Earlier this week I tweeted about the wisdom of my first ever boss. Dr Kemp was a fantastic, old-school doctor and I couldn’t have wished for a more supportive or inspiring Consultant in my first FY1 job. I’m sure he is a major reason why I pursued a career as a Physician. At the end of our attachment he checked the rota for a date when none of his team were on call and invited us all to his home for dinner with our partners. Just a demonstration of how lovely he was.
One of the titbits of his wisdom that has stayed with me for nearly 8 years now is his analogy of a medical admission to painting a picture rather than ticking the boxes. He hated the protocol driven Medicine that was starting to dominate practice at the time, and was a great believer in letting time help aid diagnosis. He would also always revisit a patient’s history with the brilliant skill of being able to pick out information, sometimes from the fairly distant past that was crucial in working out what was happening. I used to listen in awe at the back of the ward round, wondering if I could ever come anywhere near to emulating him.
There is the age old debate whether Medicine is an art or a science and most people seem to plump with somewhere in the middle, but I wonder whether we should explore our artistic tendencies a little more in the quest to improve patient care. Another boss who has been incredibly influential in my career taught me to start again and always come to my own conclusions, to paint my own picture. Of course there will always be boxes to tick in the modern day NHS, but perhaps alongside the box ticking we could get our paintbrushes out a little more often.
If being ill has taught me anything about being a doctor it is the importance of seeing a patient as a person and not merely a condition or disease sat in a hospital bed. It is amazing what you learn about people if you just ask. I have looked after a world record breaking knitter, an Olympic cyclist and a lady who had eleven children in the last few months. The disease focussed clinicians may see these facts as irrelevant, but I think they are central to understanding the person, how their pathology impacts on them and why they are special to their family.
When was the last time you stopped and had a conversation with someone on the ward just for the sake of having a conversation? We all blame being too busy on not doing this but are we really? Do we not have 10 minutes to sit down and explore someone’s worries? Having a chat can be therapeutic in itself. I know this. A few months ago when I was struggling with the uncertainty of my prognosis and the effect this was going to have on my career I had a long chat with my Oncologist. There was no examination, no diagnosing, no investigations and no prescribing; just talking. And it helped. It really did.
I see all this as painting the picture. It takes years to be able to paint a masterpiece, but the apprentice learns from the master and surely that is the model of how we all develop as clinicians. I’m going to invest in some more colours for my palette and remember to get my brushes out on Monday….