Sunday, 11 December 2011

Colourless, green, yellow or black?

Can you guess what I'm doing at the moment?  I am about to start my final week on a respiratory outpatients SSU.  I had been thinking that maybe respiratory could be the speciality for me and whilst I have enjoyed these two weeks, but now I've done a little - nope.  Another speciality choice crossed off the list.  It has been the most depressing couple of weeks.  It is probably not the most depressing - oncology, palliative, I can see those as being sad; I would go into them prepared.  This was an ambush of sad.

First patient of the day comes into the room, consultant looks at the scans.  We are sat behind the consultant staring in awe at the proceedings, not quite believing we are in an actual hospital seeing actual patients and trying really hard to look like we've done this loads of times before and sort of know what we're doing.  The consultant has quite a thick accent so I find I have to concentrate a lot on what he's saying to understand it.  What gives the game away though is the look of utter shock on the patient's and their relatives face.  The look someone gets when their whole world falls apart.  That the shortness of breath their loved one has been feeling and the slight cough is actually ideopathic pulmonary fibrosis and there's nothing that can be done.  That they have about 2-3 years left of increasing shortness of breath and decreasing quality of life as the fibrosis rips through their lungs, spreading like cancer.  Repeat this for two clinics a day for two weeks with one and a half days of to work at the GP's and that's my last two weeks.

The consultant was explaining to a patient that they could be put on this experimental anti-fibrotic drug.  It isn't licensed yet and the drug company will give it to the hospital for free to so that if it does end up being licensed the hospital will be more willing to pay for it because they have patients on it already.  The drug may not work, but you might think it's better than doing nothing.  The patient looked at me and asked what I thought they should do.  I had no words.  As they left, the patient thanked me for my time, patted me on the shoulder and told me to enjoy my life.  I know that death is a big part of being a Doctor.  I'm not naive enough to think that everyone can be saved.  I just wasn't expecting to meet it so soon.

A patient was seen with a whole list of problems, but they are happy, up beat, they have a strong family network, they still do things, but they'll be dead in 6 months.  It's incomprehensible   It just makes me want that parallel life with me curled up with mr on a big comfy sofa in front of a roaring wood fire with a couple of dogs and cats lying about the place.  I want my life now, I don't want to keep waiting for it.  It doesn't help I'm currently trying to write an essay on work life balance (as in my lack of one and the changes I plan to make to get one), and that January is creeping ever closer.  In January mr starts the longest period of time we've ever been apart.  He goes from being far away, but not too far that I can't go visiting some weekends, to ridiculously far away.  He's not going anywhere scary, but he is going far away for roughly 98 sleeps.  We don't have the exact dates yet.  Thank goodness for whoever invented Skype.

It might be a little hard to believe from the way I'm moping, but between writing this post and the last I did cheer up considerably.  I had one of those special moments girls get when they go clothes shopping and realise they've dropped a dress size.  Fantastic feeling.  I also finished all my Christmas shopping, I just have to put a few more coats of varnish on things I have been making for family presents, finish writing the cards and I am done.  Tomorrow is home visits and the cancer clinic.  Psyching myself up for it with hot chocolate and biscuits.


Audrey1119 said...

I know how you feel. Nothing can prepare you for real person whose life dramatically changes in front of you. Suddenly it's not just science, not just pathology or case, you actually realize that it's someone's life. Or death. That is what bothers me, too. And I was also very unprepared when I had to face that situation. Look that a woman gave me when she learnt she had hepatocellular carcinoma. I don't think I'll ever forget it. Or coming back to hospital after weekend and our "favourite" patient is no longer there, he died on Saturday and now there's someone new there like he never existed.
I have no idea what kind of coping mechanism doctors develop for these situations, maybe it gets easier when you remember all those patients you actually were able to help or knowing that you did the best you could.

3rd time lucky said...

Gosh! Sounds so sad..but I guess thats the harsh reality of being a doctor and its something that you'll face time and time again. Just think of the amount of lives you will be saving, that for me is priceless.

Sophie said...

Pretty much all of medicine is sad- I'm on a psych rotation atm, and it's depressing to see how mental illness can screw up someones life. In the way that you didn't think resp would be sad, I didn't think psych would be this bad!