2024-04-14 12:27:14
“We chose medicine and said ‘I want to help people.’ Don’t the residents of smaller cities need help now?”, R. Stasevičienė asks the young generation of doctors who are among the last to start working in Vilnius and Kaunas.
The interviewer was at the crossroads of choice in the late 1990s. After studying medicine in Kaunas, although the appointment system was still valid, he was able to take the position of a neurologist in Vilnius. But the woman decided to return to her native Utena. The only daughter wanted to stay closer to her parents.
The patients of Utena Hospital appreciate the dedication of the doctor, but they do not announce to the whole world what a good doctor they have.
“Doctors of other specialties receive public thanks more often. We, neurologists, less often, because our patients are mostly old people. When saying goodbye, they say a lot of nice words, but they don’t use technology, those thanks don’t go out to the public”, observed R. Stasevičienė.
However lrytas.lt In the “Thank you to the doctors” project, the doctor who received a bunch of thanks is one of the voting leaders.
“It’s nice that a neurologist can be seen and evaluated,” the interviewer was happy.
The news portal lrytas.lt is preparing the project “Thank you to the doctors”, the accompanying series of publications introduces health care specialists who are sensitive to patients’ problems. You can write a thank you to your favorite doctor in the inviting subpage: Thanks to the doctors.
– How did the decision to connect your life with medicine come about?
– I wanted to be a doctor since childhood. Why? I don’t know. I was born weak and perhaps I thought a lot about the doctors who accompanied me in the first years of my life. As a child, I had a pediatrician, a Jewish doctor who later emigrated to Israel. She took great care of me and when I was very sick as a baby, she told my mother: “Don’t worry, she will grow up and become a doctor herself.” Those words stayed with me.
I did well in school and was always asked if I would be a doctor. Therefore, I started to rebel, I came up with other specialties.
The realization of what I want in life came in the 9th grade. I sat in the polyclinic, watched the doctors buzz by and asked myself: “You really don’t want to put on a white coat?” I decided that I had to become a doctor and began to prepare for medicine in a purposeful way.
I took the exams and everyone told me that you can’t get into medicine without a car, a bribe, and what are you doing there at all. I didn’t get in, I missed half a point. True, there was still a court case regarding bribed teachers, and I was invited to the Kaunas Prosecutor’s Office as a witness. Maybe my results were underestimated.
I worked in a collective farm for a year, it was difficult, I had to walk outside the city. Then I no longer gave myself the idea that I might not enter medicine. And it worked! I scored 3 points above.
– In the acknowledgments, patients praise you for your warm communication, attention, care and smile. This is how it comes naturally, or does a doctor’s gown oblige?
– I think there are the characteristics of my manner. Of course, this is being developed. I adhere to the following principle: communicate with the patient as if a relative was sitting in front of you – father or mother.
It is not always possible to be good, warm and pleasant. We are all human. Personally, I work half the time in an inpatient facility, and from 11 a.m. I go to the clinic. Sometimes it’s so difficult in the hospital that you come full of stress, it’s hard to calm down.
Of course, it also depends on the patient’s expectations. Most go to a doctor for help, but some come to a provider just to get them an MRI, whether they actually need it or not.
– And such “omniscient” patients are increasing?
– Yes, there is a trend. One of the patient groups of neurologists is “vertebrates”. It is not uncommon for them to “need” a magnetic resonance examination. From the professional side, we know that 50% applicants do not need it. Even without him, the doctor knows how to diagnose, understand what and why it hurts.
But the patient does not believe you, no matter what you tell him, until you do an imaging study. And even after that, not everyone listens to you.
Now I don’t argue with patients, although I used to take it as a personal insult, because in that situation I am not trusted as a doctor, my knowledge is worthless. The machine will show you everything and throw out a magic pill to treat the pain.
– You have been working as a doctor for more than 30 years. What has changed in your work during that time?
– Some patients lament how good the Soviet system was. The doctor knew how to diagnose the disease, but he did not know how to help the patient. Treatment is needed and there is no cure.
At that time, one doctor consoled herself by buying a few ampoules of medicine when she went on duty to a pharmacist she knew, because she was afraid of being left empty-handed when she went to the reception. Such was the famous Soviet medicine, when people were in the hospital for a month and did not know how they were treated.
I remember, once upon a time, we read news from abroad like fantasy books. For example, about the fact that every campus has a computerized tomography machine. Now we have everything! Utena has two “magnets”. We have vascular tests, echoscopies, electroencephalography, all technologies – on our campus.
And before, I used to read English books only until the diagnosis, because it was not relevant for us after that. And now all the methodologies are the same with us, we have everything in place, except for tertiary level diagnostics, which are carried out by large medical centers in Lithuania.
– The problem these days is that doctors are crowded in big cities. What would you say to young doctors who do not want to leave Vilnius or Kaunas after their studies?
– This is a very painful problem in all regions of Lithuania. A week ago, an annual conference on stroke was held in Trakai. One session is dedicated to the shortage of neurologists. He said that Šiauliai does not have neurologists and it is difficult for them to ensure on-calls.
It is also difficult in Utena. Our doctors are practically dead or retired. My colleague and I work like slaves because there is no more time for creativity and empathy. Unless the flow of patients decreases.
Professor Daiva Rastenytė from Kaunas, who participated in the conference, was surprised. There is no shortage of schools and kindergartens in Šiauliai, and Utena is easily accessible from Vilnius. Now the road will be repaired, so flying back to Utena will be the same as crossing Vilnius.
Large grants are allocated for the establishment of families of young doctors in the regions, but money is not attractive either. Young doctors come to us on duty, but if they find a warm place in Vilnius or Kaunas, they settle there and never return to Utena.
But for a young doctor, working in Utena is fantastic, you have all the diagnostic methods here. Maybe they are afraid that there are not a bunch of professors and consilium behind them? Yes, here you are thrown into the cauldron and have to rely on your own knowledge, but there are colleagues nearby, you can ask.
Maybe the younger generation has a different attitude. We chose medicine and said “I want to help people”. Now the residents of smaller cities do not need help?
I myself, when I did not know that I would get a place in neurology in Utena, had chosen a dispensary in a small town in Anykčiai district. I thought I would go to the village to be a doctor (laughs).
But in the last years, there are difficult moments when I think that I will soon abandon this ship, I will retire. But I won’t.
Why do such thoughts occur? Because people are very angry, they do not respect doctors. Sometimes you regret being in medicine because of ungrateful patients who say insulting words.
And young doctors see that, so they choose to go to countries where the doctor is respected and receives a decent salary.
– Do disrespectful individuals make up a large percentage of patients?
– I don’t have much, I try to extinguish everyone, avoid conflicts. But there are acute situations – the already mentioned demand to get an investigation at any cost.
Another thing, the computer nowadays is an integral part of the doctor’s work. But I try not to invite a person into the office until I have filled out all the information, so that the patient does not have to sit and see the doctor “interacting” with the screen instead of him.
I organize the data and then I call, because you need to face the patient, talk to the person, after all, if you are staring at the screen, you may not see him at all.
But recently I had an unpleasant situation. Perhaps it seemed to the man that we did not invite another patient for a long time, so he went in himself. I offered him a seat, I said, you will see how we work. But the person who didn’t get attention took out his phone and started calling about his business.
It was above everything else! We kept quiet, but eventually he figured it out himself. This is so disrespectful. If necessary, go out into the corridor and make a call.
Dirty people come, untidy, smelly. But I do not educate patients, they are what they are. One of my colleagues tries to teach them and gets very ugly epithets, even though she is 100%. right
It turns out, we can not make any remark to the patient, neither because of his lifestyle, nor because he came without washing. The patient uses something other than the one that caused his illness, but the decision of what to do is made by himself. I will not change the person.
– It is said that in smaller cities the relationship between doctors and patients is closer. Do you think there is truth?
– In larger clinics, a patient comes for a consultation, the doctor sees him for the first and last time. And in Utena, patients return, you recognize them on the street. I can compare how a patient with Parkinson’s disease walks in my office and how it is in a store.
Here you will not push the patient away, you will not leave it to someone else, you must do your job to the end.
– Last week, on social networks, you shared the insights of Vilnius University Faculty of Medicine Dean Dalius Jatužis on how to prevent a stroke. Doctor, do you often have to diagnose this serious condition yourself?
– Strokes in the Utena region are particularly painful. We have the ability to apply specific thrombolysis treatment, but the bottom line is that the patient must arrive on time.
And they come to us after the therapeutic window, when they can no longer do anything. The phrase “waited for it to pass” is our swear word. People do not recognize a stroke. Distorted face, slurred speech, weakened hand – signs of a stroke. Within 10 minutes, they disappear and the person thinks that there is no need to call an ambulance. Go to the doctor immediately!
I notice that there are a lot of patients with neglected somatic pathology. A stroke is the last point for them.
Extremely difficult patients with diabetes, kidney failure, and heart failure arrive. Other neurologists who treat stroke patients also noticed this at the conference.
People don’t track their blood pressure and cholesterol, they don’t follow their doctor’s orders, and they may not even reach out to doctors. Reception doctors complain that their departments are full. Because he didn’t go to the family doctor.
2024-04-14 12:27:14