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"Those Days"

For those of us who work in the business of treating the morbidly obese there are “those days”. Days when you feel that no matter what instructions you give, no matter how much you do and no matter how much you care, there is resistance. There are days when it may take just one individual to turn the atmosphere of the whole office and hospital into a state of turmoil. On “those days” you daydream about what you should have been when you grew up and know that it would be any other profession than this. “Those days” recently turned into weeks in our office with just one resistant patient. The stress has only been tempered by all of us thinking about what we could be doing with our lives and knowing that this particular job wouldn’t be one of them.

“Your job must be a tough one,” a former patient recently said to me. I guess I never really looked at it that way. I suppose it can be rough at times, but just lately it has been a little overwhelming. Probably the average patient isn’t aware that we in this business eat, live and sleep the job. We go to bed and wake up in the middle of the night with that one individual on our minds that we could perhaps adjust the medications on, order another test on or just worry about in general. The new day begins with the same type of preoccupation. It is never ending.

By the time the annual conference of bariatric surgeons and allied health sciences rolls around everyone is ready for their own “support group therapy” session. We all realize there are others out there who are just as crazy about this business as we are. The few days of conference turn into long hours of problem solving, exchanging ideas, learning and teaching. Undoubtedly the average patient doesn’t understand that we always have a lot to learn. I tell our patients that we learn something new in this business almost everyday and that we will always share this educational process with them.

The average patient more than likely is not aware that we learn more from them than from the textbooks. Generally we learn these “lessons” from the compliant patient who runs into some technical difficulty either before or after surgery. They teach us the important lessons of patience. Their “bodies” challenge our abilities and our patience at times. We also learn from the noncompliant patient who defies our every decision and every judgement. We learn the necessity of being patient yet firm and of sometimes just having to say “no you are not a candidate for surgery”.

The average individual might not really understand that we take this business to heart. We always stress the fact that every BODY is different and should be treated as such. To individualize what we do for so many will always be stressful. There will never be enough hours in the day to do the kind of individual care that we would all like to do, we always hope that everyone understands.

I guess the job is a tough one, now that I think about it. Recently I have been reflecting on some of those tough times. I then reminded myself of another time when things in general were not going well. During that time a former “problem patient” called. “Just wanted you to know that for the first time in my life I was actually able to sit in a seat at Tiger Stadium and for that I thank you”. “Thank you,” I said, “You don’t know how much I appreciate hearing that.” And recently when things seemed to be going downhill with resistant patients I went to the labor and delivery floor of our hospital and had the privilege to hold baby Zachary. This bright and smiling newborn was the pride and joy for all of us. We had worked with Jamie who for 21 months before her pregnancy had lost 175 lbs. Just the look on Jamie’s face and to hold this miracle we call Zachary reminded me of why we are all in this business.

When we have time to reflect on the type of work we are doing we realize that some days will always challenge and frustrate us, but those days are few. Most days we know that even though miracles like Zachary do not happen everyday, the smaller miracles do. The average individual probably will never have a job this rewarding.

Jacquelyn K. Smiertka, RN, has been a bariatric surgery clinical coordinator for thirty years. Mrs. Smiertka is a member of ASMBS and IFSO and has presented papers at numerous meetings in the United States and Europe.

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