A poem written by Dr Amid, a junior doctor.
At the forefront
They say that whatever doesn’t kill you makes you stronger
Say that to the oncology patients, the pain in their eyes, wishing not to remain any longer
My heart tremors as I walk down the corridor
The palpitations of my index fingers are too persistent to ignore
My trachea collapses every time my beeper goes off
I sweat and sweat, I try to replenish it with water, but it’s not enough
Hours on the ward seem to be long days that make me weary
I think I’ve caught what the patient was diagnosed with in bed three
Although I’m told not to, I self-diagnose
Lists of symptoms and signs I compose:
- Fears of not being able to supply their demand
- Suffocating my thoughts with predictions and plans
- My imagination runs wild as I begin to contemplate
- Mistakes and devastating actions I could make
- That leaves someone who trusted me in pain
- Scribbling my signature at the bottom of their records – shame
- Blood stained resume no longer fit for practise
(A disgrace to the Medical Council, incompetent and useless)
- These notions come to greet me every moment of the day
- They’re absent at breakfast, present at lunch, occasionally there at dinner, they never go away
- Making me question my ability and sanity in this field
- I’m no longer in control of how I feel
But since I’ve started sharing the content of my mind
Something has been fertilised inside
Teamwork introduced me to ‘Mechanism to cope’
These thoughts of the day seem to be replaced with hope
Lately I’ve befriended a new angle of view
It is a subtle friendship because those that know about it are few
The budding beginnings bring about brand new brainwaves
Constantly contemplating and constructing confident considerations which are crucial
I think I’ve come to understand that I’m not the superhero the world has been waiting for
This fight isn’t over; battles are being won every day but we all remain in war
Nevertheless it is the daily combat that keeps things ticking
The persistent resistance against invasion
The inconsistent resilience that makes us human
And the hope of tomorrow that keeps us going
This poem is titled ‘At the forefront’ because it expresses the thoughts of a doctor who is struggling with the harsh uncontrolled reality of death and disease. They are constantly faced with patients who look to them for help to overcome their terrible disease they battle. At first it is all too much for Doctor A, the mental and emotional problems are presenting themselves physically, or so he believes. This portrays the first big idea in Whole Person Care, ‘Illness and its remedies lie at many levels within a system’; although the pathology can be explained through the activity of adrenaline in the body there is an emotional level that suggests a the trigger for the release of adrenaline, it is more likely that clinical signs have emotional factors are their trigger. This also addresses idea seven, “We can learn from different philosophies of health.”; the psychobiological relationship presented by Doctor Amid shows that his mental health affected his physical health, hence the physical manifestations of his worries. Integrative Medicine is employed by many practitioners to focus on the patient as a whole and to make use of all appropriate therapeutic approaches; if Dr Amid presented his physical symptoms to a fellow doctor it would be easy for his colleague to be absent-minded towards Dr Amid’s emotional symptoms and only treat the physical issue.
He comes to a point where he is emotional attached to the patients he cares for. In order for a practitioner to relate to their patient they must be able to empathise, it should be something that is constantly applied throughout a consultation. Although, being human means a doctor is often subject to emotion, empathy can consume a doctor, leaving them in a dysfunctional state. “…I think I’ve caught what the patient was diagnosed with in bed three. Although I’m told not to, I self-diagnose. Lists of symptoms and signs I compose…”. But this is something that we can all identify with, when we’re too attached to a vulnerable person we become we bear their burdens as if we were them. Empathy should be a costume doctors wear when needed, but in order to make rational decisions this costume must be taken off, it is then put on again when appropriate.
‘…Effective relationships are central to effective care…’ is the fourth Big idea, kit wasn’t until Dr Amid shared his fears and used the support system around him that he was able be released from his prison of negative thoughts. It was through teamwork that he was able to know about these mechanisms.“…But since I’ve started sharing the content of my mind. Something has been fertilised inside. Teamwork introduced me to MOC ‘Mechanism to cope’. These thoughts of the day seems to be replaced with hope. Lately I’ve befriended a new angle of view…”. The effective relationship between Dr Amid and his colleagues lead him to effective care.
The poem ends with Dr Amids new thinking; it is evident that the new technique adopted by him has created resilience. This ending does not paint a safe, comfortable and nice image of life as a doctor but accepts the reality that death is painful and despite human intervention, is inevitable. “…The inconsistent resilience that makes us human…” this shows that Dr Amid is still on a journey, like many us this journey may last for a lifetime. In practise resilience can be hard to define because people are different therefore their resilience will manifest differently; there can be no time allocation, characteristics criteria, physical duties or a check list to be ticked off. Resilience in intrinsic, it is a characteristic that can only be activated by yourself, which confirms the sixth Big Idea ‘…Self-care helps create resilient practitioners..’.
Dr Amid is a fictional character that represents the thoughts and worries of medical students and doctors.
Photo Credit: PhotoPin
Year 2 Student Doctor