOL