Thursday, April 28, 2016

Empathy, or the lack thereof.

 In my final term of the year, I am finally in my first ever Medical Rotation. And I started this when the Junior Doctors are on strike. Great. Honestly, it's great, because I get to do most things the juniors do, under the supervision of consultants, who usually don't even acknowledge our existence in the wards. So, it's so great for our education!


I was in Neurology clinic this morning. My first ever encounter with clinical neuro. It was really strange yet very interesting at the same time. The patients came in with epilepsy, migraine, headaches etc, just like how I read in the textbooks before. However, the strangest part of the whole morning was this consultation...

The patient had been experiencing difficulty walking and blurry vision, twice in 3 years time. Before she came in with her family, the consultant and I had a look at the MRI scan of her brain. 

'Look at those plaques.' It wasn't great.
'Does she has a diagnosis yet?' I asked, 
'No.' Then she walked out to get the patient in. 
I thought, No...this is bad.

The patient came in with her young family, all cheery and happy and agreed for me to be present while the consultation went on. She smiled. I forced myself to smile back. I thought, this is really bad. Does she knows? Is she suspecting? Will she walk out of this room the way she walked in?

The consultant smiled and carried on doing examinations, as if she does not know anything. Everything went on smoothly until the examination ended and everyone was back at the desk. I felt very strange throughout the whole time. I kept asking myself, how would I feel if I were in her shoes? Young family, strange symptoms happening to myself, confused, probably desperate for an answer, nah, I hope it's just something trivial. 

'Remember you had an MRI scan?' the consultant said. 
'Yes, how was it?' she replied. 
'From your history, your examination and your scans...It seems very likely that you have Multiple Sclerosis.' 
The air was cold, dead silent then. Even the baby was not making a sound. 

She started tearing. I grabbed some tissue for her immediately, having observed how the nurse reacted the last time I saw a consultant broke bad news to another patient with breast cancer. The consultation went on with her prognosis and treatment options. The patient went out slightly more composed, but I could see she was very fearful at the end. 

I was not quite sure what to feel. I was constantly battling between 2 different point of view within myself, throughout the consultation:
From the medical point of view, the consultant knew from the beginning what was happening and what will happen. She will get the diagnosis, then she will treat it the best she could and the MS should be under control, given she had RRMS. Job done. At one point, I almost could not understand why is she crying. I thought, don't have to cry, you are not going to die, at least, not that soon. There's a cure, MS is super common, I just saw several patients with MS before you. You will be fine. 
Then I put myself into her shoes: Omg, I am freaking scared, with all the news and things happening to people with MS! Will I shrivel up, stop breathing and die? Will I be wheelchair-bound? What will happen to my baby?! I want to watch him grow! 

I realised how my perspective and state of mind change as I learn more about Medicine. We see so many very very ill people coming in day in and day out, it's just seems normal to be very ill. The same for death - a dead body was pushed pass us on a trolley the other day and we continued to talk about the patient we were about to see as if nothing happened. A life just passed away, for goodness sake....

But...we don't live with those diseases and we have never experienced most of those diseases before, it is very hard to imagine how does it feel like. 

During our Clinical Communication Skills session, we were told to empathise with our patients, whom we have never met before and many with diseases which we never even heard before. I really don't know how medical students like us, 20-something years old, who barely have enough life experience or children of our own, can truly empathise with our patients. We can offer our utmost sympathy, but to empathise?

As for now, to expect us to offer empathy, as it is defined, will take more time, more experience and more deliberate effort to put ourselves in others' shoes in our every day life. 

No comments:

Post a Comment