The human side of medicine

"A young intern confronts his own demons as he cares for a demented patient and is forced to face his own father's mortality."

Sounds like the TV blurb for ER or Greys Anatomy right?

Well it's my life!

Been havign way too many 'warm and fuzzy' moments in the last few days.

I think it all began on the weekend when I was working overtime and got called to a 'code blue' on my usual ward. As I looked at my pager I recognised the bed number as one of my little old ladies and a wave of dread fell over me.

When I arrived there were already 7 other doctors cracking her ribs, jumping up and down on her tiny heart and trying to stab for those ever important ABGs. Turns out she became hypothermic and dropped her temp to 32 degrees and became bradycardic... a sign of shutdown.

We called the son to come urgently and ICU came and rammed a tube down her throat... she went into Vtach and 20 seconds later got zapped with those paddles. She came back... but only for a few hours.

As we met with the son, I felt so awful listening as my reg explained to him what was happening and discusses the Not for Resus orders with him. Although she was sick and frail and elderly, I still feel like maybe I could have done something more... maybe I could have got a peripheral line in for some fluids? Maybe I could have been more aggressive in hounding the reg to see her? Either way, she's now gone and as my reg said to me:

"You're not a real intern until you kill someone"*

Then today I had one elderly patient ask me to sit on his bed and talk with him about 'life'. he onyl had a mild cases of gallstones but was convinced he was about to shuffle off this mortal coil tomorrow. I felt really sad as I listened to him and heard him talk abotu how great his life used to be and how he had bought his own house and raised 3 sons who were now living their dreams and he was living his life now through them. And yet there was a sadness there as he talked and he said he wished he could end it all rather than live a life of disability. It made me think just how truly awful it must be to see society devalue and ignore you as you age, just because you no longer have any capitalist value to them. I'm going to miss him when he goes tomorrow.

Straight after that I got called to see a lady with breast cancer who had liver mets and was dying but came under us cos she had biliary obstruction. As I stabbed her she began to pour out HER life story too (I must have had this sign on my head saying "please tell me ALL your problems"). As I sat there listening to her battle with breast cancer at a young age, it brought back horrific memories of my own grandmothers death. My grandmother was diagnosed at 45 with breast cancer and had a protracted 12 year battle with a slow but steady decline. In fact, it was her death that inspired me to become a doctor in the first place. And seeing this young 40-something woman dying there in front of me I couldn't bear it any longer and had to leave before I lost it.

But I only just made it to the ward when I was asked to talk to the wife of one of our demented patients about his return home. It was obvious this was gonna be a long one, so we went into a nearby room and she poured out her agony till she could say no more (and she was of Mediterranean descent.. there was a LOT to say). Sitting there listening to her talk about feelings towards her dementing husband made me feel like I was talking to my mother. All the pain and suffering I saw in her eyes resonated with the anguish I see in my own Mum each day. Hearing her reactions and grief to her husband made me break. I just sat there with her and gave her the one thing that doctors don't have... time.

Amidst the incessant paging and ward rounds, between the cannulas and med charts, we lose track of what it means to be a human and what it means to go through an illness. And so today I spent some time just sitting with my patients and listening to them. Not offering them textbook answers to their problems but just sharing their pain and being there for them.

To be honest, I dont like it. It makes me vulnerable and it makes me human. And doctors aren't supposed to be human. Cos if they were then they would not be able to cope with what they do each day. And to love others is truly... definitively... human.

* I didn't 'kill' her for those of you who are non-medical readers. It refers to that feeling though when you feel responisble for their deaths even though you did all you could.