This is a compulsory reflection for the end of the rotation viva. But I want to share it in my blog.
I have learned a lot during this medicine rotation. Not only learning to get my diagnosis right but most importantly, is being empathic towards the patient and understands them.
Somehow I feel a bit weird when approaching the patient solely for clerking and physical examination without trying to understand the patient’s feelings and worries. On my first day of clerking, empathy was at my blindspot. My first aim mostly was to clerk a patient and successfully get the diagnosis right and excellently present my findings to the doctors.
On the second day, I read an article by a teaching doctor about the importance of developing empathy for patients. Immediately I snapped back to my intention of becoming a doctor. Sir William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease”. That’s what my lecturer said back in my Dublin days. It stays in my heart from the first time I heard it.
It broke my heart to once see a patient get shouted at and slapped by the doctor for not giving cooperation during physical examination. Don’t they remember that during the interview before they get into medical school, the reason they want to be a doctor was to help people? Once, I heard a nurse shouted to a patient at the end of the ward, asking to remove his pants. I was at the other end of the ward and she was very loud. I hope she could treat him with dignity. If I have a gut, I would advise her to not do it but Malaysia works with a hierarchy where ‘juniors’ should always obey the ‘seniors’. It was the opposite back in Dublin where a consultant pathologist advised on whenever we see any unprofessionalism, we have to talk to them about what they did wrong, state how we feel and if they still doing it again, he/she might be reported. It was taught in Dublin, I hope in Malaysia too.
Once, I randomly helped a patient to clean the foods that he spilt on his bed. He cannot do it himself because he cannot sit up. Later, he chatted with me about the bad treatment he got from 2 nurses. He talked about how he doesn’t care if people don’t care about him but when I stay there and listen to him, I know how much he appreciated being heard. Before I go, he thanked me for taking my time to be there and I also helped him to take a blanket to cover his cold body because there was no blanket at all on his bed earlier and he did not have any shirt on. And he also wished that he could speak fluently in Malay (he was Chinese) so we could communicate better. He held a lot of words that he couldn’t spill due to the communication barrier.
Sometimes, it is hard to see a person behind that patient uniform because they look the same: people who need to be treated. But when they changed their clothes before they discharged, suddenly we see a father, a kindergarten teacher, a student, a breadwinner of the family, a single mom etc.
As for the recent long case examination, I cried when I knew that I did badly. I feel insufficient, I thought I have tried my best. I think I was the worst among my groupmates. I cannot answer properly during the discussion because I was too nervous even though the answer was in my brain. Maybe some people would say, “It’s okay, you are just third year” but I don’t like making it as an excuse. A few minutes later after crying, I corrected where I need to improve with red markers, in hope that I won’t make the same mistake in the future. What doesn’t kill you make you stronger, right?
Now, I have a plan on how to improve. For my future rotations, I want to be more proactive: to ask the HO or MO to evaluate my history presentation and look at my skills at physical examination. Previously I was so uncomfortable asking for HOs and MOs help because I might interrupt, but I remember when I ask a MO to check if my x-ray interpretation is correct and she was okay with it.
Being a student, we will mostly see things academically. I might not be the best of the students, but I hope I am not the worst in showing empathy. No matter what it is, showing and being empathetic will always be my number one priority until forever.
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