Sunday, 12 February 2012

In which I get upset about a patient

It's odd how different human beings are. How even two people who can be considered relatively similar may be confronted with the same situation and respond completely differently.

I remember a discussion I had with a friend of mine about our placements at the start of fourth year. She was on neurology at the time, and had seen a patient newly diagnosed with a progressive condition. I couldn't understand why on earth she was so upset by it. She'd gone home, she told me, and cried. Her poor patient was "only 50" and seemed "unaware that there was no treatment". I didn't understand why that was so sad. Sure, progressive neurological conditions are horrible, but her patient was 50. Thousands of people are diagnosed in their 20s - including a relative of mine, who died in her 40s. That night, I phoned my Mum. I was worried, really worried. I'd always thought I was a caring person, but perhaps I was wrong. My friend was obviously extremely moved by something that didn't really bother me. Since then, I've seen probably a few hundred patients, each one with their own (often tragic) story to tell. At most, I've felt a little sad for them.

Last night, for the first time, I was genuinely upset by a patient I'd seen. I was moved to the point of tears, felt nauseated, couldn't focus. I can't explain why it was last night that this really hit me. The patient was a child* I'd seen on my elective who was diagnosed with an advanced malignant condition. He was 3. He'd only been ill for 2 weeks. Something about this child really got to me, and I've found myself thinking of him numerous times over the past few months. Perhaps it was his family set up (older sibling and then twins) being the same as mine. Maybe it was that despite having worked with many children who have cancer, I've never actually seen the process of diagnosing it. Possibly it was that he was just so cute and cheeky. Who knows. Whatever the reason, he affected me in a way I haven't been affected before.

We are all different and we all have different reactions to scenarios we are confronted with. Our own experiences and personalities shape how we respond, but sometimes we can't see any logical reason for the emotions stirred up inside us. As a future doctor, I am well aware that I will shed many more tears for patients. Patients and their friends and families will in turn make me happy, sad, angry, amused and a whole range of other emotions. In my opinion, the important thing is that I care for them all appropriately, regardless of how I feel about them.

When I started medical school, I wanted to know everything. I wanted to be the sort of doctor who could answer any question, who could "solve" any mysterious case, who knewthe solutions to the rarest of problems. I still think that would be great (if unrealistic). But for now? I just want my patients to feel that I care.

*I would hope that by not mentioning where I was and keeping the medical details vague that confidentiality is not broken here but if anyone senior thinks I'm being unwise, please do say something.

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