Blogs

In light of recent media coverage, it would seem our world has been turned upside down: brutal police shootings based on perceived threat of race; the horrific Orlando massacre, based on perceived threat of sexual orientation and gender identity; terrible international crimes based on perceived threat of religion and ethnicity.

“You know me well, doc. I need your advice,” says John, 43, who proceeds to tell me about severe depressive symptoms he is having. He has been brought up in a household where the thought of depression was a sign of failure, of “not being man enough.” Yet he remembers that at last year’s annual visit I had asked if he had been bothered by problems such as little interest or pleasure in doing things, or if he was feeling down, depressed or hopeless.

It was the first week of July and I was excited to meet a new patient at the Duke Family Medicine Center. Luckily, this first patient encounter would be alongside a senior attending physician from the practice so that I could learn the logistical ropes of the clinic before taking care of my own patients.

Earlier this week a resident shared that she had lost a close family member to complications of diabetes. That family member was only in her mid-60’s – young given the fact this woman’s life expectancy was 81 years.

As I enter my final year of residency, it is natural to reflect on how I have arrived at this exciting time and how far I have yet to go. I find myself giving advice to the new interns and second years about what lies ahead for them and my confidence in their abilities to do great things.

Dr. Everlyn Perez, first-year resident in the Duke Family Medicine Residency program, wrote a very moving essay last month about managing the grief that is part of the life of a physician. It is magnified with the very human tragedies we are witness to in the stories of our patients.

As physicians we are exposed to extraordinary pain and suffering. In the hospital setting we bear witness to debilitating injuries, incurable disease, and death. In an outpatient setting, we deal with many factors that lead to smoldering disease like underfunded mental health services and uncontrolled chronic conditions due to poverty.

These days, there is a lot of talk about “the patient experience” in health care. Insurers are looking at this topic, and providers and clinics are being “graded” on related metrics. We even have our own “Balanced Score Card” that our division and department leadership, and the health system, are held accountable for. You can find the survey and its results for Duke Health overall at this website.

As a family medicine resident at a large academic medical center I feel lucky to have the opportunity to interact with different disciplines within the health care field. I particularly appreciate working with the Division of Community Health in the Department of Community and Family Medicine, with whom we work hard to support many shared goals, such as those found within our residency’s population health curriculum.

Walking through our lobby/waiting room/registration area usually brings a smile to my face. It’s heartwarming to be able to greet people by their name and have them respond with a smile, a nod and sometimes a hug.