It was 2014. I was a first-year internal medicine resident in Maryland. One of the floor nurses paged me to come upstairs and attend to a patient who needed a new peripheral intravenous line. I had placed intravenous lines many times before, so I went upstairs quickly. As I was climbing up stairs to reach the 4th floor where the patient’s room was, I was thinking in my mind that ‘’ this is going to be so easy today’’. Patient’s previous intravenous line had to be removed as it had stopped working. The nurse who paged me had tried a few times to get a new one, but she could not do it.
As I entered the room, I saw a middle aged African American male lying in his bed and the way he looked at me, I instantly realized that he was waiting for me. He was calm. I could see hope in his eyes. He had bad pneumonia and needed a new intravenous line to get his medications going. I introduced myself, explained what I am going to do, and after placing a pillow under his both hands, started looking for a good vein to work with. Both of his hands were swollen. I could hardly see any veins. Puncture marks from previous attempts to insert a new intravenous line were staring at me. I tied the tourniquet up around his right upper arm and asked him to make a tight fist which he did right away. I felt a vein and introduced the catheter inside after puncturing the skin. As the catheter was tearing his skin, I could see pain on his face, but he did not utter a single word.
There was no blood return in the intravenous catheter as I withdrew the stylet. The catheter was not in the vein. I removed it altogether and did a second attempt on the other hand. It failed too. The patient, though in pain, smiled at me and said:
''Dr Butt, whatever you do, do your best''.
These words have stuck with me since then. Whenever I see a patient, I remember these words. I have contemplated about the meaning of these words many times. What is the meaning of ‘’doing your best’’ or ‘’being best’’, especially in the field of medicine and healthcare where lives are at stake. Does it mean to win the award of the best doctor of the hospital or city? Does it mean being recognized by the administration or government? Does it mean stepping up in the hierarchy of leadership of medical institution and become a principal or a vice chancellor? Or does it simply mean that whatever position you are holding, how small or large it may seem, do your job to the best of your abilities, and keep improving as your only competitor is you.
Being the best or doing the best is not a destination, it is a journey, a continuous process, struggle, and calling. And the best thing is that anyone can do it in the hospital, starting from the floor cleaners till the head of the institution.