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Indelible first-hand lesson in care

Posted on 7 January 2013 by Megan Hume  17 comments

I was diagnosed with cancer tantalisingly close to the end of my foundation year 1. Without warning I went from the bedside into the bed.

With the prospect of months of chemotherapy, I became preoccupied with the inevitable delay in my training and the gap on my CV.

Naively, I piled my bedside high with Oxford Handbooks and made mental plans to finish off that audit or submit an abstract perhaps? This would be the perfect time to catch up on accumulated paperwork, and revise for the Membership of the Royal Colleges of Physicians exams. The prospect of lying in bed for six months watching The Jeremy Kyle Show absolutely terrified me.

Alas, cycles of chemotherapy caught up on me. The books gathered dust, journals lay unopened and practice questions untouched. Some days, all I could do was lie in my bed and watch the ward go by — the hum of buzzers, beeps of empty drips and nurses’ footsteps hurrying to patients; porters back and forth, trolley after trolley of meals.

Yet, among the catheters, cannulas, sickness and scans, I gradually realised that everything I encountered was a lesson beyond that offered by any course or textbook. I learned in six months what it takes some doctors to learn in years, or perhaps, for many, what may never be realised; I gained the patient’s perspective.

I now know that, yes, cannulas hurt, but it’s not really physical pain, it’s the drip stand which looms above, trapping you so that you cannot easily move, undress or shower without assistance and ordeal. I noticed a shift in staff demeanour when they knew what I didn’t yet know and learned that reassuring smiles, honest communication and handholding are worth a thousand words.

We’ve all heard it said that being a doctor is a privilege and while it sounds absurd to say that experience of illness is a privilege, it is a unique insight that only a few doctors will ever gain.

Looking back, I feared falling behind my peers and losing out on my training. Yet what I have gained is far more valuable. It was an experience that anyone would reasonably want to forget, and now as I move on, returning to work on the wards, memories do fade. But I, for one, do not want to forget.

Megan Hume is an Edinburgh foundation doctor 1

Posted in:  Education and training Work and life

Tags:  foundation programme year 1 foundation programme cancer junior doctors

Comments

  • Dr Helen Terrell

    7 January 2013

    Megan, thank you for sharing your story. I believe that
    the insights of being a patient are invaluable.
    I am sure that reflective feedback from health
    professionals that find themselves patients
    is the secret to health improvement in the NHS.
    I really hope you are recovering well and that
    you have been well supported back into practice.
    You are going to be a talented Dr.

  • Dr Louise Kennedy

    7 January 2013

    Megan thank you for posting your inspiring story and I hope the roller coaster of being an FY1 is going well. Life is sweeter when opportunities are snatched away but later returned. Yes, going over to 'the other side' and being a patient is experience and insight that cannot be learned any other way and can only make you a better doctor.

    As Helen says, I hope you're well supported in your work. I became ill (nothing as serious as yours - I had a carotid dissection) 1 week after the end of my F2 year, having just started GP training. I was off work for 8 mths and have so far only managed to work half time after 9 mths back at work. My Occupational Health doctor has been a great help. It seems that, thankfully, there are many different ways to get through - and enjoy - training that might not have been possible years ago.

  • Dr Jiten Morarji

    8 January 2013

    Wow! Thankyou for your article Megan. I am indeed humbled by your experience. As I am going through my specialist surgical training I have seen the beneficial effects of compassion and humanity in the context of patient care. Despite the pressures and demands of the job, they are valuable commodities and innate qualities that all doctors have and should develop. I believe that more emphasis should be placed on this rather than meeting performance targets and 'production-line' healthcare. I agree with Helen - you will definately be a talented doctor and will be a very successful one. I wish you all the best in your chosen career!

  • Dr Erum A Khan

    8 January 2013

    Megan, keep up your spirits! You have got it right!
    My seven year old daughter has had liver transplant and we are still ( five weeks down the line) in the hospital due to various complications. Both my husband and myself are off work. Our lives seem to be turned upside down. My experience on the recieving end just emphasises the fact that there are other important things in being an excellent care giver that don't necessarily come with the number of degrees or experience you have. Communication , able to hear the patient's perspective and an emphatic and compassionate attitude makes a world of difference in any individual patien's care. We as doctors really should take a step back and put things in perspective next time we are running around in the wards crossing things to do in our lists.

  • Sandy Goldbeck-Wood

    8 January 2013

    Megan,

    many thanks for sharing your experiences and for drawing our attention to the value of our own subjective, non-professional experience in shaping and maturing us as doctors.

    I've been there too: a period of illness this spring, nothing like as serious as yours, was still alarming enough at the time to take me back to basics.

    I received a great deal of good (and some less good) healthcare, but among the interventions I remember most clearly was the healthcare assistant who, as I lay hidden behind a curtain in A and E, alone, tachycardic and frightened, was empathic enough to come into the cubicle, put the buzzer in my hand, and say "my name's Megan. if there's anything you need just press this." While others focussed on my heart rhythm, troponin results and place in the triaging scheme - clearly important concerns - she delivered a brief, effective and important anxiety-managing intervention.

    I think we need, in medicine, to work towards greater recognition (ore perhaps rediscovery) of the health promoting value of psychological and humanitarian interventions, alongside, say, the correct diagnosis and treatment of the heart rhythm, as part of the care of the whole person.


  • Armanda Finn

    8 January 2013

    Hi megan. I was diagnosed with cancer 6 weeks after starting as GP partner. I was very grateful for great medical care. Surgery chemo and radiotherapy followed over 6 months. I have a new view on many things because of these experiences - doctors talk all the time to patients about risk, but when that risk applies to you or those you love it takes on a very different perspective. The waiting for test results is v difficult and breaking bad news is important, I try hard to do it well. Understanding that fear underlies many questions and responding with kindness helps and makes one a better Doctor. I wish you very good health for the future.

  • Dr Fiona Cockburn

    8 January 2013

    Megan, you have been an example to us all with your positive attitude and boundless cheerful energy since you came back to work, and this article confirms you will be a superb doctor.
    It is a pleasure to have worked with you and I hope this teaches us all about the important little things which make all the difference in the world to patient care.

  • valerie Hargreaves

    8 January 2013

    Well done for taking the time to share your experience. I have also experienced the patient's side of hospital life and feel that all NHS staff would benefit from being immobilised in bed, dependent on others help and being talked over as they lie in bed ( maybe for 24 hours as part of training. I certainly do not wish real ill health on anyone)! It would be a real eye-opener to many as it is a very disempowering situation to be in and with real ill health also frightening and frustrating compounded by recent changes which see different doctors and wards dealing with the patient making information hard to get and relationships with staff impersonal.

  • Dorothy Warrington

    8 January 2013

    I hope it is not too cliched to say that "the only choice we have is to decide what to do with the time available" , you have used your time well. I hope you are my doctor when I need one.

  • Fred Hasenfuss

    8 January 2013

    Retired GP,have acquired >15 active medical problems..most empathetic
    recent carer was a medical registrar in Doncaster who had recovered from a serious illness .I felt able to relax and let them get on with the treatment
    due their understanding and demeanour.
    I would not wish illness on any one,but it seems to improve the
    Performance of those able to return to work.
    I worked for 10 years after I was first ill.Slowing down the pace of
    consultations & listening more carefully improved how I felt & seemed to do the same for patients.good wishes to all poorly medics.F H.

  • Jayne Cockburn

    8 January 2013

    Congrtulations on getting through the chemo. no mean feat.

    I enjoyedthe universality of relative denial and the taking in of books and plans, the need for kindness and honest communication. Been there got the Tshirt and made the video!

    It seems a shame we have to go through these expereinces to learn what should be assimilated in basic and continuing training. Too many docotrs say thier humanity for want of a better word was trained out of them as they learned to be defensive, fit in the medical mold and please the bosses with bosses not able to understnad that there are better ways.

    I wish you luck for your career. your expereince will make you a much better docotor and that will improve things like patient complaince etc because they can communicate better. However beware, many doctors and other health professional do not understnad the life changing expeince and attitude change and may find you threatening dismissing you as part time, caring too much as 2 examples i can think of. Do stick to your values and welcome to the club of people who contribute similar articles once they have been a patient. Its full of great doctors. joon the fight for bio-psycho social medicine to try and take in all of the patient issues

  • Rosie

    9 January 2013

    I too have been a "poorly medic" and agree it is very enlightening, you learn which procedures are the least pleasant and that HOW things are done really matters. And I am incredibly grateful to those doctors who didn't make assumptions, who stopped and thought how I was feeling, who took a little extra time when they were clearly busy. But the other thing I value, is the time it gave me to live life at a different pace, to reflect, to talk and spend unpressured time with my family, my parents, brother and sister. And it also made me realise how hard it is for those closest to you, a timely phone call and consideration from staff for my husband made a big difference. So it has altered my attitude to how I deal with relatives (my own and others!) as well as patients.

  • Arjun Samuel

    9 January 2013

    Dear Megan, I'm sorry to hear of your ill health and best wishes for a speedy recovery. I to have been on the receiving end of the scalpel, once for a fractured ankle and the second for arthroscopy. It is an eye opener when you are at the receiving end.

    You'll be an amazing doctor by the sound of your email. Keep your chin up and good luck in your career.

    Warm regards

    Arjun

  • Karen Richard

    9 January 2013

    Good luck and good health for the future!
    It is an interesting thing that in order to get into medical school, pass exams and progress through postgrad medical training is physically demanding and therefore it is difficult for most doctors to know how it feels to be ill. I suppose that is what you mean in your second last paragraph. Best wishes, Karen Richard

  • Dr Sara Khan

    17 January 2013

    Dear Megan,

    Thank you for sharing your story- you are a real inspiration.

    I'm Editor of a magazine produced by the Medical Women's Federation called Medical Woman; and we have been impressed by your story and writing.

    We wondered if you would be interested in contributing to Medical Woman, which is being re-launched in the next few months?

    If you are, please drop me a line- doctorsarahkhan@gmail.com

    Best wishes for the future,
    Sara

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  • Dr Jackson

    18 April 2013

    I agree with your sentiment that the experience of the other side of the fence is a warped kind of privilege. Don't worry about forgetting. I had cancer 14 years ago. The fear and anxiety for your own future will fade but the lessons you have learned will never go away.

    Thank you for your blog and enjoy your seconds of happiness

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