The Punch that Killed Houdini May Kill Your Doctor, Too!

Harry Houdini grimaced in pain as he reeled from the deadly blow that later ended his life. It was a punch to the gut, no different than others he had received on stage before, except for one small fact that meant the difference between life and death. He failed to tense up the muscles of his stomach and prepare for this particular blow.

The surprise punch, at the hand of the audience participant, burst Houdini's appendix, and his body set off toward a slow and agonizing death. 

The curtain fell that evening, and before long, he was dead due to overwhelming infection. He may have been powerful, and even clever – powerful traits in those days of fabulousness and fame - and yet, what beat the unbeatable Houdini ended up nothing more than a single, surprise jab to the gut.

Sadly, the healthcare of today is also dying a slow death, having been dealt its own surprise punches.

At the outset of our careers, medicine for many of us was a kind of yellow brick road, leading to a magical future peppered with wonderment - not to mention the turmoil of the occasional flying monkey. It was magical nonetheless. We never imagined it would end in anything short of the crystal palace and a click of our sparkly heels home.

But here we are, practicing physicians, reeling from punch after punch. At times we’re just trying to come up for air, struggling to figure out exactly what happened to our beloved profession.

If you ask any physician today why they're unhappy in the medical field, they will most likely choose one of many explanations. However, it all boils down to one simple fact. We can’t provide the care we feel that you, our patients, should receive, and we’re getting punched from all directions while trying to deliver it. You deserve better, we know it, but we are at a loss, and don’t know what to do.

We want you to feel empowered, but it can’t come at the expense of our ability to direct your care.

You come to us for help, so please allow yourselves to surrender a bit, and let us guide you. We know you are scared. But you have to put your trust in us.

Google.

We understand, for one, that Google can serve well as a guide, but it isn’t a substitute for the years of training and dedication we’ve committed ourselves to. 

Google can’t listen to you, or hold your hand. It doesn’t cry with you, or see the wrinkles on your face. The unease in your posture. It doesn’t understand the stressors in your life, the dynamics of your illness, or have an appreciation for how you can focus on one symptom, at the expense of a more ominous one. But we do. 

Sure, we'd like you to be happy, but in medicine, we can't always make that happen.

We can’t jump-start all hearts, we can’t cure all illnesses, and sometimes, all we can offer you is a peaceful suggestion on how to leave the world on your own terms. Know that those are some of our worst days, too. While empowering you is an imperative for a successfully functioning patient-doctor relationship, doing so with reckless abandonment, or green-lighting all of your requests, is not in your best interest, either. 

Let’s go on this journey together. Let us carry you there when you are too weak or scared to walk on your own.

Loss of Control. 

Physicians are simply no longer in full control. It’s the reality of medicine today. Simply put, your care is at the behest of those willing to pay for it.

Protocols and pathways now guide most of what we do and these are often set forth by insurance giants, pharmaceutical monsters, and policy makers on capitol hill. This three-headed monster guards the gateway to health care.

We feel their pressure, too. Every time we advocate for you - when you need more time in the hospital, or a particular test, or drug, or treatment - and they say no, we feel it. It happens every single day, over and over again. We can advocate for you on capitol hill, but only you, as a policy holder, small business, consumer or, more importantly, voter, can change the reality on the ground. We need you to champion us so we can champion you.

Tort Reform.

We need tort reform, too - to be able to practice free of frivolous litigation. 

While we know mistakes happen and have to guard against that, the vast majority of us are dedicated, responsible and caring individuals. We cannot practice scared. It is destroying medicine. It’s why we over-order, over-test, over-medicate, over-think, and expose you to unnecessary risks.

When the ‘cover your ass’ practice of medicine overrides evidence based practice, we all suffer. You more than us. It is the reality on the ground. Advocate for us so we can advocate for you.

Social Media.

On top of this all, we are in a social media crisis.

Pseudoscience has essentially taken over. When you listen to raving celebrity lunatics harking to the glory days of life without vaccines, or promoting coffee enemas, bee sting therapies, or the douche d’ jour, we all suffer.

We simply do not have time to help you navigate the world of junk science. It’s frustrating to us to have to sit and refute the expertise of a playmate centerfold, or someone whose opinion you take to heart, simply because she stars on the big screen.. sometimes. That’s just not how medicine works. We know, in the simplest terms possible, that their advice can kill. It can’t be any clearer than that, so please listen to us, and not to them. We won’t steer you wrong.

Medicine requires a unique fund of knowledge and dedication that is found in few professions. We love our jobs, and want you healthy. We do this because we care about you and are keenly aware of how privileged we are in taking this trip along you side. We thank you for the trust you have in us and, ultimately, we want to be able to help you click your heels and get home safely.

And if we can do it without getting punched in the gut, while at it… well, we’ll be all the better for it.

 Afternote: Thank you to Dr. Louis Profeta, for your wisdom, and for your help in editing this article.