In January this year, I found myself staring at a CT scan with a group of people in white coats. This is a pretty normal thing for a doctor to be doing; except I was in Mexico and the CT scan was my own, and I was wearing a hospital gown instead of a white coat.
Medicine is a strange creature. Even though it has let go of much of its paternalistic nature, an element of it still lingers in the way we practice today. We are much better at involving patients in decisions regarding their health and we (try to) embrace the concept of patient autonomy. However, there is an ever-present air of exclusivity in the knowledge we possess, and a culture of “the doctor knows best” remains. We still stand at the foot of patients’ beds and talk about them rather than to them. We oversimplify when explaining diagnoses, we frown when patients ask to see their folders and we get impatient when they ask too many questions. Often we forget that they are real people with minds of their own, and life-experiences of their own, and feelings of their own. They are lawyers and teachers and plumbers. And some of the time they are even doctors. Doctors who have become patients. Like me; lying in a hospital bed in Mexico, being prepared for surgery and feeling what it’s like, for the first time, to be on the other side of the scalpel.
I think its generally well recognized that doctors make the worst patients. They just know too much and ask too many questions. It always feels like they are watching and judging and taking note of everything you do. Having a doctor as a patient forces us to be on our best behaviour, and have all the answers ready at a moment’s notice.
I wasn’t like that at all. I think I was too shocked by the role-reversal I had been plunged into that I forgot I was a doctor at all. Initially, everything was a blur.
“We’re going to do a CT scan”
“You need emergency surgery.”
“When was your last meal?”
The only time I spoke up and sounded even a little like a medical professional was just before they put me under anaesthetic. Staring up at the blinding theatre light I asked when I was going to sign consent. They all laughed; “You have already signed it.” I remember thinking, “I have no idea what I signed. I hope I wake up with two kidneys.” And then nothing.
Two hours later I did wake up with two kidneys and only then did the reality of my situation set in. I was a patient. Yes, I was a doctor, but I was also a patient. It was a strange reality.
I remember trying to be overly helpful toward the nurses. But I probably annoyed them more than anything else. I knew all the little things that would make their job easier and I did them all. I positioned my arm just right when they had to re-site my drip, I made myself as light as possible when they had to change my linen, and so help me God, I refused to press that call button.
And when the doctors did their rounds, standing at the foot of my bed speaking Spanish, I stared quietly at my feet and realized how my own patients must feel when I present their cases on ward rounds in full medical jargon. “Mrs X, 61-year-old hypertensive, insulin-dependent diabetic, HBA1C 8.7, with stage 3 CKD. Now biventricular failure secondary to hypertensive cardiomyopathy precipitated by worsening anaemia.” I may as well be speaking Spanish. Fortunately, my doctors were brilliant and they communicated everything to me in English. They took the time to make sure I understood exactly what they were saying. The nurse who could not speak English even went as far as to download a translation app on her phone. It was such a relief.
So I listened carefully to the doctors and tried to be a model patient for the nurses. Except for one little thing. For my medically-trained readers, you know that one annoying guy that just cannot seem to get out of bed and start walking post-op; the one that complains that they feel weak or dizzy or have too much pain? I was that guy! I couldn’t maintain a blood pressure long enough to sit up, never mind stand. Every time I tried to get out of bed I fainted. Eventually, my doctor decided the pain medication was to blame and had to go; but then, of course, I could feel everything! Every contraction of my stomach muscles was agony. From turning over in bed, to lifting my legs, to simply standing up straight. And laughing! Someone managed to drag a laugh out of me on a video call… The laughter very quickly turned to tears. The pain was unbearable. After 48 hours I did manage to get out of bed and hobble around, hunched over like an old lady. It took me twenty minutes to undress and another twenty to shower. I developed a massive amount of respect for patients who have C-sections and then get up a few hours after surgery to tend to a crying baby, and I will forever have a little more patience for the ones who take a bit longer than usual to find their feet.
My experience as a patient really opened my eyes as a doctor. Being a patient is difficult. It’s frightening and confusing and lonely. Worst of all it is immensely undignified. I hated being dependent on strangers for my basic human needs, like washing and dressing and using the bathroom. I hated not being able to walk to the bathroom without someone standing by my side. I hated that far too many strangers had seen me naked. In fact, they had seen much more than that. They had seen inside of me; they had seen parts of myself that I have never even seen.
The experience taught me many lessons, including a few professional ones:
- Understanding what was said about me and my body made all the difference in making the whole experience slightly less overwhelming. I learnt that my patients need to understand what I am saying about them.
- Medical professionals are so blasé about nakedness and bodily fluids and the usually embarrassing bodily functions that we all possess. But patients are not. I learnt that I need to remember and be sensitive to that.
- I learnt that pain is truly a personal experience. I also learnt that pain can be physical or emotional and that one sort can compound the other. If a patient tells me they have pain I need to listen. Pain also doesn’t have a timeline. In fact, I still feel twinges of pain in my scar months later.
- Most importantly, I learn that patients are people first. Just as we like the world to remember that doctors are people first; we need to extend the same kindness to our patients.
Honestly, my experience as a whole was easy because the doctors and nurses at the Blue Net Hospital in Cabo were incredible. When I tell someone “I had to have surgery in Mexico” they immediately think it must have been traumatic. But it wasn’t at all and the medical staff’s kindness and patience and professionalism made all the difference. They turned a potentially horrifying experience into a bearable one just by treating me with dignity and respect. And for me that is the greatest lesson of all: The way I treat my patients can make all the difference. Not whether I can fix their pain, or cure their illness, or even save their life. As Dr Edward Trudeau said, “Cure sometimes, treat often, comfort always”. If I had to become a patient just to learn that then it was worth it.