For most of residency, I missed the opportunity to care for veterans — mainly for selfish reasons, including my unwillingness to learn a new EMR and hospital. Once I became a chief resident, I realized that I would be spending four months at our local VA hospital. When I first came to the VA as a chief, my goals were similar to that at any other site at which I work: Get to know the staff, present quality conferences, and look after the residents. Little did I know that the VA would open my eyes to the special concerns of the millions of Americans who have served in the military.
On my first day, I was incredibly touched by how different it was to walk in the hallways at the VA, compared with my other sites. A casual trip to the cafeteria was showered with “Good morning, Doc. How you doing, Doc? Have a great day, Doc” and any other respectful salutation that you could think of. It initially seemed to be casual conversation, but I soon realized it was a sign of the culture. A military culture of respect that was palpable even in the hallways or cafeteria!
As I continued to adapt to my environment, I learned that this patient population had unexpected subtle differences from my other patients. There was a spirit of stoicism that often led me to underestimate how much pain a veteran was really in, and often left me surprised when I would check the medicine administration record to see my patient with an impressive wound had not requested any pain medication. Then there was communication of treatment plans — the veterans, as a whole, did not like uncertainty. I often found patients telling my team, “Doc, I don’t want to be no guinea pig. You know what you’re doing, right?”
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