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Dear Colleagues: You Don't Hate People

<ѻý class="mpt-content-deck">— You're just stretched really thin
MedpageToday
A photo of a male physician with his head on his desk.

It's something one hears too often in healthcare. I've heard it my entire career at one time or another. More in the last few years, with the shortages, pandemics, lions, tigers, and bears...

A nurse, physician, medic, or someone else involved in the madness of bedside care comes back to their desk, collapses into their chair in frustration, and says "I really hate people!"

It might be because their intoxicated patient keeps pulling out his IV, blood pooling on the floor and dragged all across his sheets. Later he was squatting in the corner, relieving himself on the floor of his room.

It could be because a family member of a patient is particularly demanding, and due to their own fears and frustrations, says angry, biting things to the staff member. It makes it hard to go back into the room.

Sometimes it's because there are just too many patients, who are too sick, and the demands keep rising. Physicians and nurses alike face this as people live longer and have more complex illnesses. It's made worse because administrators keep piling on charting requirements; medical records systems add new time-stamps to track; and nurses, patient care techs, labs techs, respiratory therapists, and all the assorted staff of the hospital are in short supply. To top it off, housekeeping is wildly overworked and underpaid.

Patients can't get discharged because they can't go to nursing homes, or to their own homes due to weakness and infirmity. They lie in the hospital for days or weeks in a perpetual holding pattern, like a commuter flight circling Charlotte.

Other times it's far more painful. The team staggers out the room where they tried to save the child who was beaten to death by an adult. Men and women go to separate corners, cry, scream, and dream of justice.

The car crash, caused by an impaired driver, leaves a young mother paralyzed, a young father near death.

The great-grandmother, doing her best, is raising her great grand-children on virtually no money, because the children's mother and father can't escape fentanyl, or meth, or any other substance.

A fellow staff member berates a colleague. It happens to everyone. I've received my own share of this from other physicians. We are not a monolithic group. Everyone in healthcare is potentially divided by tribe and family. We can be very cruel and our words, which should heal, can cut like #11 scalpels.

After all of this, people say "I hate people, I really do!"

To which I try to reply, "I've seen you take care of patients. If you hated people, you wouldn't do this job. You love people, you just hate the way things are."

Before COVID, during COVID, after COVID, it has always been hard to take care of the sick and dying. There have always been and will always be tragic situations, hateful people, unkind fellow travelers.

All of it takes a toll. The suffering, the wounds, the death, all imprint themselves on our memories and likely onto our DNA.

But to everyone who thinks, in the midst of the fight, "I hate people," I submit that you don't.

Quite the opposite. I think you love people.

If you didn't, you would never be there in the first place, telling us about your hatred. Which is, by the way, just another way of saying that you care enough to keep doing the job even when it's terrible. You're just stretched thin; physically, emotionally, and spiritually.

So, keep the faith brothers and sisters.

The world needs you. Especially the people you think you hate.

You see, I know the work you do.

Hatred doesn't look a thing like that.

Edwin Leap, MD, is an emergency physician who blogs at , and is the author of and . You can read more of his writing on his Substack column, , where originally appeared.