The loneliness of the sick doctor

Domhnall MacAuleyDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

“It was the loneliest I’ve ever felt,” said my consultant surgeon colleague as he described lying in his hospital bed the night before cardiac surgery. Even with all his surgical experience, familiarity of the surroundings, knowledge of his own hospital, and utmost confidence in his cardiac surgical colleagues and anaesthetist, he was scared. Despite what our patients might think, being a doctor is no defence against illness and doesn’t make coping with illness any easier.

But, we are our own worst enemies. We put immense pressure on ourselves and don’t want to let our medical colleagues or patients down. I once listened to a single-handed rural GP who had recent chest pain and was awaiting an angiogram. His greatest worry was that he could not get a locum to cover his patients - and he agonised over whether to cancel his appointment. Medicine is described as a vocation, and we shackle ourselves to expectations that no one could possibly fulfill and torture ourselves when we find we are human.

It is time to be honest about our profession, our work and ourselves. We need to think about how we structure careers to allow a healthy work life balance, our well-being and our lives. As I look closely at my colleagues, seemingly in the midst of successful and rewarding careers, I can see some tell-tale signs of struggle. We read about the more high profile casualties in our profession who find themselves in front of fitness of practice committees, arrested for drunk driving or censured for medication abuse. But, there are others who are quietly struggling with the day to day pressures, overworked, stressed, just about coping. Medicine is ultimately about illness and suffering and, for those who care most, the burden seems to be greatest.

One GP colleague told me of a day he shared a diagnosis of terminal prostate cancer with a patient and, when the patient left, he stopped working for a few minutes and asked himself what he would do if given the same diagnosis. It was the start of a life changing journey that made him rethink the way he worked. In my own practice, patients who had recovered from a major medical experience sometimes told me how they resolved to change their lives- live every day it was their last and try to squeeze as much into every living moment. For them, every morning was a beautiful morning. Let’s not leave it too late.

ICPH14

This blog is part of a series that @CMAJBlogs is publishing related to the International Conference on Physician Health #ICPH2014 to be hosted by the British Medical Association September 15-17 in London, UK

Leave a Reply

Your email address will not be published. Required fields are marked *