Over the years, I’ve gotten comfortable with telling patients, “I don’t know”.
But it’s something that I’ve had to practice and constantly work on because as a doctor, you pride yourself on knowing. So it’s uncomfortable to admit that you don’t know.
You go through medical school, constantly being questioned, constantly being tested. You’re expected to know things, and even rewarded for it, and you’re made to feel like an absolute idiot if you don’t know.
It’s almost like you’re conditioned to need to have all the answers, and if you don’t, you can’t lie either because what’s worse than an idiot? A Liar. It’s the worst transgression that you can make. Instead, you have to gradually learn how to admit that you don’t know with an air of confidence that doesn’t make you seem like an incompetent ditz.
So last week when I had to tell a patient that I didn’t know what to do for them anymore, I felt sick about it. Although it wasn’t a life threatening illness, and we had ruled out anything sinister going on-that patient was still suffering. And I had tried everything. As a last resort I consulted with the hospital doctors for advice, and they didn’t know what to do either. On the one hand that made me feel a bit better about myself because it confirmed that I had in fact done everything that I could. But on the other hand I felt terrible because that meant that I was back to square one having to tell the patient that there wasn’t any more that I could do. And although it gets easier to get those words ‘I don’t know’ out of your mouth, you never get used to the emotion behind it. You feel disappointed that this person came to you for help, and you failed them.
And it sucks. There is no other way to describe it. But at the end of the day you have to be comfortable with uncertainty. This is part of the job. This is part of life. You will not know things sometimes; modern medicine hasn’t discovered the answers to everything- that’s why there is always research going on. All you can do is do your best with the knowledge that you have, keep up to date with the latest information, recognise your limitations, exclude all the sinister causes- and explain all of this to the patient in a way that they will comprehend so that they are on exactly the same page as you. Sometimes, that’s all you can do. You can’t know everything. You are not a machine.
The Weekday Notes 