Empathy: not your strong suit.

A perfect example of why I quit Metafilter. This comment recently received 270 favourites. An excerpt:

I work in healthcare. I belong to the Church of You Don’t Deserve This. I take care of alot of patients who, IMO, don’t deserve the medical care that I dispense. I know this is going to make me sound like a total and complete ass, but let me elaborate.

I take care of patients with kidney disease. Some patients got kidney disease through shitty genetics. Others through odd accidents or bizzare infections. Others through cancer. Alot of our patients (like my own father) got kidney disease from letting their diabetes go untreated for 20, 30 years. Regardless of how they got it, the vast majority of my patients refuse to take steps to prolong their life and improve their quality of life.

Dialysis patients, as a whole, are notoriously noncompliant. This is usually because they have a history of non-compliance which usually got them into their situation in the first place.

For example, dialysis patients shouldn’t really drink more than a liter of water per day. Yet we have patients who, as soon as they leave our hospital dialysis unit, go home and start chugging gallons of milk or juice. (And are consequently back in the hospital within a few days). We have patients who have two homes: their regular residence and the hospital. They treat themselves badly and then spend 1/3 of an average month in the hospital, racking up hundreds of thousands of dollars in Medicare bills over the course of a year.

You know what I think about these people? I think they don’t deserve my services. (yes this includes my dad). I think that my services are wasted on people who refuse take even basic steps to help themselves stay well. I think I’d rather focus my energies on the patients who recognize the seriousness of their condition and take an active role in their self-care.

If I were king of the world, I would tell these people, “Look, we’re giving you three months to turn your life around. Start taking better care of yourself, stop drinking yourself to death and take your medications as prescribed or else we’re going to withhold treatment until you do. There are alot of people with kidney failure who want to live and we aren’t going to divert scarce resources to people who don’t care one way or the other if they die or not.”

Thats what I would say, if I ran the world. The Church of You Don’t Deserve This.

That’s not what I say, however.

My profession demands that I dispense medical care to all who need it, regardless of my own personal judgments. My profession demands that I provide care to someone who treats their own body so badly that they have their own PO Box at the local hospital. My profession demands that I care for the unruly, the mean, the stupid and the non-compliant. My profession demands that I provide care for brain-dead patients who are just being kept alive by their families for the monthly social security cheque. My profession demands that I care for everyone who darkens the door at my clinic, regardless of whether or not they are saints or Dick Cheney. My profession demands that I do things, which, in a perfect world, I would be able to not do.

And yet I do them anyway, because it’s in the job description.

What a hero.

I apologize for my lack of analysis right now, and for my lack of recent posts, but I’m adjusting to new medication and basically have been sleeping my face off. In a few days, I should be back to my old self.

Allow me a moment of unmitigated cheesiness and affection, however, to say this: I love my commenters. You are all making this new website adventure a lot more fun than I thought it would be. I love what’s happening here, and I want it to keep happening.

So, yeah. I guess I kinda like you. That’s all. Don’t go spreading it around or anything.

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