It’s ironic that I am writing on a daily basis now when I barely paid attention in English classes and did not even do English in my last year at high school. I had a bad attitude back then and scoffed at having to read Hamlet, 1984 and Brave New World, choosing instead to read Alan Moore and Dave Gibbons’ Watchmen. Interesting that I can still remember all four books 31 years later.
The same applies to behavioural science lectures during medical school, I didn’t realise that upon graduation that a lot of the psycho-social-spiritual-cultural stuff covered in those lectures would be much more important in my day to day work life than the physical stuff. My training was in the traditional biomedical reductionist style. Medical school takes a young tree hungry for growth and knowledge and whittles it down to a sharp but prickly toothpick, with an ego the size of a man-made forest developed along the way.
I graduated from medical school thinking that I was born in the wrong era, that I would rather have been born in more paternalistic times, when the doctor called the shots. As an example of my poor attitude I disrespectfully mislabeled informed consent as informed dissent. I became annoyed when patients would not follow advice, thinking ungenerous thoughts when they would come back to hospital again. I was a product of my training, and it worsened as I progressed through the ranks in hospital.
It wasn’t until my first time working outside of the hospital environment that I realised that in the real world of the community things are much different. The power that the doctor has in the hospital ward, emergency department, or clinic setting is taken for granted. The power dynamic in a patient’s own home is much different. It is their place of power, and they call the shots. They can choose whether or not to take the doctor’s advice, or to fill the prescription. Strangely enough us doctors are not the most important thing in their lives at any given moment. People actually have a life to live outside of the brief times that they see their doctors.
Over 22 years I have grown up and learnt a lot from the patients and families that I have encountered. They taught me how to become a better doctor, and also how to become a better person. They trained my ears to be able to listen actively, with my whole brain engaged and focused on their moments of need.
My patients have given me so many treasured memories, and in Bedside Lessons I will share a selection of the ones that really made me change my thinking. The situations that transformed me from an immature paternalist-wannabe into a psycho-social-spiritual-cultural-patient rights and autonomy advocate/activist. My patients have taught me that doing the right thing is not at all easy, and that at times it can be very, very hard.