It has been nearly three years, and I still think about you sometimes. I think about the look on your face as the doctor scraped the necrotic flesh from your leg. I think about the lack of emotion as the doctor explained the complications of your condition and what would happen if you did not take care of yourself. Your face was a stone wall; your body language was nonexistent. I asked myself why someone would show such a lack of concern, but you were no ordinary patient.
I left the clinic that day wondering why you refused to take care of yourself. I wondered why your wife’s concern did not phase you. I wondered what you were thinking. Maybe you were not thinking about anything. Maybe you were merely at a loss for words. Maybe you were depressed. Maybe you did not want to live anymore. Maybe this was your way out.
After meeting you that day, I knew I needed to address this conflict within me. We did not treat your feelings. We did not treat your thoughts. We treated your necrotic leg and told you to take your insulin and left you alone in the room. We lectured you and told you that whatever we did was not going to help because, in the end, you were not going to take care of yourself. I felt hopeless. I felt unable to help you. I felt like I was not going to make a difference.
I realize now how mistaken I was. Three years later, in retrospect, I finally think I understand our interaction. When I first saw you, I thought that you were a noncompliant patient who did not care about his health. I was wrong. You did care about your health. You did care about your wife. But as providers, we failed to recognize the underlying factors contributing to your deterioration. We treated your disease, but we did not treat you.
We failed as medical professionals that day. You walked into the clinic begging for help, but we failed you. We failed to treat the underlying conditions that were affecting your health. We failed to recognize the mental illness that was destroying you from the inside. Diabetes was merely a complication of your mental health. As medical professionals, we treated the disease and failed to treat the patient.
I do not know if you are still alive today. If you are not, I assume the medical professionals will record your cause of death as complications of diabetes mellitus. However, I know now that there was much more to you than diabetes. As physicians, we failed to treat you as a person. I am deeply sorry. There is nothing I can do to change it now, but what I can do is thank you in this letter. Thank you for helping me realize that physicians do not treat diseases; physicians treat people. Thank you for helping me become a better physician that day, and I will never forget you as I continue to practice medicine throughout my life.
Image credit: “Driving the Point (Day two hundred eighty-seven)” by Madame Meow licensed under CC BY-NC-ND 2.0 license.