Becoming a doctor...
It’s getting gradually later and later, the alarm will go at six tomorrow and I can’t sleep. My brain is in that irritating foment of activity that won’t be switched off by consciously trying, so I suppose this blog is a cathartic exercise to induce somnolence…though hopefully not for those who bother to read it!!
As I was trying to dose off this evening my thoughts drifted back to what I aspired to as I applied for medical school. I wanted to become a doctor who gave patients the space and time to voice their concerns. I wanted to be a doctor who focussed on involving the patient in their care and in the decisions around their care. I wanted to be a doctor who inspired trust in their patients. I wanted to be a doctor who rose above the cynicism and resignation that many observe in the NHS and focussed on the patients as people again. I wanted to be a motivated, motivating colleague, dependable and competent. I wanted to be someone who treated these patients in a way that reflected how God saw each of them. That showed I placed a value on them not less than that which God gives each person.
Well here I am, almost 3 months into my first post as a junior doctor. Definitely different from the nervous and eager medical student that started four years ago. Wiser? Maybe. Closer to that ideal I started out with? Probably not. And on reflection, I am not sure I entirely like what I see looking back at me from the mirror each morning…I’m becoming uncomfortably familiar with someone who would rather just get the salient points of history from each patient, because they haven’t sat down, eaten or drunk in the last 8 hours and aren’t likely to if the patient tells me about his cat at home…or just perhaps, if I gave him the time of day, might tell me what he fears most while he’s under my care. It seems the mirror doctor has stopped looking each patient in the eyes every morning, because he’s too busy scribbling in the notes…and if he looked up it might start one of those conversations with the lonely or even bored patient that just take five minutes. But 5 minutes times twenty patients and suddenly there is an hour an a half missing from his schedule – and perish the thought that that should happen. And as the rest of the team move on to the next patient he’ll miss more of the information to scribble down that will make the rest of his day that tiny bit easier because it might mean one less session of wading through someone’s tome of notes. It seems this doctor has become someone who has already run out of the personal resources to engage with every patient as a human being. Who feels that he has to ration himself to stay sane and functional, although he vowed he wouldn’t be someone who did. Who has become so intent on doing the job that he has lost sight of why he was doing it in the first place.
That picture of what I was aspiring to, what makes a good doctor seems strangely changed. It appears it is alarmingly easy to lose sight of that “aspired to” reflection. All this reflecting on my reflection reminded of that verse from James.
“Anyone who listens to God’s word but doesn’t do what it says…
is like a man who looks at his face in a mirror and, after looking, goes away and immediately forgets what he looks like”.
Is that what I am doing? Looking in the mirror and straight away forgetting the things that patients need and want from a doctor in favour of my own medical priorities? Is it a bad thing that I may have to choose the things that expedite effective treatment and progression of treatment of the patients’ medical condition over spending time reassuring the patient when they are afraid or are distressed? Which is more important? Is that what I am really doing when I’d rather hurry away from someone’s worried relatives to write on a piece of paper? What are the NHS paying me to do? Is it possible, even desirable to discharge my duties of medical responsibility without engaging with patients as human beings if it means I see more patients, get more done in a day?
What would God do in each of these situations? What is he doing? How is God working for the patient who, because the insane bureaucracy of the health and social services economy can’t agree who will fund getting him to a nursing home near his family, and won’t allow his family to pay for it privately because it is an NHS nursing home and so doesn’t take “private patients”, spends the last 10 days of his life in hospital? How is God working for the man who says to me “Isn’t there somewhere you can send me and have me put down? Instead of taking up all this time and money that could be spent on someone worth it?” What is God doing for the patient whose family seems more concerned about only accepting them home if they are completely independent like they were before, than about how they are doing and whether or not they are well? Where is God when a patient’s partner is pleading, hassling, bullying manipulating, begging, trying everything to persuade us to treat a patient whose body is ravaged beyond repair? Where is God when the old boy l was talking to two hours ago lies down on his bed and slips away into oblivion without anybody noticing? The doctor staring back at me in the mirror this morning was struggling to hang on to the assurance that somehow today God is working out all things for the good of those who love him.
And it appears that all those characteristics of a good doctor, so neatly summed up in so many column inches and conversations, are also slightly less easily held on to than I had naively assumed. Perhaps it was this naivete that made me feel irritated with a peculiar phenomenon belonging to doctordom - everyone always seems to think they know more about being a good doctor than the medics they are talking to!!
James goes on “The man who looks intently into the perfect law that gives freedom, and continues to do this, not forgetting what he has heard, but doing it—he will be blessed in what he does”.
Am I prepared to intently listen? Even if I can summon up the energy to bring myself to that point, to the point where I believe I will hear an answer to all of this; even if I can convince myself that I have heard answers before, am I coming in faith? Or just with wishful thinking. Because wishful thinking doesn’t change anything – least of all the person staring back at me every morning.
Father I want to believe - help me to believe Father that you can use me each day to share your love with those around me. Help me to be more like Lord Jesus – help me in ministering to these patients as one of His Brothers, a co-heir with Him – because I can’t do it in my own strength Lord, though like a fool I’ve tried. For whatever I have done for the least of them, Father…
As I was trying to dose off this evening my thoughts drifted back to what I aspired to as I applied for medical school. I wanted to become a doctor who gave patients the space and time to voice their concerns. I wanted to be a doctor who focussed on involving the patient in their care and in the decisions around their care. I wanted to be a doctor who inspired trust in their patients. I wanted to be a doctor who rose above the cynicism and resignation that many observe in the NHS and focussed on the patients as people again. I wanted to be a motivated, motivating colleague, dependable and competent. I wanted to be someone who treated these patients in a way that reflected how God saw each of them. That showed I placed a value on them not less than that which God gives each person.
Well here I am, almost 3 months into my first post as a junior doctor. Definitely different from the nervous and eager medical student that started four years ago. Wiser? Maybe. Closer to that ideal I started out with? Probably not. And on reflection, I am not sure I entirely like what I see looking back at me from the mirror each morning…I’m becoming uncomfortably familiar with someone who would rather just get the salient points of history from each patient, because they haven’t sat down, eaten or drunk in the last 8 hours and aren’t likely to if the patient tells me about his cat at home…or just perhaps, if I gave him the time of day, might tell me what he fears most while he’s under my care. It seems the mirror doctor has stopped looking each patient in the eyes every morning, because he’s too busy scribbling in the notes…and if he looked up it might start one of those conversations with the lonely or even bored patient that just take five minutes. But 5 minutes times twenty patients and suddenly there is an hour an a half missing from his schedule – and perish the thought that that should happen. And as the rest of the team move on to the next patient he’ll miss more of the information to scribble down that will make the rest of his day that tiny bit easier because it might mean one less session of wading through someone’s tome of notes. It seems this doctor has become someone who has already run out of the personal resources to engage with every patient as a human being. Who feels that he has to ration himself to stay sane and functional, although he vowed he wouldn’t be someone who did. Who has become so intent on doing the job that he has lost sight of why he was doing it in the first place.
That picture of what I was aspiring to, what makes a good doctor seems strangely changed. It appears it is alarmingly easy to lose sight of that “aspired to” reflection. All this reflecting on my reflection reminded of that verse from James.
“Anyone who listens to God’s word but doesn’t do what it says…
is like a man who looks at his face in a mirror and, after looking, goes away and immediately forgets what he looks like”.
Is that what I am doing? Looking in the mirror and straight away forgetting the things that patients need and want from a doctor in favour of my own medical priorities? Is it a bad thing that I may have to choose the things that expedite effective treatment and progression of treatment of the patients’ medical condition over spending time reassuring the patient when they are afraid or are distressed? Which is more important? Is that what I am really doing when I’d rather hurry away from someone’s worried relatives to write on a piece of paper? What are the NHS paying me to do? Is it possible, even desirable to discharge my duties of medical responsibility without engaging with patients as human beings if it means I see more patients, get more done in a day?
What would God do in each of these situations? What is he doing? How is God working for the patient who, because the insane bureaucracy of the health and social services economy can’t agree who will fund getting him to a nursing home near his family, and won’t allow his family to pay for it privately because it is an NHS nursing home and so doesn’t take “private patients”, spends the last 10 days of his life in hospital? How is God working for the man who says to me “Isn’t there somewhere you can send me and have me put down? Instead of taking up all this time and money that could be spent on someone worth it?” What is God doing for the patient whose family seems more concerned about only accepting them home if they are completely independent like they were before, than about how they are doing and whether or not they are well? Where is God when a patient’s partner is pleading, hassling, bullying manipulating, begging, trying everything to persuade us to treat a patient whose body is ravaged beyond repair? Where is God when the old boy l was talking to two hours ago lies down on his bed and slips away into oblivion without anybody noticing? The doctor staring back at me in the mirror this morning was struggling to hang on to the assurance that somehow today God is working out all things for the good of those who love him.
And it appears that all those characteristics of a good doctor, so neatly summed up in so many column inches and conversations, are also slightly less easily held on to than I had naively assumed. Perhaps it was this naivete that made me feel irritated with a peculiar phenomenon belonging to doctordom - everyone always seems to think they know more about being a good doctor than the medics they are talking to!!
James goes on “The man who looks intently into the perfect law that gives freedom, and continues to do this, not forgetting what he has heard, but doing it—he will be blessed in what he does”.
Am I prepared to intently listen? Even if I can summon up the energy to bring myself to that point, to the point where I believe I will hear an answer to all of this; even if I can convince myself that I have heard answers before, am I coming in faith? Or just with wishful thinking. Because wishful thinking doesn’t change anything – least of all the person staring back at me every morning.
Father I want to believe - help me to believe Father that you can use me each day to share your love with those around me. Help me to be more like Lord Jesus – help me in ministering to these patients as one of His Brothers, a co-heir with Him – because I can’t do it in my own strength Lord, though like a fool I’ve tried. For whatever I have done for the least of them, Father…
posted by Duncan at 1:54 am
2 Comments:
ben and would like to comment on how much he now sees the way in which you can write, he thinks to himself, "i like it" and "what a good post".
Ben means that he would like to comment, Would has gone to Quebec.
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