My Kind of Medicine: Real Lives of Practicing Internists: Kimberly Bates, MD.
The year was 1988 and Kimberly Bates was a freshman at Bishop Hartley High School in Columbus, Ohio. It was Career Day at school, and while it may have passed without consequence for many of her classmates, for Kim it was a day that would define her life. One of the speakers that day was a pediatrician; a short and wiry man who spoke with an infectious passion and enthusiasm about his career. The more he spoke about being a physician, the more Kim wanted to be one. By the end of his presentation, Kim had made up her mind; she was going to be a doctor.
Dr. Kim Bates and her son Gregory
Fast forward fourteen years to the Intensive Care Unit of Christiana Hospital in Newark, Delaware, where a woman lay ill and unresponsive in her bed following a cardiac catherization. Dr. Bates, then a fourth year med-peds resident and her attending were uncertain how to proceed. The patient’s vital signs were stable and the imaging studies were normal, yet the patient was not recovering. It was clear something was very wrong.
The patient’s husband, visibly upset, questioned Dr. Bates: What was wrong? Couldn’t they turn it around? Was his wife going to die? She talked to him at length, trying to calm him down and asking him to trust her to keep working until she figured out what the problem was. Then she picked up the patient’s chart and set out to do what she had always done best; sit down and think it through. Solving complex problems had always been one of her greatest strengths and in that moment, she would need it more than ever.
At five foot two, wearing lip gloss and a skirt, Dr. Bates is not your typical quarterback. This however is exactly the role she sees herself fulfilling as a physician. She likens the overall care coordination of a patient to a game plan. They both require making many decisions involving overlapping factors. “As an internist, you are the one who ties it all together,” she says. “There needs to be a quarterback for the team, and you are it. You have many different roles to play, but one thing you are always doing is making sure everything is in alignment.”
As was once written in a speech prepared for a former U.S. President, “leadership and learning are indispensable.” This is a notion Dr. Bates exercises in her own life, albeit sometimes without having chosen to do so. In her third year of residency, Dr. Bates was diagnosed with breast cancer. It was the time in her life she admits was the most challenging. She underwent surgery, chemotherapy and radiation—all while completing her residency. She struggles when asked to put into words what she learned through it all, but her answer reveals a true mark of leadership: the ability to face adversity head on without losing conviction or drive.
“It made me a better physician,” she explains. “Being the patient for once taught me the true meaning of empathy. It has changed the way I talk to patients. Now if I have to deliver bad news I do it much differently, because I realize how little of the information gets through after hearing the diagnosis for the first time.”
Now she uses her commitment to taking charge in her dual roles as an internist and as a pediatrician. Four days a week Dr. Bates practices internal medicine and pediatrics at a private medical practice and she spends two days a week working with internal medicine-pediatrics residents in the med-peds program at the Ohio State University/Columbus Children’s Hospital. She also works a half day each week in a family HIV clinic. She enjoys each job equally for different reasons. The intellectual stimulation and challenge of internal medicine enthrall her, while she relishes her work as a pediatrician because of the interaction she has with children. The latter gives her exposure to a brighter side of life, something she seems to value more than most her age. “Kids are funny. There is always humor in my day,” she says.
A Thirst for Knowledge
As early as high school, Dr. Bates discovered she thrived on learning. She developed a love for science and a fascination with the human body. She talks excitedly about the clinical years of medical school, when she would spend hours poring over a problem, or coming up with 50 different outcomes for a differential diagnosis. “It was so exciting to me, to do those things,” she says, “and it is what I miss about medical school, being able to take as long as you wanted to try and get to the bottom of a problem.”
Dr. Bates is certainly not an isolated academic type. She values an interactive environment for personal and professional growth. “Teaching is one of my favorite things and something I definitely see myself doing in five to ten years,” she says. “Working with and teaching residents and students keeps me sharp and focused because no one takes what you say for granted. You have to prove it every time.”
It is fitting that Dr. Bates is comfortable in the role of a teacher. The classroom, the teacher, and the student represent home base for her. This combination is a foundation to which she can always return for inspiration, answers, strength and stability.
The Softer Side of Science
Dr. Bates loves her dissertations and diagnoses, but she pursued internal medicine as much for her love of people as she did for her love of science. For every clinical decision she makes, there is a smile for a patient. For every bit of research she evaluates there is a conversation with a medical student or resident. “Ever since I was young I envisioned myself in a job where I had interaction with people,” she says. Everything about Dr. Bates seems to have a yin-and-yang quality to it. She is quite literally half scientist and half people person. Even as much as she loves her work, she says her favorite part of the day is returning home to see her four month old son Gregory and her husband Greg.
She is perceptive and instinctive. For example, she does not wear a doctor’s coat because she senses patients are more relaxed if she is dressed more or less similarly to them. “It’s especially true with pediatrics,” she says, “but also with adults. I get a lot more accomplished with adult patients if they feel as though they’re talking to a colleague or a friend.” It is this kind of intuition that makes the difference between a good doctor and a great doctor. People often refer to it as “bedside manner,” but with Dr. Bates it goes a bit deeper.
Years ago on that day in the intensive care unit as her patient clung to life, Dr. Bates put her analytical talents to use. After looking through the woman’s chart, she decided to order an arterial blood gas. When the test came back, it indicated a respiratory acidosis which had caused the woman’s decline. She and her attending immediately intubated the patient and corrected the condition, and by later that evening the patient was better and writing notes to her husband.
The scientist in Dr. Bates served her well that day, but so did the young girl in class, the quarterback, the compassionate woman, the cancer patient and the doctor. “I’ve learned many valuable things,” she says. “Put the patient first. Take time to sit down and think a problem through, no matter how urgent. And always, always trust your intuition.”
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