The Ritual
The doctor looked at the patient with an impassive face as she described her symptoms. He is familiar with the ritual.
Crippled by an unexpected, unpreventable, and largely untreatable illness in the prime of her life, the patient had been denied many of the things in life that her peers have and continue to enjoy.
Still maintaining eye-contact, the doctor thumbed the pages of the casenotes absentmindedly as the patient continued; her myriad of vague complaints may be symptoms pointing to the diagnosis of an obscure systemic disease, except they are not - she had been 'worked up' extensively by the previous doctors, as the thickness of her file attested to, and nothing has turned up.
She was probably depressed, the doctor thought.
Certainly he too would be depressed if the same fate had befallen him. Yet despite the difficulties she faced she had managed to find and hold a job that has kept her busy and provided for. She has also kept her quarterly appointments to the clinic faithfully.
Finally, she paused.
"Am I dying, doctor?" she asked.
"We all are," the doctor replied.
The patient gazed at the floor for a good five seconds, then turning to the doctor again, said,"I know what you mean, doctor."
She leaned back in her wheelchair, the cue for her maid to wheel her out of the consultation room.
The doctor allowed himself to smile as he bade the patient goodbye.
The ritual is completed.
posted by angry doc at
5:10 pm
3 Comments:
Does the ritual help? Just wondering? I think wrote you something about drs doing some behaviourial modification to patients so that it affects the patient outcome.
Do you see the doctors role as also providing solace, comfort and acceptance for situations beyond control.
I am sure you guys face a lot of situation like this. Like breaking the bad news and telling patients no cure. Almost sounds like some ER drama or Greys anatomy
palmist
By
Anonymous, At
September 05, 2007 2:29 pm
Different patients require different rituals, I guess.
Patients tend to be more compliant with the treatment if they trust the doctor.
As for doctors providing solace, comfort, and advice on coping with life, this is what I call the 'secular priest' role; traditionally such a role would have been played the village priest or elder, but in modern society we lack such support. The idea of calling a total stranger on an SOS hotline would have been rather unthinkable back then (the yet-to-be-invented technology aside...).
Doctors today play that role by default for several reasons:
1. People medicalise their 'problems of living'.
2. Doctors are privy to a lot of personal information.
3. For many people, doctors still occupy the position of authority in the relationship.
4. We happen to be there when bad things happen: death, serious illness, family conflicts precipitated by above, etc.
When bad things happen to people and they look to you for comfort, sometimes you just have to behave decently and help however you can.
We are all taught how to do that in school, but a lot comes with experience.
By
angry doc, At
September 05, 2007 7:23 pm
"We all are" is nonetheless an unusual response to the inevitable question. Probably works better in Ang-moh land than here. The sort of ending to the consultation here strikes me like a flight of fancy... which of course it probably is.
By
blacktag, At
September 05, 2007 8:43 pm
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