...jokes about the "doctor card" (he's a general surgeon), but when he's not at work, he likes to stay in his secret identity as sloppy geek guy. The only time he's brought it out has been in cases where a relative is worried that s/he is not getting the whole story, or needs clarification.

But it does make a difference. When I was having blood pressure problems late in my second pregnancy, my ob told me to go in to the hospital and she would make arrangements. It was after midnight, and when we got to the ER entrance, it was fairly empty. In fact, there were two admissions-type people who seemed to be doing nothing--one talking to a friend, the other apparently on a personal phone call. Brett was parking the car, and I went in with our 18 month daughter. Let me just say now that I don't look like your stereotypical dr's wife. I am fat--and even fatter when 8 1/2 mos pregnant. My hair looks good perhaps one day of every month. I was not wearing make-up and my maternity clothes--just not cute. I was also very swollen, and so I was not wearing my wedding rings. As a result, I was passed back and forth between these two people, each one telling me that he and she didn't do the info-taking, and being rather vague about what I should do and where I should go. My husband came in, and I told him that I had no clue what I was supposed to do, and that no one else seemed to, either. He immediately played the doctor card and, lo and behold, within five minutes we were in L&D. I'm sure that if I had been a fat single mother expecting another child, I'd have eventually ended up there, but without the consideration and dignity that magically appeared when Brett "pulled rank," as it were. I have to say that I have never really had a horrible hospital/ER experience as a physician's wife, either for myself or my kids. People generally recognize the last name pretty quickly without my having to say anything. I would like to think that this would be true for every patient they deal with, but I wonder.

I deal with court employees, and I am not a lawyer. However, when they get the idea that I might be a lawyer, they give me great service. Those who know I am not a lawyer will not even answer questions. Even questions such as, "Isn't it a nice day?"

This snobbiness and reverse-snobbiness is crazy, but it is a feature of American life.

I am a Physician Assistant, with more than 20 yrs of experience in the OR and the ER. In 2005 my own mother seemed to be ill, non-specific complaints and gradual weight loss, and every test and endoscopy came up negative. I was always with her for procedures. When her LFT's were diffusely elevated, her GI ordered a liver biopsy. Why didn't she order a CT, I asked--it was less invasive and should look at the entire abdomen. But she insisted on a biopsy. It ended up just showing diffuse inflammation, and my mom was discharged. A few weeks later, she began getting more pain and actually looked jaundiced. Finally, she was had a CT and was discovered to have a biliary obstruction, and her pancreatic cancer was diagnosed. Throughout the entire 2 years following, including surgeries, hospital visits, and home care, and finallly hospice, I was there with her, able to understand discussions, when she could not.

I must say, even before my mom got sick, I made an effort to spend time talking to my own patients in the ER. It should have to happen, but so often, we are the first-line providers, who end up beinghte ones who have to tell a patient and family that they they have leukemia, or diabetes, or cancer. No training really prepares anyone to do this day after day. But I personally say, to hell with the rules, and I don't care any more about any incentives I may qualify for because I saw more patients and got them out quicker. I spend time with them, especially if I have to impart bad news. And I feel blessed that IWas able to give something back to my own mother when it helped. I don't hesitate to "play the doctor card". Whatever it takes.

We have a real disconnect in contemorary medical care--on one hand, we encourage and insist that patients be pro-active and knowledgeable, and on the other hand, we then get upset when they are impatient or argumentative. I see my own role as part coordinator, working with patients (and sometimes very difficult, challenging patients) to find what plan will work for them.

To the author: I am sure that your parents were extremely glad you were there for them.

As a physician it is difficult to always feel empathy towards our patients. We struggle with 12 hours days, 7 days a week, 10 minute appointment times and malpractice, business management and the stress of continuing to learn about our given speciality. Now add your own family and family problems and pressures to the mix. The lifestyle often seems impossible. (oh yes, did I mention that we are stressed out about our patients health as well.)

Given all of this, our demeanor often demonstrates a lack of empathy. And realistically, if I were to have deep empathy for each patient how would I emotionally survive my choosen career.

Given all of that, I do try my best to listen to my patients and acknowledge their fears, but honestly sometimes, at the end of the day, when I feel like no one is paying attention to my suggestions, I really dont care either.

Am I a bad doctor? I hope not. Am I a bad person? I really really hope not.

Patients who have a background in biology and have had to educate themselves about medicine (like I did when my wife got lupus nephritis, followed by two hip replacements due to steroids) are given the stiff arm by every doctor I've ever met, to one degree or another. And God forbid you have something that doesn't follow the "rules" laid down for a given condition. You are really on your own at that point. Low probability presentations of common conditions and rare conditions are treated horribly these days.

I wish I had the ability to "pull rank" when I need to, to get around rude, curt nurses or doctors who just don't give a damn.

And yes, if you find yourself not empathizing with a patient and not having "patience" with them, you need to consider another field. It is NOT the patient's fault that the healthcare system sucks eggs and treats doctors like crap.