It’s Christmas – the season of Goodwill, and presumably also of Loving and Caring. Over the past year there was lot of talk about doctors Caring and, more recently, even Loving their patients.
Consequently, The Witch Doctor has been doing a bit of Christmas naval gazing and considering whether, over the years, she has loved or even cared about her patients. She has also considered what a “heart-sink patient” means to her.
Even at the best of times, love is a difficult word. Apparently some languages have several words describing various kinds of love but the English language is stuck with one and that is probably where the difficulty arises. So The Witch Doctor, not being multi-lingual, thinks she should avoid “love” when it comes to patient care. Anyway, what if you loved some patients and not others? Would you have favourites among your patients? Would there not be a danger of prioritising your time to spend more of it with those you loved? Would there be a tendency to neglect an unloved patient? Would The Witch Doctor feel guilty if she found she could not love some of her patients? If love-like emotions arise and be acceptable regarding patients then would it also be acceptable to despise a particular patient?
No, The Witch Doctor neither loves nor despises her patients. Her training somehow or another has seen to that.
Does the Witch Doctor care about her patients?
She recollects that over the years there have been times when she definitely did not. I can tell those of you who have never experienced sleep deprivation in significant amounts, that caring goes out the window when your head has not touched a pillow from Friday morning until Monday night in a hospital where “on call” means working flat out. Sleep is the only thing you care about. It is your professionalism that drives you to attempt to look after patients properly in these circumstances. It is what you were trained to do. It is what is expected of you. Caring takes patience, and patience takes time. Caring also needs time to rest. The NHS, as The Witch Doctor has known it over the years, is bereft of time allocated to certain individual patient’s needs and in years past did not acknowledge a doctor’s need for rest.
Also, caring is related to love. Caring means the pain of devastating sadness when someone suffers or dies. It means grief. The Witch Doctor is not devastated when a patient dies. Perhaps she could become devastated sometimes but she would see that as a kind of self-indulgence that stood in the way of her job. Somehow or another her training has seen to that.
So what was The Witch Doctor trained to do?
She was trained to empathise with all patients whatever their circumstances, to help each one to the best of her ability, to keep her abilities up to date, and to identify and highlight when, because of various constraints, she is not able to help to the best of her ability.
That’s all she has ever tried to do.
Who then are the “heart-sink patients?
To The Witch Doctor, they are the ones that she has neither the time, nor ability, to help properly.
Often a heart-sink patient is simply one who needs to talk a lot and who is difficult to interrupt. GPs apparently are taught in their training how to put an end to a consultation that is taking too long. Close the case notes, get up and walk towards the door etc. The Witch Doctor does not have the benefit of a GP training and she finds it difficult to end the conversation with a patient who wants to express themselves profusely. Appointment slots do not reflect the time it takes to consult with these patients.
The Witch Doctor, however has a way of dealing with this situation that no computer generated appointment system can ever do. Doubtless her method would be frowned upon by GP training schemes up and down the land. Over many years she has given her heart-sink patients the very last appointment in the afternoon. Then they can talk away to their heart’s content without the doctor’s heart sinking over the queue of patients accumulating outside. Occasionally The Witch Doctor has found herself literally locked in a clinic room (as in key turned in door) with a patient well after 5.00pm. She has found the drama associated with this an excellent way of ending a consultation.
Merry Christmas to you all including heart-sink patients everywhere.
a red apple ……………………
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