Tuesday 14 November 2017

Is There a (Happy and Rested) Doctor in the House?



Do you ever worry about your doctor's health? If indeed you have a doctor? I have to confess that I only occasionally remember to wonder if my doctor is doing okay. I am much more likely to be thinking in terms of whether she is available to me, competent, perceptive, on top of things concerning my health, friendly and considerate and compassionate when I need her to be. As someone who spends a lot of her time thinking about how my friends are doing, and offering support when I am able, it is disappointing to realize how one-sided my thoughts are concerning someone who I have known and liked for quite a few years. We do express affection for each other, and when she was brutally assaulted a number of years ago I was sensitive to her distress for months afterward. But then I fell back into being the baby in the relationship.

Now that it is stirred up in my mind, though, I can't help stringing together all the moments I have stopped and wondered how a doctor friend of mine manages his or her enormous and taxing workload, or been horrified to hear the hours that ER doctors work, heard about increasing restrictions on the amount of time allowed per consultation, and so on. It adds up to a lot of moments over a bunch of years. Doctors in this country are suffering, and I have been mostly oblivious to it.

What stirred these thoughts up was an episode that aired this week on White Coat, Black Art, on CBC: Doctor Burnout. It begins with a recording of a doctor freaking out at a patient who has made a demand on him that he is in no shape to respond to. It was a wakeup call for me.

At one time in Canada we felt pretty smug about our health care system, especially when (imagine us fluffing our feathers here) we compared ours to the system available in the United States. We meanwhile streamed in and out of our doctors' offices and hospitals concerned only with how well we were treated and how good the food was, and, of course, whether we got better. I speak only of those I knew. Doubtless there were holes in the system even in the good old days, but those holes got bigger and bigger over the decades, and in time there was a constant flow of talk about the myriad problems we now face, from increasing costs (both to society and to the individual), loooong waitlists, a rising two-tiered health care system, and suddenly (or perhaps not so suddenly), the near-impossibility of getting a GP (family doctor). Our cries of "Unfair!" resounded, and I was not alone in looking with fear at the disintegration of that once envied system, hoping it would not crash at last into a mimic of the US system, sure that this was the direction certain forces were trying to make it go.

In the midst of all of that, I for one felt disappointed and at times angry with my continually disappearing GPs, leaving me in sometimes a very difficult position, with a grouchiness that arose not only in some physicians but in the nurses, receptionists, and other practitioners that people the health care sytem, with overlooked health conditions (even when I pleaded with them to take care of them--I am thinking particularly but not only about the cancer that went undiagnosed for nearly a year despite my repeated requests to have the lump removed)... But only occasionally did the fog of my (reasonable) self-interest clear enough for me to see how the people in that system were suffering.

I particularly remember being helpless in a hospital bed when a certain nurse was cutting and abrupt with both myself and another patient. It was only later that she said to me--I suppose I must have called her on it in a gentle way--that she cared a lot and was in a fractious state because she couldn't do what needed to be done for patients and was exhausted. So her distress that arose from compassion resulted in her acting uncompassionately. A lightbulb went on, then fizzled out again when I got back to normal life.

There are a million reasons why we need to shore up our ailing health care system. The suffering of the people whose job it is to deliver it is one huge reason. Even if that suffering didn't result in mistakes and bad bedside manner, it would be reason enough to put things right. We wouldn't want to live stretched past the limit ourselves. Why would we expect it of them?

Below are links to the radio program I listened to and to an excellent article on the topic I was pointed to by a doctor friend of mine. The article, from a US newspaper, points out that 300-400 doctors (presumably in the States) kill themselves every year, and that doctors are at double the risk of other professionals to take that terrible step. Women physicians are especially vulnerable.

So, I am glad that I start every appointment with my doctor with the question, "How have you been?" and that I get to actually hear from her how she is. Now I hope I will be more forgiving when she is impatient with me (as she has been perhaps twice in the decade or so I've known her), and that I will remember that she is doing the best she can in an imperfect system. And, by and large, doing it very well.

Doctor Burnout, CBC Radio One, White Coat, Black Art, with Doctor Brian Goldman. 11 November 2017.
Taking Care of the Physician, by Perri Klass MD. The New York Times, 13 November 2017.





Image: "Daydreams of a Doctor" by Columbus Barlow (1898) (14778458162). By Internet Archive Book Images [No restrictions], via Wikimedia Commons