I haven’t seen any huge differences in terms of medical practice between Melbourne, where I am at the moment, and Auckland my home town. But something I did notice was this thing I like to call Intuitive Sensitivity.
Basically, back home, when doctors see patients, they are super intuitive about recognising what the patient is feeling and what they need. So many times I have seen registrars, house officers, consultants, etc. jump up and move to the patient’s side to put an arm around them or offer them some tissues even before they start crying. They just know when it’s coming. I’ve marveled at this several times. I certainly don’t see it coming. But they do. And it’s pretty great to watch.
But since being in Melbourne, I’ve already met several patients with terminal or extremely disabling conditions who burst into tears on ward rounds or during clinical consultations. But I am yet to see even a single doctor step forward to comfort them. House officers, registrars and consultants alike, just let the patient cry. It just becomes really quiet in the room while the patient cries.
This bothers me quite a bit. I hate standing (or sitting) around watching a patient cry. Or anyone, for that matter. No matter how staunch or independent a person is, everyone but everyone could use a gesture of reassurance. A hug, some tissues, a kind word, etc. Anything could help. But you have got to acknowledge, surely. Not just watch them while they cry.
Of course this could be a cultural thing. Basically Kiwis have a reputation worldwide of being the “softies” in everything. So I suppose it’s not surprising that people cry or people have that innate sense to comfort. And this might not necessarily translate in other countries. But then again, I have seen some consultants back home who just plain ignore patients when they cry.
But either way, I would hate to just sit in a room with a bunch of doctors staring at me blankly while I cry. And so, I can’t watch that. But it’s super awkward for me because (and I’ve said this a million times already) I am the student.
I have no role there really. I can’t just jump in and comfort patients while consultants are around. How awkward would that be. Or if it isn’t even acceptable culturally, I’d be both awkward and culturally incompetent.
But there was one point that I just couldn’t stand to watch a woman cry any longer. There’s this clinic called ‘functional gut disorders’ clinic. And I have to say it’s the most depressing set up I have ever heard of. Basically we just see patients with functional gut disorders that are incurable and are super complex and debilitating and we just tell them to continue their current treatment. Patients just come in to cry about their conditions, basically. So you’d think the doctors at this clinic would be super intuitively sensitive and do a lot of reassuring. But nope. I sat through multiple consultations where the consultant was, incredibly, typing notes while a patient sobbed away. This woman had an extremely disabling functional gut disorder. She cried for a few minutes, stopped, then cried again. Unable to watch her anymore, I had a huge internal conflict about moving towards her to offer some comfort while also not annoying the consultant. In the end, as a compromise, when it looked like she was about to cry again, I picked up the tissue box near me and offered it to her.
She accepted it gratefully and thanked me. The consultant gave me a small surprised look but then smiled and said “thank you for doing that”.
Okay it wasn’t a big gesture, but it was the most I could manage. And I think it kind of helped the lady. Which probably means it’s not culturally unacceptable. But yeah, there were a few more patients after that and my consultant still let them cry. As do the other doctors. And I’m still the med student so I can’t do much. Sigh.
I just don’t know how you can be okay with watching someone cry. Or knowing someone is sad. It makes me feel yucky.
I suppose I am developing this intuitive sensitivity though. I just have to try make as many small gestures as I can.