Background

Let’s consider a patient named Jack—an active 26-year-old male who developed a dependency on opioids after suffering a lower-back injury that caused him acute, then chronic, severe lower-back pain. With there being no medically identifiable reason for his pain, he was treated with opioids prescribed by his GP, as well as ER and walk-in clinic doctors—prescriptions that were renewed and refilled regularly. Over time Jack became dependent on the prescriptions, requiring them to function on a daily basis and suffering terrible withdrawal symptoms without them.

As a recent graduate of a Canadian medical school, it has been cemented in my brain that I am to wash my hands before and after every patient interaction. I’m grateful for this practice, which keeps me and my patients safe from contagious infections. What is taught with much less emphasis, however, is the transmission of emotions from one patient interaction to the next. I suspect that just as bacterial and viral infections can be passed from one patient to the next, then even taken home with the practitioner, so too can emotional trauma.

There are pros and cons to being part of a small community when you are a physician. Some days it seems that everyone knows who you are and what you are like, and other days you are a total stranger—when you see someone out of context they can be completely unfamiliar.

My first job was in a bustling bedroom community, 15 minutes north down a country road from where we lived. There was not a single stoplight on my brief commute to the hospital—just one grocery store, a Canadian Tire, and a local watering hole.

“Excuse me, are you wearing one of those new Fitbits?” I asked a healthy looking woman in her 40s while shopping.

“Oh, yes, I am. Not only is it stylish but it tracks my activity. I do between 5000 and 10 000 steps per day,” she answered proudly.

“Wow, that’s really good, especially for someone with a physical disability,” I replied.

“What are you talking about?” she queried.

“On the way in I noticed that you parked in a disabled parking spot,” I remarked, at which point our conversation came to an abrupt end.