Monday, 11 August 2008

Being serious

At the weekend I went to a local builders' merchant to choose some paving slabs. The staff were friendly and one said “can I help, you look a bit worried”. To which I replied “I always look worried”. Unfortunately this is true. On Friday evening things were going well and I popped my head into the nurse's room for a chat and a joke. Our senior nurse and I go back a long way, she has been in the practice almost as long as I and we have a friendly relationship based on mutual respect. “It's good to see you smiling” she said, implying that usually I don't.

It's true that my attitude to things tends to be serious and gloomy. And although I have a quick wit and an absurd sense of humour, I fear that when I display them I appear frivolous. I also think that people would prefer their doctor to be serious but with occasional flashes of wit, rather than a joker who is occasionally serious.

Today was a busy day, which made me realise how hard it is for me to speed up. Although in theory I could “cut to the chase” and just deal with the most important problem in an expeditious way, in practice I would feel uncomfortable doing that. I feel obliged to take the time to listen, to understand, to review the notes, and to discuss options with every single patient, and that just can't be speeded up. I am not very quick on the uptake, and it often takes me a minute or two to work out what is going on.

On the other hand, I don't take things to extremes. One of my partners worries dreadfully about his patients, and is constantly contacting different people at the hospital to ensure that he is doing the right thing. I rarely do this, and make my own decision after assessing the situation; possibly looking up some information on the internet to revise the topic concerned. I had a flash of insight the other day when attending a patient for whom I feel special responsibility. I have known him for a long time and he is an important person in two of my social circles, so I feel a particular need to do my very best for him. Having seen him and made my decision I was then stricken by doubt and rang the Registrar at the hospital, who confirmed that what I was doing was correct. I suspect that my partner feels this level of responsibility for all his patients, which must be totally exhausting for him. He's a better man than me.

I was delighted today when a GP who I know quite well asked if I would be his doctor. The doctor with whom he is registered at present is up to date and efficient, but my new patient said that he felt he wouldn't be able to talk to him if he were to have an emotional problem. There are other practices locally with good reputations so I was pleased that he chose me, based I think on his previous personal knowledge.

He will get the same level of care that I give everyone else, except that I recognise that it is difficult to be a patient when you are a doctor. He may need a little reassurance that he can ask for what he wants without being “difficult”.


Anonymous said...

I hope you're not drifting down a bit again; it's been good to see the non-worrier side of Dr Brown for a while. Are you affected by the length of day / sunshine? I'm sure I am. Interesting that you partner is an ultra-worrier: does this make you more understanding of each other or the reverse?

Dr Andrew Brown said...

Thank you for your concern. No I don't think I'm drifting down again, or at least only slightly. This posting falls under the category of reflection and self-analysis.

Unfortunately I can find my partner's fastidious approach somewhat trying at times, which is a shame because he's a really decent and likeable person.

Bright-eyed said...

It's interesting reading how different doctors strike a balance between being caring and compassionate, while detached enough so that work doesn't consume them (as your partner seems at risk of). From a personal point of view, I think I would like to see the doctor's personality shine through in a consultation - the sharp wit and absurd sense of humour sounds appealing and adds an extra human touch.

Elaine said...

I agree with bright eyed. I have seen a fair number of GPs in my time as I moved around the country - at a quick count, 9, I think and the outstanding best one was one who showed a deal of empathy but whose quick wit and sense of humour helped me through some difficult times.

Mind you I shall probably joke to the undertaker!

Anonymous said...

Ace post!

I'm quite sure that your new patient (the GP) chose you as his doctor because he liked what he saw in you... I do too!

"I feel obliged to take the time to listen, to understand, to review the notes, and to discuss options with every single patient"

I suspect the paving slabs were getting the same treatment ;-)

Anonymous said...

I take it as a good sign that the nurse that has known you for so long comments on your smile. It probably means that she had noticed it when you were depressed and worn down; and now she notices the difference and is glad about that. Probably it wasn't this one smile she was commenting at, but your whole recent happier behaviour.
I'm glad for you too and I hope the sun will keep on shining.

Dr Andrew Brown said...

Thanks everyone. You are all most kind.

Bright-eyed: I'm glad you found the post interesting. Not all doctors have chosen my solution, but we all have to grapple with the same problem that you elucidate so well. I'm sure that more of my personality leaks out than I realise - I am The Drug Doctor, after all. :-)

Steph: the paving slabs were chosen very quickly. When it comes to making decisions that only affect me I know that I can live with the consequences if I get it wrong.