by Charlotte Ralph
I've been under the shared care of three consultants for six years now following a diagnosis of Hodgkin's lymphoma and subsequent stem cell transplant.
My main consultant is the most personable, caring doctor I've ever met. She greets me with a hug every time she sees me and would always well up when imparting bad news, even made my parents a cup of tea when things were really awful. An absolute heart-on-her-sleeve lady.
Meanwhile, I really struggled to develop a rapport with one of the other consultants. I was always glad he wasn't my main consultant but I saw him many times on ward rounds when I was an inpatient and sometimes at clinic appointments. He was always professional but distant and cool, and my family and I found him very hard to read (you're always grappling for any life-raft of hope they may throw you, but he never gave anything away).
The transplant team doctors are extremely strict. If, after transplant, they could send you out into the world wrapped in cotton wool for ever more, they would. Huge resource goes into carrying out a stem cell transplant, so understandably they expect you to adhere religiously to some very stringent rules. This is to keep you safe and give you the best chance of a good outcome - no tap water, raw vegetables, wearing contact lenses, mixing in crowds to name a few! I'm a total teacher's pet and always eager to please (and was also, of course, desperate to get better) but even I lapsed once or twice. Usually this took the form of eating something that was off limits (not in rebellion but because I didn't realise). I had a couple of real dressing downs from this particular doctor when I accidentally didn't comply and suffered the consequences as a result - and was left with a feeling that he didn't approve of or believe in me.
Last week I went to the hospital for my routine clinic appointment. I felt a bit downhearted to find out when I got there that it was this doctor running the clinic. One way or another it had been several years since I'd seen him. I can remember the last time - my lung had collapsed and things weren't looking good.
When we sat down in the consultation room yesterday he was formal but courteous as always. He went through the usual routine (how's my skin, my bowels, my joints, my breathing, listened to my chest, shone a torch in my mouth... all things that are affected by transplant). After all this he stated "my impression is that you are well and you are stable." Then he said "it's been several years since I've seen you, you were very unwell the last time. Seeing you today has been therapeutic for me. You're my last patient today and this clinic has ended on a high note for me." A big warm smile spread to his eyes above his mask.
Even typing this brings tears to my eyes, it's hard to explain why it means so much. A realisation that all along he was so invested in a good outcome for me that it feels therapeutic for him to see me better?!
What seemed his distant approach I realise now is probably his means of protecting himself. Working with patients who are absolutely dependent on you for their survival, who may very well not survive, who spend weeks and months and (if things go well) years in your care must be a heavy burden to bear. It's easy to forget that doctors are only human and ways of coping with this depend on the individual's personality and circumstances. In this doctor's case, keeping patients at arm's length emotionally may well be what enables him to do his job. Or perhaps my personal case was triggering to him in some way, who knows? Either way, in hindsight I can understand his despair at a patient inadvertently risking their life as a result of a silly mistake.
I was so happy to see this doctor's humanity, and even vulnerability yesterday and to reflect on this all with a fresh perspective now that I'm more well and life is easier.
Comments