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Too Emotional For Medicine?

One can't deny the fact dealing with your emotions in Medicine is challenging. You come across different things everyday, it's very rare for your encounters not to tug on your heart strings.

A few months ago, I started placement. My medical school arranges it in 8 week blocks, where you will spend your time at one hospital moving around different departments based on the theme of your placement. This was a whole new experience for me, going on ward rounds, performing skills on real patients e.g. venipuncture, injections etc. and being part of clinics. Now I don't really know how much I can say I was prepared for placement; the intensity of it all. All of a sudden you no longer find yourself discussing theoretical situations but these patients have life in the them, they're real people with real stories and real illnesses. My first placement block was eye opening to say the least but I wanted to talk about the difficulty I had processing my emotions.

My first 4 weeks were spent on the Respiratory Ward. In summary, it was full of a lot of Pneumonia, Lung Cancer, COPD and Interstitial Lung Disease patients. Each morning at 9am the ward round would begin, I would tag along with the team of doctors (normally a Registrar, F1 & F2 sometimes there would be a consultant) as they visit each patient and decide on their next steps and what further tests need to be ordered. On my first day I met a patient with lung cancer and possible metastases to the spine. I knew things were not looking good. Sometimes I feel like knowing so much in comparison to the patient makes me less hopeful and makes me anticipate the worst possible outcome. I'm generally a forward-thinker, so I fast forward my mind to what I think might happen just to prepare myself for when things take a turn for the worst. I guess one could say this is my way of managing my emotions but at times I just think I'm incredibly pessimistic. Each day I would watch as more and more of his family members visited him in hospital, he was one of the loveliest patients that I met during my time on that ward. One day I noticed that he wasn't in his bed, I assumed that they moved him or maybe he went home but the truth is I'll probably never know.

While I was on the respiratory ward, there was a patient that I came across who had Pneumonia. For the first few days he seemed relatively stable until one day he rapidly deteriorated. His breathing was increasingly laboured and his blood pressure was dropping; when the doctor ordered supportive care only I kind of new that meant he wouldn't make it. It was a Friday, he was surrounded by his family, their faces morose and down but then I had to leave. The whole weekend I just assumed the worst, I was even a bit scared to come back on the ward on Monday to find out that he'd gone but to my surprise there he was, he had regained the strength that was lost and seemed to be improving!

This moment made be process the concept of death, now when you're so far away from it it's easy to view it so simplistically. But when you're face to face with a patient who is literally on the brink of death all of a sudden it seems so difficult to comprehend, how a person could have life in them one minute and then a split second later they're gone.

I spent about a week on the Dialysis unit. I had very little prior knowledge on Dialysis and really underestimated the impact it has on a persons life. Patients on haemodialysis come in 3 times a week for 4 hours to be dialysed, this is the process of filtering their blood due to the poor function of their kidneys. Now what shocked me the most was that some of the patients were quite young, I'm talking late 20s and early 30s, of course the majority of the patients were elderly but I just couldn't get my head around the fact that these people will most likely be on dialysis for the rest of their lives if they are unable to get a kidney transplant. I felt so sad, especially knowing that some of them were relying on family members to donate their kidney however due to one reason or another they wouldn't be able to. As a medical student you would speak to the patient and realise how hopeful they were that they would get a transplant but then when talking to the consultant after they would say just how slim their chances were. Was it wrong for the patient to be hopeful even though their chances were so slim? But then again, hope is all that they could hold onto; no one wants to be confronted with the harsh reality that they might spend the rest of their lives dependent on a machine.

The truth is my emotions were all over the place, at times I felt heartless, I felt fake because I couldn't relate to what patients were going through or had been through but then other times I felt sad and helpless. Before placement I had such a naive perspective of the clinical world of Medicine, that everything was so black and white but it isn't. Somedays I felt strong where as other days I struggled and that's okay. It is all a process, and with time I know that I will learn to manage my emotions better. As for now, my emotions remind me that I am human.


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