This I Believe

Darren - Corrales, New Mexico
Entered on August 23, 2006
Age Group: 30 - 50
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There is always more to the story.

I practice and teach emergency medicine. Not long ago, our staff was arguing with a patient brought to the ER who had taken a handful of pills to end his life. He fought to leave the ER, yet we couldn’t let him do that. When words failed, he ended up in physical restraints and unspokenly labeled a “difficult patient.” My insincere “What can I help you with tonight?” was met with profanity and anger. I wanted to say, “Listen, I’m not the one who is suicidal and tied up. I’m just doing my job. Don’t swear at me.” Then my inner voice started repeating the mantra, “There’s always more to the story.” I looked up the patient’s history and learned he had experienced several tragedies lately that would have brought most of us to our knees. I could no longer blame him for being suicidal nor for being angry at the world. I went back, my words the same but my body language and tone clearly sympathetic. I got him some water. I listened. I no longer expected him to be what he could not be and with that, he softened.

Some days I repeat my mantra so many times that I sound like a broken record. Other days I find myself forgetting it like those I was preaching to the day before.

Recently a patient pulled out her IV and started to leave. I asked her why she was leaving and what I could do to help. She thanked me but said there was nothing I could do. “Ma’am”, I said, “I’m worried about you. It’s not normal to ask for help and just leave. Is someone else making you leave?” She broke down. Domestic violence had reared its ugly head again. While we could not keep her from leaving we could put a sheet of resources in her hand before she left. Fortunately my inner voice told me that this was unusual behavior and there must be more to the story.

As one of my collateral duties, I am an EMS medical director for a busy air medical service. Recently, I got a phone call in the middle of the night from a physician irate about something one of my crew had done. It sounded bad. I might have called and confronted the crew with an angry and disapproving voice notifying them that they had already been deemed guilty. Instead, I listened patiently to the doctor and assured him I would investigate. I took a deep breath, reminded myself that there had to be more to the story and called the crew to ask — openly, simply — “What happened?” I was not surprised to find out that there was much more to the story.

It’s not easy to believe there are always two or more sides to every story; this is a very grey way to live. There are many times I wish I could be more black and white, yet those who live with that approach are the kind of people I often call reactionary: people who hear something, believe it because it is believable, and respond instantly as if it were true. We all know people like that and I don’t want to be one of them. So I will continue to live in my grey world where there is always more to the story.