Thursday, 9 August 2012

Caught in the Middle

I spent 24 hours in the local surgical admissions unit this week getting some much needed IV fluids and continuing my search for the perfect anti-emetic.

I'd spent quite a lot of time on this ward during placement and I knew a couple of the junior doctors. The staff all knew that I was a medical student (every medical letter written about me begins 'this 24 year old medical student' but that's a whole other post) and so (curtains not being soundproof) did the other women in my ward.

In this way I am never just a patient, I am a patient that is a medical student. It comes with certain expectations - I will not complain when things are delayed because I know how chaotic it is to work a receiving shift, I won't go out for a cigarette with the others, I will be a good historian even at midnight when I'm really sick. From the outside those expectations look different I think - my roommates couldn't believe that as a medical student I wasn't given a private room for example.

In the same way, now I use the wheelchair and am in other ways visibly impaired I am never just a medical student. I am a medical student that is a patient. Some consultants think this gives them permission to ask me intrusive personal questions 'so what's wrong with you then?'. Others think that this will make me super-empathetic towards patients or that I chose to be a doctor because of my experiences as a patient.

There is overlap and divide between these two identities.

My experience as an acute patient was also very different to my roommates for another reason - they were otherwise pretty healthy. To them this was an acute episode of ill health which could be expected to resolve completely. To me it was an exacerbation of an existing condition, which had a knock-on effect on my other conditions. I couldn't take the first two medications suggested because they would interact with my other meds. The hospital could not cater to my complex dietary needs. I had to try and rest without the special cushions that I have at home to hold my joints in place overnight. Hospitals are not designed to care for patients with complex chronic conditions, with the possible exception of well-run care of the elderly units.

Our expectations of treatment were a lot different - they were expecting to be all better by the time they went home. I left as soon as my symptoms reached a level where I knew I could manage at home. When I told one of them that I had experienced moderate to severe nausea constantly for over a year now she was completely horrified.

I just don't know how to integrate my experiences. How to use my medical knowledge without irritating my doctors, how to treat patients better because of what I've learned from being sick. It is a work in progress and I imagine it always will be.


  1. Hello!

    I read your blog on and off when I need to be inspired, its brill!

    You say you don't know how to use your experiences to help your patients, but you said it perfectly in a previous blog - "Then we had a discussion (yes, a real discussion where she listened to me and everything) about...." That's the important think - listen and discuss - as much as my doc is good, sometimes he doesn't listen and takes the easy symptom to fix, rather than listening to everything that is going on leaving a clutch of symptoms that won't fix.

  2. Thanks for commenting =] I am really trying to listen carefully to patients - especially to what the thing is that is affecting them / scaring them the most. Also trying to make sure everything is explained - I hate when my docs do things without telling me!