Wednesday 5 February 2014


There are a few moments that I can pick out of the last few years which have really defined for me the kind of doctor that I want to be. This happened one rainy summer afternoon, while I sat in the corner of a clinic room and watched. You do a lot of watching as a medical student - watching and listening, picking things up from the doctors, trying them on for size - a phrase, a way of asking or explaining.

The striking thing about that afternoon was that we had two patients, both women of a similar age, living with the same condition, affected by it in a similar way.

The first lady was explaining that because her mobility was getting worse, her family had bought her a wheelchair and were pestering her to use it - not all the time, just for days out. They would get frustrated with her when she would insist on walking, slowly. Walking to her was independence and freedom - she recognised that one day soon she wouldn't have a choice, but for now she was refusing to use it.

The doctor listened to her, and nodded and told her that she was doing a great job advocating for her needs and wants to her family- that she should continue listening to her body and doing what was best for her health and wellbeing.

The next lady told us that because her mobility was getting worse she had bought herself a wheelchair - not to use all the time, just for days out. She was frustrated with her limitations on foot and felt that the wheelchair gave her back her independence and freedom. Her family were embarrassed that she would use a wheelchair when she was able to walk and kept trying to persuade her not to use it.

Again the doctor listened and nodded. He told her that she had done really well listening to her body and finding a solution that was best for her and encouraged her to keep talking to her family about how the chair was helping her.

This encounter really struck me - obviously, sometimes in medicine there is a right and a wrong answer - a specific treatment to fit a specific diagnosis. Often though - more often then I ever anticipated before starting my clinical placements - there are choices to be weighed and decisions to be made. A knee replacement may improve your mobility, but there are risks and complications and recovery to consider. Warfarin might help prevent stroke in AF, but if you're prone to falling over and knocking your head it's probably not the drug for you. We have guidelines and risk calculators, we can draw pros and cons lists, we can advise and suggest, but at the end of the day it's the patient's decision.

And people want to know that they're making the right choice. They ask what we would do if it were us - and I'm drawn back to that room, that afternoon - listening to your body and advocating for your needs and finding the solution that is best for you.

As a patient, it is really important to me that doctors affirm my choices about my health and the hard work that I put into staying healthy. I think that's because, in doing so, they see me as a person and not a diagnosis.

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