Working in healthcare can be an emotionally challenging experience. Over the years, for reasons such as self preservation or over familiarity, we can find ourselves losing touch with our humanity. This can lead to a loss of empathy and compassion for our patients and colleagues and difficulty finding joy in our work.
A new website has been set up to help those of us in healthcare to try and reconnect with that side of ourselves: The Re-Humanising Revolution. It is being curated by two experienced bloggers and their hope is to fill the site with real stories by real people that will give readers a chance to reflect upon their own feelings and maybe, just maybe, help them start to reconnect with their own humanity.
I was delighted to have the opportunity to support the project with a story of my own from what seems like a lifetime ago. So, if you’ve started to feel unappreciated by patients or that maybe you’re just another faceless cog in the wheel of the system, this one’s for you…
It was back in 1994, when I was doing my medical house job, that I met Peter. Peter was a man in his late sixties and he suffered with COAD… that’s what we called COPD back then! When I say he suffered with it I mean he really suffered. He’d got to the stage where he was constantly short of breath and his medications gave him very little relief. Try breathing through a straw for any period of time and feel how uncomfortable it is: that was Peter’s normal. I met him during a few stays for infective exacerbations of his condition and each time he deteriorated a little further… he was in the terminal phase of his disease. Despite his condition he remained remarkably cheerful and he always liked to have a chat with me anytime I passed by.
These were the years when junior staff worked 100 hour weeks so Peter and I saw a lot of each other as I passed by quite regularly! He’d ask me how I was getting on, how long I’d been at work that day and whether I’d had anything to eat recently. Peter would then offer me a sweet… always a Murray Mint… from his bedside locker, just to keep me going. It became such a routine that on the consultant ward round we’d exchange no more than a knowing glance before I quickly grabbed a mint as everyone moved on to the next patient. I really liked Peter.
As time went on it became clear that there was little more we could do for Peter other than manage his symptoms. As was the way at that time, we started him on Oromorph to try and reduce his distressing breathlessness, knowing full well that it would also reduce his respiratory drive. It was crude palliative medicine but it was all we could realistically offer. We didn’t tell him that it might shorten his life, I’m not really sure why, but I suppose it just was how things were done then. If that seems wrong to you now reading this, trust me it feels wrong writing it, but all I have to offer in defence is we thought that that was the right way to do things then… it isn’t.
Towards the end of that job, at about 6am one on-call, I got bleeped to come to the ward. It was Peter, he was distressed. As I walked towards him and knelt at his bedside he looked at me and said ‘Can you give me something to finish me off? I’ve had enough. I don’t want to be like this anymore.’ I was shocked. I didn’t know what to say to him, he was asking me to kill him. ‘You can’t ask me to do that Peter,’ I said. ‘I’m not allowed to give you something to do that.’ He looked at me carefully, then nodded slowly and apologised for asking. He knew I couldn’t do what he wanted but he’d just felt so desperate. I felt so useless but then I realised I could maybe help a little. ‘Listen Peter,’ I said, ‘I can’t give you something just to end things but I need you to trust me.’ I held his hand. ‘I need you to keep taking the medication we’ve prescribed for your breathlessness. It helps with your symptoms, that’s why we’re giving it to you, but it has a side effect that will get you what you want. Do you trust me?’ Peter began to calm a little, his breathing eased a bit as he nodded at me and then he smiled, thanking me for my help. I felt a bit odd, not really sure what I’d done, whether it was right or wrong, but there was more work to be done so I got up to leave. ‘Murray Mint?’ he asked. I turned back, took the sweet, thanked him and headed off to my next task. I don’t recall seeing Peter again: he died about a week or so later and then I moved to another hospital to start my first SHO job in A&E.
Now, the story could end here. It could be a rather unremarkable story about how paternalistic we used to be ‘back in my day’. It could be a tale about how rubbish we were at palliation and how my first clumsy encounter with a patient who wanted to die led to a career in palliative medicine… it didn’t. No, the story goes a little further.
About two weeks after I started my new job I went to my locker in the A&E changing rooms and inside I found a small brown Jiffy bag envelope with my name on it. It was hand written, addressed to me at my previous ward but someone had redirected to me here. As I opened the envelope, a packet of Murray Mints fell in to my hand, with a note wrapped around it. The note was from Peter’s wife and in it she thanked me for how I’d looked after Peter, that he had appreciated the care I’d shown him and that she hoped I’d enjoy the sweets. I just stood looking at the note, staring at the sweet packet not really able to take it in properly. Even writing about it now makes me feel a little odd and causes the hairs to stand up on the back of my neck. This story isn’t about me, it is about a dying man and his wife who, even through their own life ending problems, noticed a young doctor and cared about him.
I honestly don’t think Peter and his wife are unique. I firmly believe many of our patients watch on with compassion for the staff who are caring for them, astonished at the work we do and the conditions in which we do it. They are more than capable of caring for us, of being there for us and connecting with us as fellow humans if we are prepared to give them the chance. I urge you to take a risk and give them that opportunity. Next time a patient asks you if you are alright, smiles at you or offers you a sweet, take a moment to stop and spend a couple of minutes with them. Re- connect with your humanity, for both of your sakes.