Thursday 6 February 2014

Mirrors and Walls

I was on Day 3 as a resident.

I was in a new department, working with new people, fulfilling a new role in a new rotation.

Even on Day 3, I still felt completely lost.

She was on Day 3 at her new job.

She was in a new town, working with new people, fulfilling a new role in a new and unfamiliar field.

And on Day 3, she was stretched to her limits.

We spoke about the stressors of her new work and life, the guilt that comes with putting herself above a commitment that she's made, and the feelings of uncertainty and inadequacy that she felt in her new role. We talked about the difficulties she was facing and discussed options that could assist with making things better.

Even today, I'm not sure if the nature of the discussion we had was part of my role as an ED resident, but I stuck with it because it was what needed to be discussed. If not now, then when, and if not me, then who?

As I worked within the limits of our professional relationship to defuse some of her fears and anxiety, I had to make a conscious effort to go against some of my own natural responses that were driven by my instincts of compassion and empathy and this was a real challenge.

Medicine is a paradox of incredible proportions. Isn't it funny how the exact qualities that draw individuals into the profession, the very fundamental values that we seek to instill in our doctors and the ones that we identify present in good doctors, are the ones that they are often required to silence in order to appropriately fulfil their roles?

I have no doubt that she will be okay. All that she really needs is time to prove to herself that she, in the words of Christopher Robin, is "braver than she believes, stronger than she thinks, smarter than she thinks", and that there are always options in her favour. And in the time that she is discovering that, all she needs is someone to be kind to her on days when she hasn't got the ability to be kind to herself.

In retrospect, I wonder if some would have thought that I had spent to much time with her in that consult. The truth was that I took as much time as I needed to get the work done. 

I gave her the time she deserved, the time that she needed and the time that I secretly wished I could give to myself for the same purpose.

In the end though, I think what matters most is that we ended the consultation with her stating, "I don't feel sick anymore".

Amidst all my doubt about whether I'm following all the rules, fulfilling all the criteria and being and doing my best, I can't help but be extremely comforted by her parting statement.

After all, if my patients can honestly say that they feel better after a consult, surely I must be doing something right.

Isn't that what I'm ultimately here for?

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