It can be trying, but sometimes we really need to listen to our patients and do the best we can to help them, even if it’s not solely a dental problem.
How much do we really care about patients? This may be a loaded question, but let’s be honest. Do we even have time to care if they are suffering? Or is it just about production—getting them in on time, finishing up, and getting the room flipped for the next one.
My patient, Cierra, made me stop in my tracks today. To be honest, Cierra is one of my favorite patients; she is always laughing, energetic, and is a true fashionista. When Cierra came in today, she was walking cautiously. There wasn’t the usual bounce in her step, and she looked a bit stiff. Cierra told me that she was experiencing severe pain everywhere due to some kind of neurological syndrome that was rapidly progressing. I am not going to get into the specifics, but she landed at my doorstep with her temporomandibular joint (TMJ) reactivated, which had been stable for the past 5 years.
I felt terrible and wanted to help. Our practice was doing all the usual things we do when someone is suffering like this, and Cierra was doing everything she could to get the care she needed, but she was overwhelmed. I took some time to just sit and listen to her story, and it frightened me. If you don’t have your wits about you or have resources, you are in trouble.
Cierra is a healthy 32-year-old mother of 2, does Zumba 3 times per week, is a vegetarian, and lives a very active lifestyle. She started having pain in her legs and feet a couple months ago, and it just started spreading. The pain doesn’t follow a particular pattern and it comes and goes. She showed me a video of her getting out of bed in the morning, and it looked like her feet were heavy and she couldn’t lift her legs. I am not a doctor, but I thought maybe it could be multiple sclerosis, or something that might land her in a wheelchair. It gets better and worse throughout her day, but her world has gotten smaller.
She can’t lift her baby anymore, as her muscle strength is becoming weaker. Maybe part of it is fear that she might drop her daughter, I don’t know, but fear is debilitating. She isn’t able work and standing on her feet can be a problem, so she is focused on getting her health back. She puts her kids in day care and stays off her feet as much as possible. The pain has migrated into her neck, and her TMJ is excruciating.
Despite all this, she keeps going. What choice does she have? She advocates for herself and is trying to get the help she needs, but her doctor isn’t helping. Telling a patient, “I don’t know who to refer you to,” doesn’t give them confidence. Her internist should just ask another doctor for their opinion.
Cierra was excited because she received some alarming iron deficiency results, which may be a step toward solving this mystery. Her teeth started to bleed when she brushed them, so she sent a message to her doctor and was reprimanded for sending emails. This is a patient who is declining rapidly, who has crawled 3 times in the past week because her feet didn’t work, and who finally got a referral from her doctor to neurology—but her appointment is 5 weeks out.
She asked her doctor for help to call neurology to get her in earlier and was told she couldn’t help her with that. Now, here she is in our office. Cierra has always been a delightful patient—what could we do to help?
I felt terrible. Maybe I shouldn’t have taken so much time to sit and listen to her, as this wasn’t really a dental issue, but how couldn’t I? I was watching someone suffer, and we are but 1 part of the mystery. Of course, we will get on the phone and advocate for her to her doctor, but this is sobering. We are busy. Everyone is busy. This patient is going down the rabbit hole and I feel powerless. I cried right alongside her. There really was nothing else I could do.
We never really talk about how powerless we feel in health care or dentistry when bad things happen, and we can’t make miracles happen. We will do our best. Sometimes we bring these nightmares home with us, and it keeps us up at night. Taking the time to just sit with her and get the dentist to call her doctor was the best I could do. We gave her everything we could think of regarding treatment, but this was neurological in nature. I felt like a failure, but sometimes there just is nothing else we can do.
How do you cope with your feelings when patients like this come into your practice? Email me at email@example.com and share them with me. It helps to know I am not alone.