Monday, June 05, 2006

the useless doctor (um, that's me)

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,, 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.


Motherkitty said...

There are some patients where all you can give them is attention and affection. Mrs. I (or is it L?) must have a sad, lonely life. There are so many out there, aren't there? You go through your day, you do the best you can, and at the end of the day you say, "I tried. I won some and I lost some." That's life.

Your post reminds us that physicians are human just like the rest of us. Thank you for caring. And, I'm sure that's why Mrs. I (or is it L?) is always thanking you -- because you have shown compassionate care for her wellbeing.

PHOTO said...

Compassion. What a wonderful medicine that is. If you counted the things pills fix and the things compassion fix I wonder which would end up #1.

John Cowart said...

Sometimes just being there for someone is the most important thing you can ever do.

mackeydoodle said...

How I wish I lived in Australia just so you could be my Dr.

shellyC said...

yep...wish you mine too...not that i would see you often!!!!

shellyC said...

WERE mine too.....why don't I proof read BEFORE I post???

susan said...

No, you are not "the useless doctor." You obviously do a lot of good, whether it be medical or social or just being there to listen. You learned all the books had to offer and now you are learning the other half - what the patients really need.

My mom always got frustrated with doctors, always trying different stuff on her. She would say, "That's why they all them practicing physicians, because they practice on us!"

Keep up the good work, and thanks for your comments in my little neck of cyberspace, you are very sweet!

Abandoned in Pasadena said...

I think there are patients like Mrs. I that just need you to listen & to be there and show some compassion...and you seem to be doing just that for Mrs. I and she is very grateful.

Kerri said...

'Photo' said it very well...compassion probably is the #1 fixerupper and you obviously have lots of it. There's a lady in our church like that. I always ask 'How are you today?' and then think, 'Oh why did I ask that?' but then I do it again next time. Some people just need someone to listen, and you obviously give them that much-needed attention. Keep up the good work Jelly. You're doing a world of good, I'm sure.

Franny said...

I *think* sometimes ppl need to be reassured that there is not something mortally wrong with them...? They KNOW they only have the stomach flu (or whatnot), but deep inside they want to hear it from the doctor that yes, its just going around, and you dont have a 'special' illness requiring immediate hospitalization. My hubby is like that, *sigh*.

It's okay that you don't have all the answers, and it's okay that you see her name on the roster and cringe. That's human.

But nonetheless, I bet you still make that woman feel special every time you see her. That's humanity.