Crusty Patient Helps Shape Doctor's Career Dr. Suzanne Mitchell credits an ornery patient she met years ago with teaching her the difference between medical treatment and medical care. Today, she shares his story with medical students in hopes of making them better doctors.
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Crusty Patient Helps Shape Doctor's Career

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Crusty Patient Helps Shape Doctor's Career

Crusty Patient Helps Shape Doctor's Career

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We're heading into a year in which Congress may change the health care system. Sometimes, though, a change in health care does not take a change in the law. NPR's Richard Knox spoke with a Boston doctor who recalls a patient who changed the way she practices medicine.

RICHARD KNOX: A couple of years ago, Suzanne Mitchell was in a funk. Her research wasn't going anywhere. And she was burned out by her hectic practice.

Dr. SUZANNE MITCHELL: I've been in settings that are brutally busy and can really drain the physician just by the sheer number of patients you have to see every day. And I think that was part of what led me to this crisis in my career is that, you know, what am I doing here?

KNOX: To give herself time to take stock, she took a part-time job in Gloucester, an old fishing port north of Boston. Her first patient she visited at home.

Dr. MITCHELL: The door opened and I saw this older gentleman with his dog beside him, defending him fiercely.

KNOX: The man's name was Dick. He was a guy who didn't like doctors.

Dr. MITCHELL: An old New England salt, had a beard like the Gloucester fisherman. All he needed was a pipe and a hat, I think, and a pea coat. Very independent-minded, a little bit gruff: If it needs to be done, I can do it myself.

KNOX: Dick ran his own heating supply business until he got very sick with an intestinal problem. He had some bad experiences in the hospital and then he got diagnosed with multiple sclerosis. By that time, he was so fed up that he didn't see a doctor for years.

Dr. MITCHELL: Which I found astonishing that anyone could manage to avoid the health care system after 20 years from being diagnosed with multiple sclerosis.

KNOX: But Dick was having problems walking. His wife had health problems of her own, so they called for help. Dr. Mitchell ordered routine blood tests. They showed anemia, a further workup, x-rays, a CAT scan, showed a tumor in his kidney. Specialists decided to check it again in three months.

Meanwhile, Dick's MS got worse. His family summoned Dr. Mitchell for another house call.

Dr. MITCHELL: I looked at him from across the room and I just knew that he was really in a crisis. And I walked over and I knelt down in front of him and I looked him in the eye. And I knew in my heart that I was taking a chance. And I said, Dick, you need to go to the hospital. You need to go to the hospital. He looked at me and said, okay. And I knew then that he had placed his trust in me.

KNOX: But once he was in the hospital, things didn't go well. The doctors wanted to treat his kidney cancer aggressively. Dick just wanted to go home.

Dr. MITCHELL: He was, at this time, very ornery and unhappy with me. And he didn't trust me anymore. And he just kept telling me to bring him home, bring him home.

KNOX: Mitchell realized then that she'd made a mistake by putting him in the hospital. But that decision turned out to be incredibly difficult to reverse. Some family members didn't think they could care for him at home. Mitchell's colleagues questioned her judgment. But she kept pushing to get him home, and she prevailed.

Dr. MITCHELL: We brought him home on Christmas Eve, and all of his family was there � his children, his grandchildren, his dog, his wife. It was the first time he smiled, I think, in months. And six hours later, he passed away at home.

KNOX: Which is where he wanted to be all along.

Mitchell says Dick taught her the difference between medical treatment and medical care.

Dr. MITCHELL: To be willing to follow your patient to where they want to go is an uncomfortable journey, and it changed me forever.

KNOX: How are you different now?

Dr. MITCHELL: I'm not afraid. I'm not afraid to allow my patients to take me on their journey. Whatever expertise we have, the patient holds the wisdom of their life. And we need to be with our patients, really be with them.

KNOX: Mitchell tells this story to medical students and young doctors in training. Sometimes they say: How will we have time to get to know our patients?

Her response is: you can't afford not to, not if you're going to be a good doctor.

Richard Knox, NPR News.

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