Monday Morning by Natasha Khalid (guest writer)

8:00 AM: Monday mornings are generally abhorred comprehensively but they are gloomier if you work as an intern. However, for me, this Monday was an anticipated work free day. Hence, not too sad. I had spent a long time on the breakfast table catching up with friends and then later grabbed my books and went to the library to catch up on my studies. However, this happiness was short lived and in the afternoon I was called to assist in the clinics and a day of no work turned into work again.

2:30 PM: I grabbed coffee and rushed to the clinics, began my job of taking a detailed history of the patient. The patient was a twenty-year-old plain looking girl who didn’t talk much and replied mostly with a yes or no. I started my usual work, asked her questions pertaining to her disease, did a thorough examination and then the hardest part of listing possible differentials and chalking out a plan for treatment. I did my work, stepped out of the room and discussed the case with a senior to be sure of my diagnosis and then I began brainstorming about the possible things I could be questioned about. I was rotating in neurosurgery so my knowledge of the various neurological diseases at this point was not apt and to keep up with the impression of being a good clinician I resorted to Google and read up on a few syndromes to boast off my knowledge. Just to be sure, so that when asked about the disease the patient has, I know exactly which gene is missing on which chromosome arm, what signs and symptoms it can possibly present with, what possible treatments are available and the prognosis. I did my best and read up much as I could in 10 minutes.

3:00 PM: When my consultant arrived, I confidently presented my case and everything went smoothly. Patient was a twenty-year-old girl who was diagnosed with a brain tumor at the age of fifteen and ever since then she had undergone multiple surgeries and therapies to recover. At this visit she was doing well on medications and we decided not to alter treatment.

3:15 PM: To my surprise the consultant agreed with my plan. All that I had worked hard on for the past twenty minutes. However, in between, my consultant asked me “So, did you ask the patient what she does?” And here my past few minutes of hard work melted away and I couldn’t answer because I didn’t bother asking. I was so busy thinking about what she has, how it was treated and all those textbook details that I need to know about her disease, that not for a second I thought I should have chit chatted a bit to know how she is doing otherwise. 

“Beta [Child], this girl has been through so much at a young age, at least ask her if she studies or does something to keep herself busy?” said my consultant in a displeased manner.“Take some interest in the patient” he added. And then we asked the patient about her personal life, I was amazed to find out that she had resumed education and was now in a diploma program.

4:00 PM: It was at this point that I realized that we, as doctors, are so absorbed in the disease, that we treat the other person as an object and work on getting every single detail right, from diagnosis, examination, treatment and prognosis, that we neglect the fact that the person we are examining deserves a little extra attention and conversation too. By saying so, I refer to the conversation where you ask about what they do, their hobbies and education; questions outside the sphere of clinical history. Just casual conversation that we often have with strangers at any social meeting. In the process of healing, medicines do play a pivotal role but so does the mind and creativity.

The fact that people who are diagnosed with a critical disease at a young age find it hard to catch up with their peers and this results in depression. Staying in a healthy mental state is the crux to therapy no matter what the illness is. It is indeed vital to converse with the patient and find out about their personal lives.

It is after this incident that I make it a point to know what the patient does in his personal time to keep himself busy or what he aspires to do. Not only has this improved my patient-doctor relationship but also clinical skills.

[from Narrative Medicine]

CREDITS:

About the Author: Natasha Khalid, is a Research Associate in Obstetrics Department. She runs her own blog on the side, along with contributions to express tribune and other magazines as a hobby and out of passion for writing . 

Editorial Note: This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20^th, 2016. The editorial work was performed by the Writers’ Guild, an interest group at AKU, with the purpose to promote love of reflective reading and writing, within and outside of  AKU. 

     

DISCLAIMER: Copyright belongs to the author. This blog cannot be held responsible for events bearing overt resemblance to any actual occurrences.