There is this unspoken line that is not supposed to be crossed when you are a doctor, not with your patients, not with the nurses, and not with your office staff.  There is this unspoken line that the doctor is the authority and to be too chummy with anyone in that circle would diminish that authority.  Order, authority, hierarchy, all of these are essential for the doctor to instill a little fear into everyone, staff and patients alike, so that no one questions or defies them.

I have always had trouble with that part of the job.  I think I might have a problem with boundaries.  Not in a weird creepy way, I’m not going to follow someone home.  I just really like to let the guard down.  I like to be friends with my staff.  I enjoy getting to  know my patients, their families, all about their lives and I equally share stories about me and my experiences with them.  I invited patients to my wedding.  I’m friends with my patients on Facebook.  Friends from work have come to my baby showers and my kids’ birthday parties.

There are moments that I wonder, am I being appropriate?  Am I too nice?  Do people respect my authority?  My partner in practice often looks at me with a manly countenance of disapproval, “You stand up for the staff too much.  You are always on their side.”

“You always get higher scores on the patient satisfaction surveys because you are too nice to the patients.”

Jeez.  I must be such a pushover.  I’m too nice.  No one will respect me.  I stand up for the wrong people.  Regular Goody-Two-Shoes.  Typical woman.  Always smiling and laughing.  Why aren’t I more professional?  Stoic?  Angry?  Authoritative?  Full of righteous indignation? Doctor-ish?

I tried being all of those things at first.  I can pull it out of my ass when I need to.  It feels contrived and a bit unleashed, like something pent up and frustrated barrels out of me.  I don’t feel very happy being that way.  I choose another way.  My way.

The first time I met someone else like me was when I did my very first clinical rotation in medical school with Dr. Sortino.  He would sit down beside the patients and talk to them about their lives, he’d tell them jokes, shoot the shit, all the while assessing them, reading through their chart and formulating his plans.  They LOVED him.  I LOVED him.  He  would call me up at night and ask me what color scrubs I was going to wear the next day so that we could match.  He was warm and endearing and he was a great doctor.  He didn’t know it, but watching him early on gave me the permission I needed to be the kind of doctor I wanted to be.

I remember seeing someone else like that.  It would be two years before I started medical school that the 1998 semi-biographical account of the life of Hunter Adams, M.D. AKA Patch Adams came out in theaters.  He donned a clown nose and used humor as an essential part of his therapies.  He dreamed of a different way of being a doctor using equal parts joy, laughter, and happiness in his practice.  After graduating from medical school in 1971, he and a small band of like-minded people founded the Gesundheit Institute, a free clinic that operated for 12 years using happiness as one of the tenets of healthcare.

I hadn’t thought of Patch Adams in years, not until the death of Robin Williams in 2014.  It made me wonder, whatever happened to Patch Adams?  Did he achieve his dreams of a Gesundheit Institute complete with a free hospital, free healthcare, and centered on providing humor, joy, and happiness to his patients?  If he did achieve the dream, was it working?  Could free healthcare and laughter be the answer to the problems facing healthcare today?

What Ever Happened to Patch Adams? Part 2

1. http://www.patchadams.org
2. https://en.wikipedia.org/wiki/Patch_Adams