Of Leaves, Trees, Forests, and Primary Care

Adam Seth Cifu

doi:10.7326/M13-2984

On Being a Doctor |3 June 2014

Of Leaves, Trees, Forests, and Primary Care

Adam Seth Cifu, MD

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We all recognize that we are not the same doctor from day to day. Our mood, how well we slept, how our kids are doing in school, and what our chair said to us on the way to clinic all affect us in our clinical setting. Although we like to think that the quality of care that we deliver stays constant, I certainly know that the focus with which I attend to my patients varies enormously.

On the days when I feel most besieged, I see only the leaves. Patients' issues and, unfortunately, patients themselves become blood pressures, hemoglobin A_1c and microalbumin levels, and the assorted aches and pains that fill the professional life of a general internist. Also clear on these days is the effect that certain patients have on me. Call it what you like, transference or gut reaction, but just looking over the names on my schedule triggers strong emotions. There are the people I look forward to seeing; those who engender grief and hopelessness; and those who leave me aggravated, aggrieved, and annoyed—even when they are doing well.

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On Being a Doctor |3 June 2014

Of Leaves, Trees, Forests, and Primary Care

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On Being a Doctor |3 June 2014

Of Leaves, Trees, Forests, and Primary Care

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