One of the things it's taken me a long time to accept in my work is that I can't fix everybody. I can't cure all ills, and I can't ease all ailments. Were I to be the smartest, most innovative GP that ever walked the earth, I still could not eradicate all disease and suffering in my patients.
It may sound silly that this should be such a revelation to me, but such is the ethos of doctoring - we are taught to investigate, diagnose and treat. Textbooks are even written with diseases described under these very headings. Medical students are led to believe that they will save countless peoples' lives, riding in on their high horses to rescue the sick and the injured, then galloping away again (preferably with some very shiny medals pinned to their chests). No-one talks about the many, many patients for whom the medical profession can do very little.
Take the most common of illnesses...a 'cold'. What does the doctor say? "Rest, take some decongestant, maybe some paracetomol, rest, and ah, rest. Yes. Hope you feel better soon. Plenty of rest now. Bye!". I said just that today to someone. Maybe not as perkily, but conveying a similar message.
What about stomach wogs? "Ah, yes...rest, take fluids, and above all rest. Get better quickly. Did I remind you to rest? O-kay then! Bye!"
In actual fact, it has been quite awhile now that I have been comfortable with the futility of my advice when it comes to these minor illnesses. I quickly realised that time healed these diseases, while my role was merely to reassure. It has taken me a bit longer to discern that for other, more serious conditions, I must also accept that my role is supportive not curative.
Mrs I, a thin, worried-looking lady in her 60's came to see me today. When Mrs I first started coming to see me about a year ago, my heart used to sink just at the sight of her name on my schedule. YES, I know that is not very nice of me, but I'm trying to be honest here. The woman's very name was enough to give me a migraine. I dreaded the consultations. Mrs I always had about 7 complaints for me. Many of these complaints had been extensively investigated, and multiple treatments had been tried. Mrs I was now coming to see me, she explained at the time, because Dr 'Bloggs' (another doctor at my practice) 'doesn't listen to me anymore'. Poor Dr Bloggs. I think his well of empathy had run dry. I, on the other hand, had the deepest empathy- for Dr Bloggs.
Every time I saw Mrs I, I tried my darnedest to sort out some of her problems. I had to page back through her computer file; I had to retrieve her paper file. I detailed all her symptoms. I organised some more investigations, where I felt it was appropriate. I suggested a few treatment options. I suspect I sighed a lot.
Nothing I did made a scrap of difference. Every test I ordered found nothing useful. Everything I advised caused Mrs I to retort, "Yeah, I've tried that doctor - it didn't help at all". Eventually, I simply said to Mrs I, "It must be so hard to put up with all these problems. You must get very frustrated."
Every time I see Mrs I, I check her over, and I listen to her telling me what is bothering her. I do nothing to fix her ailments ...... not because I am unwilling, but because I do not know how. And yet - Mrs I treats me as if I am someone special to her. She is always thanking me, though I can never figure out what for.
I went through 6 years of medical school and 3 years of family physician training, and no-one ever told me that I would do so little, for so many people. I'm slowly getting used to it.
And Mrs I, I'm sorry. You have had a hard life, and you deserve all the kindness in the world. I'm learning. Thank you for teaching me.