Being a Doctor

Everyone gets sick. This is an unavoidable part of the human condition. The human body is an unimaginably complex machine that is at once delicate and fragile but other times tough and resilient. We survive a fusillade of bullets but are brought low by the tiniest of viruses. Caring for humanity is a demanding vocation. It requires an unusual intelligence coupled with perseverance to learn and understand the intricacies of humanity, a selfless, lifelong commitment to people, loyalty to colleagues and a deep understanding from family and friends. I became a doctor in 1974, when doctors were Godlike figures who had a secret understanding into our innermost workings and possessed a magic touch that could offer relief of symptoms and perhaps cure of illnesses. As time has passed knowledge and technology has progressed in ways that my grandfather and great grandfather could never have imagined. I was at medical school when the first colonoscopy was performed, the first CT scan was ordered, and the first medical ultrasound was done. We were taught history and physical examination for diagnosis, and ancient tools such as rigid proctoscopy and barium enema for investigation of the large intestine. There were no surgical staplers, no polypectomy snares and a limited range of pharmaceuticals. Now, even our patients have changed. I learned in a society that never dreamed of personal computers, personal cell phones, something called the internet, or the concept of social media. These are realities, and they have shaped the way that doctors relate to patients. And that is the point. We, as doctors, are all about our patients. In 2020 many of our patients have researched their symptoms, their diseases, and the possible treatments. They have usually even researched us. We are all reviewed and graded according to what our patients think of us. Our diagnoses and recommendations may be second guessed. What does this mean for us as doctors?

Well one thing has not changed over the last 30 years. Our patients are still human beings, and they are still sick. They still need to be diagnosed and treated. They still need to be cared for with compassion and humanity. I am wondering if you, or anyone you love, has ever been a patient. I have been a patient several times over the years, as have Lois, Jamie, Emma, and Lucy. I know what it’s like to be anxious, scared, desperate for updates. I have experienced incomprehensible waits in a waiting room, unsatisfying consultations with someone who never listened to you, reassurances that seemed false or placating. These experiences reinforced for me what I already knew. That the best way to know how to care for a patient is to be one yourself. That all patients are entitled to a fair hearing, an open mind, and the best that you have to give. This is a maxim that needs to be regularly rehearsed, as stress and busyness drive it from memory. The rewards, however, are worth the effort. The satisfaction of helping, of making a real difference, and sometimes of saving or extending a life last for your whole career. Grateful and appreciative patients are the real currency of a career in service. In this sense I am rich. A patient of mine gave me a present recently. I had met her when she was in her twenties, and pregnant. She has been diagnosed with Crohn’s colitis. Unfortunately, she had a cancer at her rectosigmoid junction. She had her baby, had her surgery, and when her son turned 21 she gave me a watch that was engraved with the following “Thank you for the time”.