I think we have to be transparent with our patients when the answers are not certain.
Josh Burnett, MD, was my senior clinical mentor. He was the first rheumatologist in New Hampshire and among the first formally trained rheumatologists in the U.S., having spent six months at Massachusetts General Hospital. I can remember more than a few patients telling him something to the effect of, ‘Dr. Burnett, I am so sorry you have to deal with all my problems and have such poor treatment options.’ Josh was a towering, sweet man. He would hold patients’ hands, which always looked so small in his, and tell them he was there for them and would help however he could, especially for those ailments/comorbidities that could be treated more effectively. He was my hero. He was beloved and taught me more than I can express about the humanity of being a doctor.
Josh also taught me about mentoring beyond medicine. He frequently had us over for dinner and made sure to learn about the fellows with respect to our spouses, significant others, passions, problems and goals. We also learned about him and his family. These were special times that enhanced our investment in each other and I think made us a happier and more effective rheumatology division.
Josh and Edward (Ted) Harris, MD, encouraged me to spend time with surgical and rehabilitation consultants. I went to operating rooms, watched surgeries and became involved with rehabilitation, later even becoming director of a rehabilitation/physical therapy unit. These colleagues were wonderful teachers who taught me how they were helping my patients, and they also showed the limitations of their practices.
I continued that approach with surgeons for my vasculitis patients who were undergoing vascular bypass, subglottic, tubular airway and sinus surgeries. Not only did I learn, but almost without exception, whenever I called them with urgent problems, my patient and I were rewarded with prompt and friendly responses. It was so much fun! It is sad to see how little time is allowed for this kind of team relationship building in today’s ultra-busy practices.
During these years my research was all over the map, driven by patient problems that were confusing, and led to literature reviews and new questions about lupus and pregnancy, antiphospholipid antibodies, myositis, calcium oxalate arthropathy in renal failure, pelvic/musculoskeletal tumors masquerading as hip pain and septic bursitis. Not focusing on a single subject will not create a foundation for an academic career, but it made me feel like a more effective doctor, and I thoroughly enjoyed it.
