Dear Gastroenterologists of the World,
On behalf of my friends and families and all others who have ulcerative colitis, thank you for having the will power to show up for work each day to look inside people like me. I have been meaning to personally thank all of the doctors who have gone where no other has gone before, the deep, the dark, the do do hole that is, and I thought today was the perfect day for this thank you.
I have often wondered how someone can choose to become a GI doctor when it will probably mean looking inside the anus of random patients week after week, year after year. I am guessing that there is probably no pleasure at all in this type of medicine, just business as usual. But wait, maybe I am totally wrong. Maybe there is great pleasure in scanning the walls of a doodie hole also known as the colon or other funny words. Maybe there is something to really enjoy when you are starring at a TV screen picking out where you will take your next bite out of the inner lining of the large intestine. And then stash the small biopsy into some tube to be looked at further by the trusty pathologist…
I am just not sure how one goes from medical school to an eventual gastro doctor, but it sure amazes me.
There was a time when I was really really sick. It was sigmoidoscopy episode number 1. I was showing many many symptoms of severe ulcerative colitis. Especially liquified bloody stools. There actually was no stool about it. So, the sigmoidoscopy began. Actually, it all began in the exam room when my favorite GI doctor said, “Hey Adam, we’re going to do a quick check on your colon”. So off to the room we went. There was a bed to lay down in, more like a massage table. And then all types of medical equipment. The nurse told me to go to the bathroom and to take off everything and then to put on the gown. So, in I went, and out I came, all gowned out. Not quite sure what was next.
And then there you came, my favorite GI doctor was hoovering over me. He explained it would be very quick, no pain, just a quick look inside to see what was going on with my colitis. I rolled over to my left side, stared at a TV screen, and within seconds it all began. It was like nothing else before. My gastro doctor was at the joy stick of the video game, cruising up the colon. And it was all right in front of me on the TV screen. Walls covered in red, tiny white spots, basically a severely inflamed colon. And then, a tiny little poke. Actually it was a snip of the colon. And a tiny splat of blood was noticeable. That was a fresh new biopsy. On a scale of 1-10, 1 being little pain, it was a 1/2. Almost nothing, but sure strange to witness live. How can you do this all day long gastro doctors? This sure amazed me to think a gastro doctor may do several hundred of these “procedures” per year, maybe way more than that. That is hundreds of do do holes!
What blows me away just as much GI doctors, is how you can get so close to curing patients, or at least making them feel better for a while, and then to learn that the medication or therapy you have prescribed is no longer working. If I was a GI doctor, I wouldn’t be able to deal with the mental side of not being able to help patients who are really really sick ALL of the time. Nope, this sure would not be for me. I like seeing problems getting fixed quick and fast. I like cutting corners, I like taking shortcuts. This doesn’t seem to be the solution to ulcerative colitis, or at least that is what the world of western medicine seems to be saying. So how can you deal with not being able to help all your patients all the time GI doctors? That must be hard for you.
What is the biggest victory or pat on the back for a GI doctor who has an ulcerative colitis patient? My guess would be seeing them feel better, and feeling better for the longterm might be the best. As for the biggest loss or failure, my guess would be when a GI doctor has tried all the medications known to man on a colitis patient, yet that patient still needs to have surgery to remove the colon. That must be really difficult to see a patient sent off for colon removal. Especially if you have met with them fifty plus times, and tried all types of things medically to get them feeling better. Once again, I can’t imagine how that must feel for the GI doctor. I sure couldn’t deal with that. Thanks for being able to handle that situation, and to continue practicing GI docs. You are truly amazing.
One final note, to all the GI doctors who return phone calls promptly, take the extra minutes to explain the thought process, review medication side effects, explain what ulcerative colitis actually is, and who are just generally friendly people to your ulcerative colitis patients, this letter is meant for you. My GI doctor is one of those.
But, for all the GI docs(and I know there is at least one) who just throw medications at patients, are more interested in the drug representatives free lunches than their patients well being, never return urgent phone calls, don’t explain medication side effects, and are not open minded to treatment plans, well, this is definitely not meant for you and you still have alot to learn about being a good doctor even if you feel you know everything already.