Richard F. Mitchell, MD,
For many clinicians, the path of medicine is a comfortable one—well-worn, made by many feet before your own. From college to residency and beyond, the courses to take, exams to pass, and applications to fill out have been laid out for us in a nice, orderly path. There is some room for brief excursions off the path, but the route to our prescribed life of clinic medicine, hospital medicine, specialty care like sports med, OB, or geriatrics, or some combination thereof is a well-marked trail with lighted signs to guide us all the way.
Until the day you decide to teach. I recall talking to our program director on the first day I had administrative time and asked, “What should I do?” His response: “I don’t care.”
Jennifer Ayres, PhD
As a trauma psychologist, I find that my greatest challenge in working with survivors of Intimate Partner Violence (IPV) is contending with my automatic bias that the “happily ever after” includes my patient leaving his or her perpetrator. When my bias arises, I reflect on three truths I learned from my undergraduate employment at a battered women’s shelter.
- Most people go back.
- If he or she goes back, and you made it clear that you thought it wasn’t a good decision, the patient can’t return to you the next time.
- It will happen again.
And there are a couple truths I’ve learned since I worked at the shelter.
- Basic decisions become complicated when you consider all the repercussions.
- Leaving might not be the best decision.
- If he or she does leave, the resources often aren’t available, and there is no referral for “make someone feel safe and free.”
These last three are challenging because I am much more comfortable with the patient who decides to flee the abusive situation or engage in the legal fight.