Meeting patients, and ourselves, where we are

During medical training, and beyond, we often hear an adage about compassionate care. “Meeting people where they are,” is regularly recommended by mentors. The challenge for me has been to figure out what that really means and how to implement that in practice. What follows is my interpretation of this and how I have come to offer this type of care. 

First, this begins with centering and clearing myself so that I do not bring a rigid point of view to my work. Spending time in my own therapy sessions is helping me heal my wounds so that I do not impose these on others. An example of this is as recent as the past week. I have a patient that I will call Jimena. Jimena is a woman in her 50’s who works hard and is trying to do the best for herself and her family. I also see one of her adult sons. It feels like clockwork that she will often interject questions about her son during our visits despite me repeatedly informing her that I do not share sensitive information about patients with one another. She also has made it clear she does not want her information shared but feels it is her right to know about her son. I have explained and re-explained that I cannot legally share information but round and round we go. Last week we had a great conversation about how this could have dramatic impacts on her family. If I were to share, her son would likely come to know I broke my promise and possibly never trust me again. This could have a major impact on our doctor-patient relationship.  She seemed to understand and thanked me for my boundaries. The funny thing is that there is logic and then there is human emotions. It is entirely possible that she will continue to ask I will need to continue to hold strong with this stance. I have felt on guard and disrespected because she continues to try when I have asked her not to. During my therapy session this week, I went within to see how my beliefs are causing me pain and shame around this. I had an old belief that if “I explained this correctly, she would understand and stop the behavior.” This belief has roots in past experiences that taught me this unhealthy belief. I was able to see that she is likely worried, and frantic and her culture does not hold personal privacy in high value. It was freeing to see that her behavior had nothing to do with me. With this new perspective, I can continue with my healthy boundaries without it causing me psychic injury every time she asks me inappropriate questions.

I used to find it frustrating when patients would ask my advice and then directly do the opposite. I used to think to myself “It is ok that you choose differently than what I recommended but why are you asking me if you are not going to follow what I recommend.” And then in the past 2 months, Eureka happened. A patient repeatedly asked my opinion and then followed a path very different than the one I recommended. I was able to support her as she found a way to heal herself and manage her symptoms. She thanked me profusely.  I realized that what she needed was for me to offer my thoughts while being comfortable with people being people. Perhaps she just needed to know that I care and allow her to process her thoughts with me. It is also ok if patients make choices that ultimately end up harming them. Sometimes in our own feelings of powerlessness, we hold on to our choices, even if those choices are damaging. Empowerment is sought in different ways. 

And so how have I been able to meet patients where they are? This has come about by accepting myself for who I am and where I am at rather than who I think I should be and where I should be. Granting myself grace while seeing that I am doing the best is my new way of thinking. Life can be chaotic and opening a Direct Primary Care and Psychedelic Practice has been a beautiful mess-but it is indeed my mess, and this is empowering!

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