Sunday, July 31st, 2011
It’s a universally accepted truth that doctors make the worst patients. We struggle to exist in the healthy area under the bell curve, instead, resting in either extremes of “Closet hypochondriac” or “Call me Mr Invincible.” Maybe it’s an occupational hazard, one that is, to some degree, inevitable, because we separate ourselves from our patients everyday. They are sick, we are not; they need help, we are fine. We live out the days of our lives in the hospital and rather than associating it with hurt, suffering, and pain (as most people would do), the hospital is our playground.
I have been blessed in my life in that I have never really had to deal with illness or suffering, in myself or in those I love. The two times I can remember seeing a doctor during medical school was once to see if anything could be done for my perpetually frozen toes (Dx: Dunedin), and once during fifth year when I was sure I was anaemic given how tired I always was (Dx: final exams).
So what’s with all this “Get a GP” business everyone seems to keep going on about? Apparently, “Doctors need doctors too!” Really? Do we? Not only that, but apparently, it’s not good for us to treat our loved ones, even if it will save them forty dollars at the GP. If I’m being completely honest, I had never seen what the big deal was. Two recent events, however, has me converted: Oh, Medical Council, I concede, you are right.
One of the first things they recommended during our Orientation week was that each of us should be registered with a GP Practice. Being new to Auckland I didn’t really know where to start so I told myself “Future” Anna could figure it out once life had settled down a bit.
Seven months later I found myself in survival mode, desperate to see a GP, but with nowhere to go.
Naturally being a morning person sleeping during the day is not something I have done much throughout my life, and this year I have come to realise I have an all-resistant circadian clock (black-out curtains, eye mask, ear plug – the works). Middlemore medical nights which are notorious for their constant deluge of jobs meant no sleep during the shift itself, followed by no more than three hours broken sleep during the day. Sympathetic to my plight many house officers and registrars offered up various suggestions, pharmaceutical and otherwise. But I was hesitant. I thought if I could just get through the week I would be fine. By the end of my third shift, however, I was broken. I now understand why sleep deprivation is such an effective method of torture.
Which brings me to my drive home at eight in the morning, knowing I couldn’t survive another shift in the state I was in, and I was desperate for help.
I drove up to the nearest GP Practice to where I lived. I saw that it had just opened and walked in to ask for the next available appointment (enrolling in the process!). But the battle didn’t end there. Sitting in the waiting room, I fought the impulse to leave: Was I really “sick”? Did this even qualify as a “Presenting complaint”? I was pretty sure there was no mention of my current ailment in Harrison’s Principles of Internal Medicine.
At the end of the ten-minute appointment my GP wrote two sentences in his notes: “BP 105/60. Heavy night shifts as first year house surgeon.”
I laughed. It was nothing life changing. No miraculous healing. Yet, somehow, leaving his office I felt surprisingly… better. It wasn’t just because of what he offered for my problem in that moment, but, rather, a sense that I was now no longer alone in holding responsibility for my health, and that there was some sort of accountability, documentation, and safety net I could rely on over time. A fresh, objective set of eyes, working in conjunction with an experienced medical brain. If Joe Bloggs down the street is entitled to this (also know as healthcare), are we not also? We pay enough taxes certainly!
Along those lines, a couple weeks later my mum – a fierce four foot nine woman who has never been sick in her life – had sudden onset of severe vertigo. My dad, distraught, didn’t know what to do apart from wanting to call the ambulance. My mum, not wanting to spend the fifty dollars, refused, but in saying that, I had never seen her look so scared in my life.
How many times during on-call shifts had I been paged about a patient “complaining of dizziness”? Yet as I knelt beside my mum lying in bed, taking her pulse and flashing a light into her pupils, my own heart began beating exponentially faster. Vitals signs being vital, all I wanted was a way to take her temperature and measure her blood pressure (oh, the things we take for granted!). After doing a neuro exam (which was, objectively, unremarkable), I still had no idea what to do. All along I knew in my mind it was probably “just” labyrinthitis but was I sure enough to call it? And even if I was confident to make the diagnosis, what did I have to offer to this tiny suffering woman who gave me LIFE!?
The GP listened for two minutes, asked a few questions, performed a Dix-Hallpike manoeuvre, and then declared that what my mum had was, indeed, viral labyrinthitis. He gave us a script for stemetil and it was all over. Just like that.
Again, it was nothing life changing. He confirmed what I had already been thinking. Yet upon leaving his office I felt as if a ten-tonne load had been lifted off my heart. An objective, experienced medical professional deemed the cause of my mum’s suffering as a simple self-limiting viral illness. What’s more, he now held the responsibility for her diagnosis and treatment… not me. It’s not that I don’t want any responsibility in the well-being of those I love. If I disagreed or had reason to worry, I can’t see myself sitting passively by. But I understand now how you can lose your objectivity when it’s someone you care about; I was surprised how quickly distressed I became, seeing my mum so upset, because her suffering became my suffering, and all I wanted was for it to end.
An important part of growing into this new role of being a “doctor” is knowing when we need to relinquish it to some degree. This is easier said than done because like I mentioned earlier, being a doctor is not like a coat we can take on and off, but rather, a new skin we grow into. With that, we’ll never be able to fully separate ourselves from our identity as a doctor. But in those moments when it comes to our own health and well-being, and of those we love, it’s important that we recognise that we are only human. At the end of the day, you are right Dr Dre.
