My first house job was in a London teaching hospital, where I worked a full five-day week as well as one night and one weekend in three (weekends started early Friday morning and didn’t finish until Monday evening). I looked after haematology and oncology patients. I worked, lived and spent my life in the hospital.
There were no nurses to take blood, give chemotherapy, set up drips, order or read tests. There were no senior doctors at weekends and life would have been lonely had it not been for my patients. Many were in the hospital for extended periods, and in between mundane procedures I filled time at their bedsides, chatting. I now know this was a precious and important time. I learned to build relationships centred on trust, professional understanding and mutual respect.
One patient on the haematology ward was having a bone marrow transplant. He was a few years older than me, married with a young child; I knew him on first name terms and I often paid him my last visit of the shift, late at night. I would sit at his bedside and we would chat, usually about irrelevant things, and while away his weeks in hospital.
One evening, at a time when his blood count was returning and he was feeling less exhausted, we talked about his wife, his child, his hopes for the future. He then turned to me and said, in his Cockney accent: “I’ve made plans and if for any reason I don’t make it, I’ve left a note for my wife in a book at home – just let her know”. I dismissed his pessimism; his recovery was almost a done deal.
A week later I was following my registrar round the ward when a shrill, mind-penetrating cry came from his room. Head pain was followed by loss of consciousness, and a CT scan showed a massive brain haemorrhage, which would be fatal.
I felt unable to pass on the message to his wife, like a coward leaving my ward registrar to do this. I shall always keep this patient as a precious memory – and now I can share it. He taught me a lesson early in my career: that the role of a doctor is a vocation and not just a job.
We must spend time with our patients and use our time together effectively. We build and form relationships, which in general practice – the specialty I now do – can span decades. We grow old together and patients put their trust in us. We share stories and make decisions together.
That patient’s child is now an adult, and I often wonder about his wife. He taught me a more important lesson than any I had learned in my previous five years at medical school.
As junior doctors go on strike, I reminisce about when I was a junior doctor. It was a different era, one where I continued my learning in the hospital, and where patients were my teachers.
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