“Don’t feel obligated.” I have said these words often to my employees when I ask them to do something extra. I say it because I do not want them to feel coerced or pressured to do something they do not want to so. Recently I have concluded that I am unintentionally sending another message when I use these words, a message that reveals something troubling about American culture- we think feeling obligated is a bad thing. We are wrong. People who only do what they want are very selfish people!
Not too long ago I was awakened at 4:00 on a Saturday morning by a message from my answering service. A patient of mine was in the emergency room with severe pain and significant urinary bleeding. The 43 year-old woman thought she was having the symptoms of a kidney stone and went to the ER in hopes of finding relief. The routine CAT scan revealed something much worse than a kidney stone. She had a tennis ball sized tumor in her kidney. The ER doctor was calling at 4 AM to discuss possibly admitting her to the hospital. As she was medically stable and it was highly unlikely that any surgery would be done that weekend we agreed that she could be sent home. I hung up the phone and prepared to go back to sleep.
The thought then came, “Should I go to the hospital?” There was no medical reason to go. She was stable and would be sent home. There was no medical treatment I could give. More thoughts came. She had been a patient for over 15 years. I had delivered one of her children and had cared for her and her kids for years. A devout Christian, I knew she looked up to me and trusted me. I also knew that she would be frightened and in need of comfort, of a type no other doctor could give. She needed her Family Doctor.
I sat for a few moments and debated what to do. I had not been sleeping well for several nights and desperately needed sleep. I told myself that no other doctor would go in to see a patient at that hour. In spite of my best efforts I could not shake the thought that I needed to go whether I wanted to or not. Somewhat begrudgingly I put on jeans and a sweatshirt and headed to the hospital.
After showing my badge to the ER clerk I made my way to her room. When I pulled back the curtain and entered she began to cry,“I told my husband that if Dr. Barrett walks in I will know it is bad,” she said. She trusted me so much, believed in me so much, that she was sure that if it was serious I would be there for her. She understood my need to listen to my heart, perhaps even more that I understood it. The fact that it was a sense of duty and obligation that caused me to come, that my heart was not fully cooperating when I left home did not matter. A sense of obligation began the process, my heart followed behind. Nevertheless my heart did follow. Her words erased any doubts that remained, I needed to be there.
I was not there long, just long enough to review her history, give her a hug and pray for her, but I was there long enough to make a difference. As I left I reflected on the truth that feeling obligated is not such a bad thing after all. Sometimes a sense of obligation is the first step in doing the right thing.