Aperture…

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The photo circulating around the internet, that one of the doctor crouched down outside reportedly weighed down by the grief of losing a patient… 

I swear I have seen that photo somewhere before. Years ago. Maybe it is just because I relate. Maybe I saw something like it involving another physician. Dunno.

I am glad that this is out there but to be honest it has bothered me on some level that it took a photo to get people to talk about doctors caring.

Yes, we do feel.

Sure, you don’t see that as a patient. In a crisis you don’t want your doctor breaking down, overcome with emotion. We push it back, bury it. We have to so we can do our job.

Then afterwards, we have guilt. We weren’t good enough. What right do we have to something so selfish as our own grief? That was not our family member. 

And so we go on. And on. And on.

Our families don’t understand. 

Our friends do not understand. 

And our colleagues are too busy or too burdened themselves to share our load…

It’s what we signed up for, though. We knew it wasn’t going to be easy. So we might indulge, give ourselves a minute or two out in the cool night air, or maybe not. We shake it off and keep going and pray that it does not take our soul in the end.

I hear from people here and in my real life how generally awful doctors are, how I must be so unique. I don’t believe it. I am not special. There are so many out there who care, who give their lives to this profession. 

We all have different personalities. Patients have different personalities. Diversity is good. Some like a touchy-feely emotional doctor. Some like the reticent, to the point type. Maybe they want something somewhere in between. I have been both cussed out and complimented for being so “perky”. No single person can be all things to all people. 

Are we all perfect? No. Do we have bad days? Yes. I certainly do from time to time. Are there bad doctors? Sure. Do good doctors do bad things? Absolutely. We would all be fools to think otherwise.

So in the end, what am I trying to say? Our humanity makes us vulnerable to imperfection even as people are searching for our perfection. Keep your heart and mind open. Look for the light instead of the dark. It is there, I promise.

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111 thoughts on “Aperture…

  1. I have seen the pain in my doctor’s eyes when he tells me bad news. I believe you.
    But also, that makes me believe in him when he tells me that there is no need to worry about other things, especially as a mother. It gives me confidence in him. He is a person.

    Liked by 1 person

  2. I knew and know many doctors. I think that at least 75% of them were and are excellent, caring, skilled professionals. I also want to clarify one point: in the Soviet Union (I lived there 40 years) doctors had small salaries. Family doctors went to visit patients, during a day they climbed many floors in buildings without elevators. Still they managed to be cheerful and caring.

    Liked by 2 people

  3. Thank you for posting this!! I hope to be a doctor one day, so it’s nice to hear an honest opinion about how doctors are perceived. I would hope to be identified as a good doctor who does good things. But like you said, there’s a lot of other doctors out there who don’t follow that mold and I think it’s good for everyone to understand that doctors are humans too. I guess they just can’t afford to make as many mistakes as other people can…

    Liked by 1 person

  4. I’ve had a number of good doctors who have shown they care about their patients – it’s in their eyes when they speak with you. it’s never wrong to care about another human being.

    In some ways, I guess veterinarians have it easier. I’ve had two of them cry with me after having to put down morbidly ill pets. No one expects, or wants, people doctors to break down. I don’t know why that is.

    Liked by 1 person

  5. Having been a frequent patient for so very many years, I really think that doctors are more willing to be caring now than they used to be. They used to feel the need to be god-like. Now they need to be the more knowledgeable guide as patients are expected to participate more in stead of just following the doctor’s orders.

    Liked by 1 person

  6. thanks for writing this… indeed, people forget that as health professionals we are human too. i too am surprised by people’s responses on my blog, when people comment with “there are few nurses that care, thanks for being one of those few…’ because of their previous negative experiences in the hospital or healthcare setting. it’s sad and sobering at the same time, but reminds me to keep on blogging and sharing about what it means to grapple with life and death daily.

    write on…
    write on. =)

    Liked by 1 person

  7. I am always so happy when I see your new posts in the “Reader”.
    I am not a physician, I am a Pediatric Nurse Practitioner. I have been working in Pediatrics for almost 30 years, which seems crazy to me. But I remember every single patient that has succumbed to their illness, or their traumas. I like to say I have a slide show in my mind’s eye of all the patients I have lost, and those faces pop into my head when I least expect it. Maybe when I am in the garden, folding laundry, or even watching my own children, those faces and their stories are there – they pop up like a fishing float bobs to the surface. Thanks for the beautiful post!!!

    Liked by 1 person

  8. What an honest post, Victo! I worked as an NP in psychiatry so knew many caring docs. We had more time than the regular 10-15 minutes with patients, and could include pschotherapy. The patients I lost while in nurses training (50 + years ago) are the ones I still remember. Christine

    Liked by 1 person

  9. For over twenty years I had the same doctor. Then one day when I went in to see him he talked to me as if I were on the other side of the desk. He talked about all the poetry he had written and how just the day before he had burnt it all in the back yard incinerator. I don’t think at the time I was witnessing a person actually having a breakdown. But we talked for about an hour and his patients were backing up. He stopped working that week and I later learned that he gave up working for a number of years but then went back to part time at the local Aboriginal Centre. I now see one of his colleagues and we often mention him. He was very much loved by his patients and his work mates. He cared and cared too much and it nearly killed him.

    Liked by 1 person

  10. Your blog has actually made me see the human behind my doctors much clearer. It is easy to lose that perspective in the news they deliver or the problems I take to them. Thank you.

    Liked by 1 person

  11. Hey Victo,

    A fascinating read on many levels, least of all because of your touching honesty and forthright openness.

    I do not work in a medical role or similar practice, but occasionally in my job I am asked to deal directly with highly vulnerable individuals, often with prevailing mental health conditions and acute physical disabilities who are also haunted by suicidal ideations. Although I fulfil the requirements of my duties, I often feel both ill-equipped and insufficiently unable to remain professionally detached from their situation and circumstance and suffer personally as a result. The withering thought that I might be the last person with whom that individual speaks is deeply troubling. I can therefore only begin to imagine the sustained and elevated intensity and pressure that falls upon your shoulders when carrying out the requirements of your job. Where I may have the opportunity to address my mistakes by contacting the emergency services in advance of concluding their contact with me, you do not have that opportunity to step away from your charge. Such constant pressure would bend me to breaking point. I am in admiration of all in medical practice whose learned craft and unwavering courage simultaneously sustains health and well-being, and promotes belief in the sacredness of human life.

    Namaste

    DN – 28/03/2015

    Liked by 1 person

  12. For me, the most important criteria is competence. Can you fix what needs fixing? Great. And if you’re nice about it, great. If not, I can hold my own. Just as long as don’t amputate the wrong leg or give me giant boobs.

    Liked by 2 people

      • Is it your experience that the complaints are more about doctors not caring, or about doctors not paying enough attention to what patients tell them? You may have a doctor who is quite caring, but not the best listener, and the rushed managed care environment doesn’t help.

        Liked by 1 person

      • Somehow, doctors became the enemy. It is a trust issue. Suspicion. Questioning motives and knowledge and integrity. I have seen/felt it shift over the past ten years. I feel I am constantly on the defensive. Not everyone is like that, and I cannot quantify it, but there are enough people that it is disconcerting. I have another post planned that may help explain it further.

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      • Do you think perhaps that it is a growing suspicion and distrust of those perceived to have power, Victo? I see it in other areas of our society.

        Liked by 1 person

  13. I still get annoyed by the Nurse Ratchet images because I’ve NEVER known a nurse like that. Even after thirty years. I’ve stroked the hair of many a new grad who wept in the hallway of her patient, and spent quite a few hours embraced in group hugs in conference rooms.

    Liked by 2 people

  14. I hope the health care profession moves toward better health for those providing care. There should grief support offered and easily available when some one dies, and it should be normal. My husband was an EMT/fire fighter and had a counselor contracted by his company who would come find him and encourage him to talk when really hard fatalities occurred. He appreciated her doing that. I don’t want a doctor crying all over the place, but I think it’s perfectly okay if a doctor gets a few tears in his or her eyes, even in front of a patient, if something really hard is going on. But that’s just me.

    Liked by 2 people

  15. Great post. I think many of us are on the offensive when we go in and have such high expectations from those that see us at our most vulnerable. Pretty much sets the bar so high from the get-go that it’s nearly impossible to reach it before things even get started.

    Liked by 3 people

  16. My partner is currently in hospital following a serious accident, the staff have been wonderful! They are not perfect, they are overworked, they are under resourced but they care and are doing their very best for the best possible outcome.

    Liked by 2 people

    • Sending you and your partner my love and thoughts. My husband’s colleague had a serious accident and came close to losing his leg, which now only has one artery and is seemingly held together with paperclips. The shock of such a sudden trauma is terrible and it turns your life upside down in an instant. Hang in there. It can be a long road and I’ve found any setbacks hit twice as hard. I’ve also found that the emotion reaction can take awhile to hit so just when you both might feel like the worst is behind you, all this emotional trauma reaction hits you in the face like a sour custard pie. I’ve been through a bit and this sort of info isn’t readily available so I hope that helps. xx Rowena

      Liked by 2 people

      • I’ve spent quite a lot of time around hospitals, doctors etc and used to have blood transfusions every 3 weeks which took around 5 hours and I’d inevitably getting talking to people going through all sorts such as chemo etc. I have heard that phrase so often, even from people who are in a terrible predicament and it really seems to help us cope. I am starting to think that it perversely turns our bad luck into good luck. I heard it again last week with parents I met with a severely disabled child who as far as her condition is concerned, is doing very well. This thought really intrigues me.

        Liked by 1 person

  17. I think your post was excellent. I agree that it would aid the doctor/patient relationship if both remembered that the other was just a person, like the other. I think a very simple measure would help immensely:

    Normally, I dislike the informality of strangers addressing me by my first name, but since almost all doctors do so: If a doctor wants to call me Babe, fine. I will call her Rosa.. Or Lamont. Or what have you. Then, I’ll have no problem remembering s/he’s just a person, same as I.

    Liked by 1 person

  18. true doc…and most of the times we don’t know why the doc is behaving out of character, if they do…happened with my old family doc…earlier he was talkative but now talks just to the point..maybe too loaded with patients..but its a bit sad to see him turned this way…

    Liked by 1 person

    • It is the electronic health record, trying to meet all of the documentation requirements for the various measures (preventive care, meaningful use, patient satisfaction, disease management), working longer hours, dealing with the new impatient right now spirit that society has… For the old docs, it has been hard to watch their profession change so dramatically.

      Liked by 1 person

  19. Reblogged this on Conversations I Wish I Had and commented:
    It’s so true. Reminded me of this: “We have made virtues of independence and objectivity, though it is where lives intersect that medicine is practiced. We teach doctors about clinical depression but very little about human misery and we teach them how to treat cancer but next to nothing about how to deal with the fear of death. We train doctors to be scientist problem solvers, viscera-mechanics rather than holistic practitioners who will sooner or later discover that what ails the body also ails the soul. In part this is because medicine has provided us with a taxonomy of suffering according to whether it can provide diagnostic proof, therapeutic intervention or profits. What falls outside is none of our business, in the widest sense of the word. We propagate a medical persona, individually and collectively internalised, that unlike our patients we are healthy, resilient, rational and indefatigable.[ii] We proudly display our passports for the kingdom of the healthy, because secretly, we believe that the kingdom of the sick is a punishment for weakness of the will, lack of stamina or moral turpitude. Little surprise then that for too many doctors, death is preferable to being seen to be vulnerable or weak. Ours is a one-way mirror, designed to protect us from our own suffering and vulnerability, but allowing us to look right through it and see in others what we fear in ourselves. ” Full text at: https://abetternhs.wordpress.com/2014/08/01/wounded-healers/

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  20. Thank you so much for sharing your perspective. I have numerous doctors in my family and have a lot of interaction with doctors for myself and my kids. It does seem that doctor bashing has become a bit of a sport, which is so unfair.
    I had an interesting experience when it was found that my auto-immune disease had become active in my lungs and was causing fibrosis. This setback was handled by three doctors: my rheumatologist who oversees my treatments, my lung specialist and my GP. After seeing these doctors for a few years and going through a bit, we have those closeness that you get from being part of a team. My GP and I always exchange a good read when we find one. Anyway, it was a big blow to all of us when we were confronted by he news. I was 43 and my children were 9 and 7 at the time and it was a terribly stressful, agonising time. To be honest, my GP was a bit teary when we talked but she did encourage me to be optimistic. Medical research was going forward in leaps and bounds. My lung specialist was so lovely, which he is anyway, but this was his way of relaying the news. My rheumatologist who I usually have a few jokes with, couldn’t look me in the eye and was looking at the floor. He’s given a paper about me at a conference.
    Fortunately, they gave me some treatments of cyclaphosphamide and I’m now on cellcept and I’m back in remission.
    I’m now in a bit of a different position myself where my daughter is having some tests and I am the mother, not the patient and I am having to manage my response. I have to be patient, compassionate, caring and yet as solid as a rock…no tears in front of her. Indeed, I have to encourage her and build her morale. I need to advocate for her but I also need to stay her mum and not become her doctor. I have researched things on Google and I think that’s a good thing because then I can ask informed questions. Well, that’s my aim. Her doctors are relying on my husband and I to be good reporters. What have we observed? What’s happening outside their surgery? We know that nitty gritty stuff and I guess they have the big medical picture and hopefully can work out where we fit in.
    UNfortunately, I think society’s obsession with perfection is very unrealistic because everyone makes mistakes. Everybody is human. Sometimes, I would like to see doctors employed with better communication skills but our universities in Australia are working on that…especially Newcastle Uni.
    I do believe, by the way, that hospitals need to provide staff with some form of outlet for expressing their grief. It must feel like a huge responsibility having someone else’s life in your hands. Each patient has many layers of relationships which all feel that loss as well as their hopes and dreams. At the same time, we all die someday and I personally do believe that when you’re number’s up, it’s up. Just like the rest of us mere mortals, doctors aren’t God and can’t offer anyone a free ticket to immortality. LIfe is what it is.

    Liked by 1 person

  21. Just so you know, I love, truly love my doctor. She is compassionate, thorough, caring, and warm. She takes care of me, my husband, and my mother. I have complete confidence in her. It would grieve me to lose her. She makes me a responsible partner in my healthcare. I don’t want to let her down. I know it matters to her.

    Liked by 1 person

  22. I’ve always looked for professionalism and kindness in any Dr. If those 2 qualities are lacking, I bolt. I’ve been very fortunate to find the right caregivers. It must take such an emotional toll on you. I’m not sure how you handle it, but I’m so glad that you do. The world needs more like you ! ☺ Van

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  23. As a care aid I was very affected by the suffering and sometimes death of my clients. I didn’t see the full extent of the effects it had on me until I was out of the profession. I developed a fear of getting old. I can’t imagine what you as doctors carry with you. I’m really glad you wrote this. It reminds me that there’s a human side to doctors. I’ve learned so much from reading your blog.

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  25. I have the tendency to avoid the doctor as much as possible. Thankfully I am seldom ill.

    In light of that and the aperture being at least F2, doctors are medical professionals who are personally involved. I have had enough injuries to know that without them my life could be worse off. In the lower apertures, F5.6 the doctor might look more two dimensional.

    Lower apertures do not catch the fine details in the eyes. Those fine details often show a vulnerable human, someone simply trying to live…

    Liked by 1 person

  26. I still remember patients I nursed 25 years ago. When young Daniel (13) my friends boy was being discharged to come home to die after five months in hospital, and eleven months of treatment, the consultant who had fought so hard to save him came to wave him off. Thankfully Danny was asleep, but his team said that it was one of the very few times they had ever seen him cry, which he did as he hugged Dans Mom, and touched Dan’s hand.
    His mom and dad was very touched by his tears.

    Liked by 1 person

  27. Very true, and beautifully written. I wanted to write a post about that picture, myself.
    I once had an osce station (that was aimed at communication) with a prompt kind of like this: “you were called to review a case that you saw on call the previous night, where a baby came in with (X condition), you saw them, and they later passed away after your shift was over. It turns out that the child was given an incorrect dose of the medication you wrote (10x too high.) Discuss this situation with your interviewer.”
    I stared at the prompt for the whole two minutes without even blinking. The first thing I said when I got into the room is that I was very upset by the prompt and the first thing I would want to do is talk to someone to debrief. I worry that I failed that osce station because the first thing I did was express my emotions and difficulty with the situation. But, what’s wrong with reacting that way to that kind of news?

    Liked by 1 person

    • I don’t think you failed it. Certainly in that context a debriefing would be appropriate. It is not like you were in the throws of CPR or something. The deed was done. What an upsetting topic!

      Like

  28. Yes, we have all been there. The doubt, the ” It is all my fault”.

    But of course, it does not happen all the time. If it did, suicides among doctors, already high, would be even higher. I am a professional. I try to work as well as possible and help my patients, but they are patients, it is my job. If a friend gets cancer it is different. Sometimes, my job is similar to a job of a really good actor. You believe the emotions concerns and other feelings they are expressing on scene, but they are not REALLY upset, angry or sad. They are just doing their job. It is similar. My patients must feel my empathy and sympathy, interest and believe I am sincere. And I am, at that moment, like the actress crying in grief on scene. But then, the curtains fall on her, and I see the next patient. The next patients NEEDS me to start from scratch, new empathy, new emotions. This almost calls for a new blog!!! As always.

    Liked by 1 person

  29. I agree with other commentators that you are doing something very special and worthwhile here, giving the world a window into the soul of a doctor, a perspective not often seen. As to perfection, we are all fallible creatures and our mental health, at least, depends on recognizing this.

    Liked by 1 person

  30. Very beautifully said, and something that should be said on more than one occasion. I’ve found myself disturbed a number of times upon hearing people air their views about the medical profession. Fortunately, I’ve also heard people whose opinions dovetailed much more closely with the positive views that I myself possess most often. In the end I always remind myself that they’re human like the rest of us, which means some good, some bad, and most somewhere in the middle just trying to make the best of a really hard job that I myself readily admit I couldn’t handle. I’d like to think most rational people appreciate the work you do.

    Liked by 1 person

  31. Just like with any profession, (I’m thinking teachers, specifically), I’ve encountered many doctors over the years, and because a few stand out and were over-the-top amazing, the others just couldn’t compete. It’s like 10% were excellent, 80% were average, and 10% were so stuck on themselves, they didn’t even hear what I was saying. (About the same with teachers, too.) But I don’t think the “average” doctors were “bad” per se… I just think insurance laws and other legal factors kept them from being the best they could be. But I am sorry to hear that so many people think the medical profession is bad as a whole. That’s not right.

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