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Writing. It is a personal favourite when it comes to relieving a burden off my chest. There is a freedom to it that can’t be explained, only felt. The raw emotion, the power of words and the ability to evoke a response from the reader are all part of its majesty.
It mesmerises when engaged by a master. It can brighten your mood, uplift your spirit, darken your soul and send you to the gallows all at the same time. It is the power of writing. In fact, once many leaders discovered and adopted it as a part and parcel of governance, it was donned to be a form of ‘magic’.
You would no longer need to keep all information stored in your head. It could be documented and preserved for many more years than an individual’s life-span. Words were indeed timeless. They could take you on a journey through time without needing a time-machine.
They well up tears of joy, crush your dreams or even render you speechless. It is the power of writing. In the hands of somebody that appreciates its value, it is a weapon like no other. In the grasp of a fool, beware of its ability to make the truth appear a lie and a lie the truth. It is the power of writing.
It can allow you to transcend into a fictional land that has been designed for you by a manipulator of its powers and create a world that only exists in your mind. It is so powerful, you can even forget your current reality and use that world as an escape from your real-world problems. It is the power of writing.
For some, it wells up a sense of national pride, an urge to serve and put their bodies on the line. Others it pushes to opposition, sedition and making it their life-time goal to be a thorn in the patriot’s side. It is the power of writing.
It polarises, is responsible for paradoxes and it’s understanding by individuals leads to varying interpretations even on the same text, read with the same eyes! It is the power of writing. It’s marvel is endless and my admiration for its power is also infinite. These pages are unfortunately limited and time doesn’t permit to continue without an end-in-sight.
Although writing’s power is worth much more than these quickly dotted points, its value is only held in esteem by those who understand its usefulness. Indeed, it is the power of writing!
“Number 328 to Consultant Room 12 Blue”
I spun around in my chair and stood up, opening the door. My partner sat at the only place available-the bed. We were sitting in our own consult room at fracture clinic, taking in turns to see patients. The one we had just called in was a woman in her 60s, with what seemed to be a minor fracture on the calcaneus. A man approached, pushing a woman-my patient-in a wheelchair. I greeted them, and whilst the man seemed quite engaged, the woman merely smiled, and already I was beginning to question the lady’s cognition.
Don’t be so judgmental, I told myself. Perhaps she just isn’t in the mood to visit clinics and get questioned, poked and prodded.
I began to ask her questions, to establish her history of presenting complaint. I’d already read most of her story from the correspondence and outpatient notes however we had always been taught to learn the story firsthand. Despite my best efforts she would look at me blankly every time I directed a question at her, and eventually the man would respond. I found myself directing more and more questions to him before catching myself and returning to the patient. From the consult I had determined that although she was wheelchair bound due to the fracture (which resulted from a fall), there was a number of other co-morbidities, the most limiting to the issue we were addressing being her weight.
“I’m basically her caregiver, you know,” the man was saying. “Like I cook and help her and take her around and everything, I look after her.” I nodded and glanced at her for a reaction. Nothing much. I decided to move on to the examination.
I examined her foot, which seemed tense and leg attached a little swollen. She indicated there was some tenderness over the area where her fracture was on the X-Ray however she didn’t seem completely certain that that was the case.
“So before the fall, how much were you able to walk around?” She gazed at me, with no indication that she intended to respond. “She hasn’t done much walking for years,” the man answered for her. I nodded. “I had a walker. “ She interjected. I repeated the last word inquisitively, hoping she would provide me with more information without me needing to ask directly. “Yeah I used to go shopping, with my walker. I could go for hours, I just took a seat when I was tired.” I tried to delve further, to ask how long she had been on the walker, but when she didn’t seem to comprehend my questions I turned to the man. “So before the fall, what was your mum’s mobility like?
The man nodded and smiled. “Well she hasn’t been properly walking for years, and then she got a walker you know, because of her legs and her weight you know, and then the fall and now this. She hasn’t been walking for years. I’m her husband by the way.”
The seconds for which I was rendered speechless seemed to last forever.
Did I just?
I thought he said mum?
Oh God no, he said caregiver.
I could almost sense the amusement emanating off my partner. I made a conscious effort to not glance in her direction.
“Oh my gosh I am so sorry!” I gasped. Thankfully they seemed amused. “For some reason I thought you mentioned that you were his mum.” He laughed “Oh really, no no, we’re married.” The woman looked at me and sighed in jest. “Yeah.”
I shook my head and laughed at myself. “Wow, I am so sorry. What I’ll do now is I’ll have a chat to the bosses and we’ll have a look at your X-Rays and work out where to go from there, how does that sound?” They nodded and said no worries, and as I stood up I had to apologise once more. “Again, I’m so sorry, we’ve had a few kids come in with their mums so I must be in that mindset, sorry!” They smiled again and told me not to worry.
Alright Priscilla, you haven’t dug a ditch, you’ve dug a ravine, time to back out and recompose.
The management was simple: the X-Ray had shown complete healing of the fracture, and so it was recommended that she weight bear as tolerated. The husband thanked me as the patient smiled. “Great, we’ll try to get her back on her walker. Thank you so much.” I nodded and smiled. “No worries, hope it all goes well. It was lovely to see you, sorry again for my slip-up before!”
They left the room and I turned to my partner.
“So how do we do this what are we doing?”
We peered at the computer screen as my partner typed her login. “Goddamnit, we need to set a new password.”
I have yet to see a hospital computer using at least a Windows XP and this one was no exception. As the screen loaded slowly I tried to curb my frustration. We’d been dropped into a consult room and told to see some patients and we had no idea what the process even was. The registrar was not unkind, but there was a lack of communication of vital information (like how do we find out which patients we’re meant to see). And there was a fine line between asking the perfect amount of questions and asking way too many to the point of wasting the registrars’ time.
After about 20 minutes of fluffing around trying to log in to the right programs, working out where to find the outpatient progress note, and realising that we needed IT support to add the patient calling program to my friend’s profile, we were finally ready to begin.
“So who do we want to see?”
“We don’t know what they’re in for, what if it’s something we don’t know at all.”
“Oh god, how about we just look through their details and see if it’s an easy one or not.”
We selected our first patient, but she hadn’t arrived yet (she didn’t arrive at all in the end), so in fear of being accused of dawdling we decided to choose another patient. My partner and I took turns leading the consult, feeling more and more comfortable with every session. Before the end of each consult we would consult with the registrars about their X-Rays and their management plan and then relay it to the patient. Thankfully, every person we saw had no qualms about the fact that they were talking to medical students, and we were greeted by smiles and no condescension.
“This isn’t too bad.” My partner said, in between patients. “I think we’re doing alright.” I agreed. I was less anxious now and feeling a bit more invigorated, and more useful. We were looking through the notes of a patient and was about to click the call button when her status was changed to “Called to Consult room Yellow 11.” I paused. “That’s not us. Why has she been called to 11, we’re Consult Blue 12.”
“But I’ve got the notes.” What we knew the system to be was that if you intended to see the patient you would go into the drawer, pick up the patient notes and take it to your room. Therefore if someone else was to have the same intention, they’d see the missing notes and realise the patient was being seen to. Yet our patient had been called to another room…whilst we sat in ours holding her notes.
“What do we do? We can’t just knock, can we?” I grimaced. On the one hand we could knock, interrupt the consult to let the resident know that he just so happened to be seeing the patient without the notes which might give off an impression of incompetency, or we could wait and give it to him afterwards. We decided on the latter.
Standing outside the room, I felt mildly uncomfortable. We were feeling a bit (for a lack of a better word) shafted by this particular doctor. The registrars were kind and happy to listen to us report back, whereas this resident seemed to dislike our very presence, and had even made an offhand comment during ward rounds about us not needing to attend clinic even after the registrars had extended the invitation. First impressions count, and he did not make a good one.
The door opened, and the patient left. He swivelled around and looked at us.
“Um, sorry, we’ve just got her notes we were wondering if you wanted them.” He smiled (sort of). “Oh uh, I just did it electronically, so, I don’t really need them. But thanks, I suppose.” We gave them to him and returned to our room.
“I don’t like him.” My partner said. I agreed. His tone seemed slightly irritated that we had the audacity to come and give him the patient notes. “We’re not the ones who just ignored the system and did our own thing.” We had a bit of a mumble and grumble before we decided on our next patient.
And that one, is another story.
“…and unfortunately, Jacqueline, he is going to die.”
There was silence. The nurse rested a hand on Jacqueline’s back. Her face was blank, and she stared unblinkingly at the space above the consultant’s head.
Then at once, as if her control had completely snapped, her face crumpled. Her tears were silent. No-one moved. It was as if we were afraid that movement would intrude on her grief.
We were sitting at a round table, yet still there was a divide. The bedside nurse with the devastated wife on one side, and the small panel of doctors (plus my curious self) on the other-sympathetic but serious, a solemn row of doomsayers changing a family’s life forever.
The family meeting was brief, but heavy. We left her in the room alone (by request) and filed out. Once we were back in ICU however, as if the veil of mourning had been whipped off, the senior doctors began speaking earnestly, discussing details of the palliation and the patient’s family situation. The wife was estranged from her in-laws and wished for them to not be present whilst her husband’s support system was being switched off. This meant that the consultant was to inform the parents and sister of his palliation the following morning and allow them only the morning hours to say their goodbyes before the wife was to return in the afternoon.
“This is such a shitty situation,” the senior registrar was saying. “He’s dying.” The nursing manager nodded. “Exactly. The poor man is passing away yet his wife and family can’t set aside their differences for one day just so they can say goodbye together, it’s so sad.”
He sighed and shook his head. “You do see it happen though, sometimes. But I suppose mostly it’s when the patient’s been in here for a long time, and they’ve had time to come together. He only started deteriorating last Friday.”
Meanwhile the consultant turned to me. “See it’s actually really important that you specifically say the ‘d’ word-you’d be amazed to know how many people can walk away from a family meeting thinking something completely different if you don’t explicitly say it.” The junior registrar was nodding in agreement. “People can be really dense when they’re grieving, or they simply just stop listening. Don’t beat around the bush, you have to be straight and honest.” Having seen from my wide-eyed look that I definitely got the message, they began to discuss the patients that needed to be seen first in the afternoon ward rounds.
Thus began my short-lived stint in ICU. We were only rostered on for 1.5 days, my reasoning being that if I were an ICU doctor I probably would not want a clueless third year medical student running around after me for 5 days of the week. It was unfortunate for us but also fair enough-as a medical student in her first year of clinical placement I was probably as useful in ICU as a solar powered torch.
It did make me think however. I’d been warned by one of the registrars beforehand: “Just be aware, Priscilla that this can be very tough, and you just need to stay calm. It doesn’t really help if you start crying.” I had been expecting to feel completely overwhelmed, yet whilst I felt sympathy and compassion I didn’t feel such overflowing emotion. Perhaps it was because I was simply an observer and felt no personal connection. Or perhaps it was because he was not my patient, and I had only seen him once and only very briefly.
It made me wonder what it would be like if I knew the patient, and had made a connection. How would I handle it? Would I struggle? I am a curious mix of stoic and highly emotive. Sometimes I can be surprised by my own reactions. My desire to attend the family meeting was to not only observe firsthand the proceedings but to also challenge my mental strength. Could I deal with it? It appeared I could, but I was not completely convinced.
I suppose this is something I would find out in the future, and all I can do is be as ready for it as I can.
“He’s a bit grumpy this one, but we’ll see how he is.” It was just me and the Gen Med APT, as we had chosen to divide and conquer (the patient list). She was a wonderful woman and thanks to her and the rest of the team I had been thoroughly enjoying my rotation with the General Medicine department. I scurried after her (she was much taller than me) patient folder in my hand, as I had by now learnt to write proper patient progress notes without needing to question what needed to be included with every second sentence.
“Hello Frank (pseudonym), how are you?” the APT was a tall blonde woman, a British accent giving away her country of origin. The patient was in a single room with the windows covered. He had sat up as we’d come in, and after flicking a quick glance at me, he now looked at her expectantly. I positioned myself behind her against the wall in the standard furniture position.
“I’m good, I’m good, are you my doctor?” She told him yes, she was. “Oh good, good, I just don’t want one of them oriental doctors you know?” I stifled a snort. He was an old Caucasian man, and frankly I was not surprised. The APT turned to glance at me, eyes wide. I merely grinned.
“Uh well I’ll be your doctor while you’re here is that ok with you?” He waved his hand. “Yes, yes I just had an oriental doctor last time I was here and he was awful, I did not like him, so I just don’t want another oriental doctor this time.”
If only he’d said oriental doctor one more time in that sentence he might have just summoned one.
She shook her head and repeated that he would be seeing her, the interns and our consultant (all of whom thankfully for this fellow were not ‘oriental’) and that they would be doing their best to make his stay as comfortable as possible. She then moved on to the actual consult, and discussed his current issues. I paid attention, but having already had my opinion of this patient lowered by his outspokenly racist comments I was not inclined to participate any further. I wrote my notes, and nodded goodbye as well left.
The door closed behind us and we went back to the nurses’ station. “Oh my god, Priscilla, I am so sorry!” I laughed as the APT put her hand to her mouth, looking absolutely mortified. “I can’t believe he said that, you were right in the room, I’m so sorry you had to hear that!” I shook my head. “No it’s ok, I’m not offended! There are people like that everywhere.” She shook her hand, one hand on her hip. “I just can’t believe-let’s just fix him so we can get him out of here. That was so rude.” We carried on with our day, and I stored the moment away as a story to tell.
Racism is something that so many people experience, and as a Chinese-born Australian who grew up in an Italian/Greek populated area I have had my fair share of offhand comments and confrontations about my appearance and background. This experience (which occurred several months ago) however, was my first as a medical student and it gave me a glimpse into my future.
Recently there was a female Asian emergency physician who posted tweets about patients who had refused her care because of colour of her skin. What baffled me (and many others) was that because she had the audacity to be born a non-Caucasian woman she was refused the expertise and skills she had studied for years to develop. Imagine finding yourself hanging off a balcony and refusing the hand of your Indian next door neighbour simply because his ancestry did not trace back to Europe. All that tells me is that there are some people who would rather die, than accept the aid of someone whose skin colour is not akin to Dulux 15W (for those not much into renovations, that is the number code for the paint colour ‘Natural White’), which for a human whose basic instinct is to survive, seems a bit odd.
What’s hard, I’ve found, is trying to change the mind of a racist/sexist/homophobic (the list goes on) bigot. It is most definitely their loss and some other person’s gain. We’re told to treat each patient equally and indeed if that were the case, I would give that patient my best care. But if they refused it I doubt I’d waste my energy chasing after them. I would ensure someone else took over and not give them another iota of my attention.
Perhaps it’s better, but while I am an aspiring doctor, I am also human.
Mr Henry Wallace (pseudonym) was a 70 year old gentleman who upon first impression I perceived to be a friendly, but world-weary man. He had a myriad of health conditions, of which he claimed his inability to walk to be the most important. We took his history, and in discovering he was a diabetic, was experiencing left foot drop, and loss of peripheral sensation, we began to suspect peripheral neuropathy. It was the ulcerated right toe however, that was the cause of his admission. Mr Wallace was responsive, eager to answer our questions, and after a while, it was quite apparent he was also eager to share. He stressed the frustration he felt at his inability to walk, which had developed some months ago. He was once an active man, and he was accepting of all his medical conditions, had no qualms managing them, but the debilitating aspect of his failing legs meant that he no longer felt independent. He lived in a building owned by a Church, and although he admitted he mostly stayed in his room, there were neighbours there that he was fond of. He had no wife, and no children. He mentioned no other positive social relationships. I could detect an undercurrent of sadness in his voice, and it soon became apparent that the source of such melancholy was his own history. It was during his response to one of our questions that he apologised and stated that he had a story he wished to tell us.
Many years ago, Mr Wallace was working for a big brand company. At the time of the story he had been an employee for 16 years. During this period, Mr Wallace’s father was residing in a nursing home, with the expectation that he was dying. It came then a day, which his father was not expected to live past, where his sister-in-law called the company for which is worked, requesting that Mr Wallace be excused of his duties in order to tend to his father. However the company’s response was that no such employee existed, and the phone call was over.
It was at this point in his story that Mr Wallace began to cry. I was already, in truth, fighting the urge to respond sympathetically. He cursed the company he worked for, the company who after 16 years of labour, were unable to acknowledge his existence, the company whose inefficiency or incompetence meant that he returned home from work that day to learn that he had lost his father. He shook his head as the tears rolled down his cheeks, regretting that he was not given the opportunity to say goodbye. “I hate them”, he said to us. “I will never use [the brand name] again”. We agreed. We responded in our own way, offering some form of comfort. But I believe the greatest comfort he took in our presence was the opportunity to talk, to tell his story. I suspected that it was not something that he came across often.
His second story was told in brief, yet it had an impact much greater than its length. It was not told to us by him, as we felt we had taken much of his time and thus we decided to leave him to rest. It was our tutor (his doctor), who was given permission to recount. This story, our tutor said to us, is perhaps the reason why our patient had no wife, and no children. At the age of 23, Mr Wallace was in a committed relationship with a woman that I will call Grace. It was a couple of days before Christmas and Mr Wallace was intending to pick Grace up from her house (where she lived with her parents) for dinner. He arrived instead to a scene of devastation. A fire had burned the house to the ground.
Grace, was inside.
Our tutor described how broken Mr Wallace appeared to be when telling this story. He stressed that patients will come in with more than one problem, and while we may not be able to fix everything, if there was something we could do for them, it was to listen.
I walked away from that session with an overwhelming sense of sadness. It was sobering to realise and remember that there are hardships people experience that I (selfishly but hopefully) never will. How different we people are, the paths we take, yet somehow we end up here, on two sides of a bed (terrible way to put it, I know). We may all be cogs in a wheel, but hell, do we have a story to tell.
“Oh hello, I’ll find you one of the registrars, I’m just the resident.”
I scurried after him with an internal sigh, wondering who I was going to be palmed off to next. I was in an Orthopaedics Fracture Clinic, and was hoping to get something practical out of my session (such as ticking off necessary examinations in my logbook). But it was starting to look like that might not be the case.
We wandered over to one of the rooms, where three of the registrars were sitting together discussing something I was paying very little attention to. “Hey got a medical student here, anyone want one?”
They stopped talking. No-one responded. “No?” the resident asked. I was getting the idea that he wasn’t particularly interested in having me sit in with him either. “We’ve already got the other medical students.” (note: the medical students were actually with none of these doctors). The resident continued to stand by the doorway until another registrar piped up: “She can go to the plaster technician-that would be useful for her.” The resident straightened. “Good idea.” He turned to me. “They might let you do something.”
The plaster room was no good. She appeared as genial as I felt, though it was not directed at us. “Just not today, I’m sorry.” We backed out and I mentally prepared myself to return to the common room and reassess my plan for the day while indulging in feeling just a little sorry for myself.
“Hm.” I turned to the resident: “That’s ok, I can just come back another time.” To his credit (considering he didn’t seem very interested in the situation) he shook his head. “No no, come with me.” We walked back to the room assigned to him for the day and he sat down. He began setting up the computer. “Yeah, it’s just I’m just the resident, everything I do I have to run it by the regs, so it’s probably better if you were with them.” I quietly wondered if I should fake a tutorial and spare him the pain.
I made some agreeable noise I think, and stayed silent. The less I spoke, I thought, the less annoyed he might get for having been stuck with me.
“So what did you want to get out of this, Priscilla?” I dithered, and shrugged. “To learn, to do a few things.” I told him about the items I needed ticked off on my logbook. He nodded. “Well we probably won’t get the hip and back exams. But we can probably get a shoulder one in.” By then the patient was walking in and so it was left at that. Midway through the clinic however, he turned to me and said: “Ok, you’re leading this one.”
I blinked. “What?” He grinned. “You’re sitting in the chair, and you’re taking the notes, I’m not telling you her story, it’s your patient!” At that moment, I had no time to wonder wildly what my plan was, I had to just do. I sat down awkwardly. The patient had been called in, but as it turned out she was a 92 year old delightful woman who was stuck with a walker thanks to a patellar fracture. “I’m walking as fast as I can!” she said light heartedly, and we watched. “No, no. This is part of our exam; we just want to see your walking.” The resident said. “Now this is Priscilla, she’s going to be in charge today, is that ok with you?” She laughed as she sat down. “She’s going to be in charge? A woman in charge, of course I’m ok with that!” With that comment, I knew I was going to survive the consult.
She was an amusing historian, and also a very independent and determined woman, with an incredible amount of eagerness to resume her two daily walks a day. Once the resident had taken off her Zimmer knee splint and I’d performed both a quick knee and shoulder examination (she had a history of two shoulder replacements and the resident thought that was the perfect opportunity to ask), she was up and walking around the room. “What are you doing mum?” the daughter (who had accompanied her) asked. “Testing it out of course!” she retorted, as she resumed her seat. We left them for a moment to consult the registrar who did not glance at me at all even as I reported back.
We relayed the news to the patient. She grinned. “Oh thank god, I can go for walks now?” The resident reassured her that she could, however to be safe she should take her walker and continue to use the splint for one to two weeks and slowly wean as she pleased. Thanking us profusely, we watched her leave, and I daresay I almost saw a spring in her step.
Smiling the resident turned to me. “Perfect. Well done.” It was three words, but I knew they were genuine and was feeling incredibly proud of myself, and satisfied with my morning. Thanks to the kindness of one resident, I was actually able to do something I had never done before. I could have just left in a huff after being rejected by the registrars but I stayed, and it definitely paid off.
“So Priscilla, what can you tell me about cirrhosis?”
As per usual, my mind went blank. Two months into placement and my brain had yet to successfully retrieve and open fire responses to questions within a reasonable amount of time. To confuse it even further, I had just finished a cardiovascular and respiratory rotation and was now doing a stint with gastroenterology unit. I was still stuck on murmurs and hyper-resonant lung fields.
“Cirrhosis?” he nodded at me kindly. My mind raced. Think, Priscilla, what does cirrhosis sound like? I might add at this point, that whilst I’ve spelt the word perfectly on paper, at the time, I received it phonetically and thus you must forgive my next response: “Is it…inflammation of the serous membrane?”
He looked at me. I’m sure I had the most dumbfounded expression on my face and he smiled. “…cirrhosis?” was all he said and suddenly it clicked. “Oh my god no, I’m so sorry, I don’t know what happened to my brain there, permanent scarring of the liver?”
Here’s the kicker. I was sitting with a gastroenterologist in what was specifically called the Liver Clinic.
He laughed and nodded. “Don’t worry, I have those moments all the time, but yes, that is cirrhosis. Now can you tell me why that might occur?” I spent the rest of the morning with this kind and absolutely willing to teach doctor, and whilst I did learn, my mind continued to revert back to that dunce moment I’d had. I was thankful that he was the only one who had heard my response. If this occurred in the middle of the ward in front of the gastroenterology team there would have been a high likelihood of me becoming too embarrassed to show my face in that ward ever again.
It might interest you to know that my ambition in medical school is to never become a funny topic of conversation during morning tea in the breakroom.
Mistakes though, do happen. And it’s necessary to remember that they happen to everyone, whether they are a consultant or a clueless third year medical student. But since I am not (yet) the former, my musings are perhaps more relevant to the latter.
It’s hard to forget that our peers don’t actually know everything. Group tutorials are a constant reminder that someone knows more than you. But we have been told time and time again that this is never the case. Your colleague doesn’t know more, they simply know different things. Medicine is too broad for one person to be an expert in everything, and too varied for them to have a vested interest in all topics anyway. Often what we know best is what we find to be the most intriguing as there arises a desire to learn more. So often we sit (or stand) in these tutorials, a mounting panic growing as we realise that someone seems to have memorised the whole CHADSVASC score and the whole treatment plan for deep vein thrombosis and are now appearing to be infinitely better than you are. When in fact, you happen to know COPD like it was your own child and they can’t even distinguish between Chronic Bronchitis and Emphysema. Perhaps poor choices in examples, as both of these topics should be a staple in a medical student’s diet, however I think I’m making a valid point.
So while it is easy to say and hard to do, try not to panic too much when you feel as if someone knows more than you do. Note down that gap in your knowledge, and fill it in (also something that is easily said and harder to do). Sometimes you are going to be embarrassed by blurting out a completely incorrect response. The Liver Clinic incident was only one of the many times I’ve said something that has been completely off the mark. Funnily enough I’ve found that my confidence has been slowly growing at just attempting to answer questions with only a vague idea as to the correct response. Trying is never the wrong thing to do, and sometimes you just might be correct.
Besides, think of how inwardly envious your peers would be when the doctor smiles and says: “Yes, you’re right.”
Life, for all of us, has always been about balance. It might, I say with exuberant sarcasm, surprise you to know that this is certainly the case for a medical student. All aspects of one’s life comes under a certain amount of strain for this select group of masochists, whose sole purpose appears to revolve around making it through 4 or 5 years of relentless studying without losing their minds. Coupled with the fact that we all know perfectly well that studying does not stop with the title ‘Doctor’ and we have actually subjected ourselves to a lifetime of pressing our noses against books (or computer screens), stress is a constant presence in our lives.
So I have to express my incredulity as to how so many of my peers seem to be able to competently accomplish their academic goals whilst in romantic relationships, maintaining friendships and family relationships, working shifts, keeping up with their hobbies and, if social media tells me anything, go out for a drink or two at a reasonable amount of frequency so as to not be classified as a hermit. The level of admiration I have for their expert juggling skills is simply immeasurable.
I myself am committed to only a small handful of pursuits. As I creep slowly towards my mid-twenties I’ve come to the realisation that there is only one question one must ask when encountering another individual, whether it be in the hallway, or at a social gathering: “How are you?” And often the standard reply would be: “Good, how are you?”
Now in the off chance the conversation must continue, the follow-up question is: “What’s been happening with you?” or variations thereof. Unfortunately for myself, I’m quite limited in my response. I perhaps have two priorities in my life and that is my medicine career and the gym. If (and we must touch wood for this) I were believed to have gone missing there are really only two places to look. Three, if you count my home.
So consider me flabbergasted that one of my best friends is not only at placement every day, but works a couple of shifts, exercises a few times a week, maintains her two year relationship and still has time to go out with me for brunch or dinner every now and again. The idea of being booked in for two social events in one week stresses me out more than it should if I have to be honest. I do love to socialise, but I become quite highly-strung if I cannot make it to a gym session.
It all comes down, in the end, to priorities. Lately there has been a lot of coverage on burn-out, where medical students are struggling and failing to feel mentally and physically able to handle the stresses that come with medicine and maintaining a balanced life. We all, not just medical students, have many things we value, and wish to prioritise, and keep in our lives. But an expert juggler can still drop their pins after a while, not because they are incompetent, but because they are exhausted. Overstimulated nerves, become exhausted and fail. Overused muscles break down, and fail. An over-activated heart, will fail. We humans are not made to last forever.
I reached this topic in such a roundabout way to demonstrate that we are all different. We have different limitations, we value different things, and we have different strengths and capabilities. What one person can do, is not necessarily what you can do. This does not make you, or them, lesser. Sometimes it is difficult to remember to do what suits you best. Sometimes it is easy become caught up in the ever-increasing chaos, to forget to stop, take a step back, and reassess your surroundings. And it’s much easier to forget to take a look at yourself. Am I sleeping less, becoming more irritated, worried, stress, frustrated? And if so, what can I do about this? Perhaps it is a selfish thing to say, but I am my priority. I want to be mentally and physically capable to face what is in front of me. And I paint myself as a strong character, but I know there are others for which this self-evaluation is harder, or they are so focussed on their goals they forget to look after themselves.
There is nothing wrong with saying you are drowning. We shout and scream for help in an ocean when we feel like we are going under, because we know we need the help. I wrote this piece in the hope that it may serve as a reminder for those who have neglected their own health to remember to give themselves a perfect OSCE-worthy history and exam. Are you ok? And if you are not, find some help. Your family and friends are there for you. Your tutors and mentors are there for you. Professionals are there for you. Asking for help is a simple piece of advice, but for some it is difficult to follow.
Take a step back. Look after yourselves.