Been There Done That (Leffersbee #1) - Hope Ellis Page 0,122

bad goals.”

I shrugged. “Well, I guess not. We’re first in introducing products most of the time, sure enough. Eddie keeps telling we’ve made enough money, which I don’t know if I’ll ever agree with. But, yeah, I guess I miss that thrill of the chase. It’s not enough to just be first anymore. I guess I have been restless, looking for that next thing that would give me that buzz, you know? Haven’t had enough new challenges, apparently.” I snuck at look at her. “Is that what happened to you too?”

She sighed, sliding down until she was almost horizontal in the truck’s bed. “Maybe. I don’t know what’s wrong with me.”

I kept my tone casual. “Would getting tenure, getting the grant, fix things for you? Make you excited about your work again?”

She took a long time answering. By the time she spoke again, I barely made out her face in the gathering shadows. “It’s not that I’m not excited about my work, per se. I just don’t know if it’s the thing I want to focus on forever, from here on out.”

“Yes, but would you feel the same discontent if you got tenure and enough funding to take care of your employees for the long term?”

I made out her crumpled forehead in the gathering darkness. “I think so.”

I poured another refill of gumbo. “Alright.”

“It’s just . . . When you’re trying to solve a problem, you can never account for all the contributing factors, the complexities of the issue. You know why I started the clinician communication training at the hospital?”

“Tell me.”

“It wasn’t about helping the hospital meet their metrics. That was an important benefit. It helped us measure outcomes and incentivized the hospital to support my work. But why I really did it was because I met and talked to our doctors, nurses, and nurse practitioners. I saw how burnt out they were, how badly they wanted to help their patients, wanted to spend more time with them. Among all of them, one of the most common themes that emerged was that they didn’t expect practicing medicine to be this way. Most of them became clinicians because they wanted to help people. They wanted to make a change, be the difference. Just like I did.”

I groped for her hand, found it in the darkness and held on.

“They weren’t prepared for the reality of practicing medicine in our deeply-flawed system. They hadn’t anticipated how the industry would cripple them, how the machine of medicine and all the chains of bureaucracy would squeeze them, demand all their time, keep them up night and weekends charting. How their clinics were so full, with barely enough time to say hello to their patients, let alone prepare for a meaningful exchange. The people I work with and train, they’re not apathetic monsters. If anything, they’re most injured by their own dismay, by their disappointment that they often aren’t supported in delivering the kind of care that motivated them to become clinicians in the first place. The training we offer? It helps. It gives them tools to connect, to facilitate the meaningful interactions with patients they dreamed of having as medical students. It shows them a way back to practicing medicine the way they dreamed of, even in the midst of all the bullshit, the noise.”

I set down my empty bowl and slid down next to her, pulled her to me.

“What about you? What’s the shot in the arm, the solution, that would help you remember why you got into this work?”

Her exhale warmed my neck. “I don’t know. It’s all so much. It’s so big. I don’t know if it’s enough to address just the individual, interpersonal level barriers like I am. Yes, we’re trying to address disparities in care by improving the quality of communication that takes place between doctors and patients. It does help, it does work. Our data clearly show that patients are getting better information provisioning, more high quality discussions of information related to diagnosis, treatment and ongoing care, they’re actively included in decision making about treatment plans, next steps. They feel empowered to take care of themselves, to advocate and press for the information they need to manage their health. But now I see how glaring the other barriers are.”

I sat back and folded my arms as I studied her in the near-dark, moved by her agitation and passion.

“What are the other barriers?”

Her arm lifted, then fell limply against the truck. “So many. We’re not adequately addressing all the