Unless they are lucky, most newly graduated doctors end up changing apartments/homes after graduating, and before starting their new jobs. In the weeks leading up to DAY 1, they spend as much time worrying about putting a bed frame together as they do about accidentally killing a patient while on call. At least that is what was occupying me. It is a heady time of jubilation and terror.
The privilege of sipping this emotional cocktail was interrupted for me when I passed out and experienced my first seizure three weeks before my first day of work. The eventual diagnosis was orthostatic hypotension leading to syncope, likely triggered by a combination of sunbathing, beer, and shisha. The "seizure" was actually convulsions, which sometimes occur when you faint, and technically aren't a seizure at all. As far as medical issues go, it was all very benign and uninteresting, which is a fact you kind of ignore when you're sitting in an emergency ward thinking things like, "Hey, you know what else causes seizures? Tumours." Welcome to the world of not yet being a doctor but knowing just enough to shit your own damn pants.
I knew what I was in for when the ambulance came to get me; a young guy with stable vital signs who fainted but otherwise looked okay wasn't getting seen right away.
Low danger. Low priority.
"You, sir, are gonna wait."
I loaded my bag up with books, portable chargers, sweatshirts, water bottles... you name it. I was ready for boredom. And yet, of all the activities I lined up for The Wait, here's what I ended up doing:
Read 2 pages of my book: 15 minutes.
Read the news: 4 minutes.
Googled "brain cancer": 7 minutes.
Beat 3 levels of Candy Crush: 11 minutes.
Texted people that I was okay: 25 minutes.
Sipped some water: 2 minutes.
Interacted with medical staff: 10 minutes.
Stared at the ceiling and other patients: 286 minutes.
I didn't chose to read a single page of text in 7.5 minutes; I just couldn't do any more, or do it any faster. Believe me, I didn't want to stare at a dimly lit hallway for over four hours, and yet, there I was, staring off into space, actually pondering my own mortality.
Once the Internal Freak Out Monologue subsided, I got to more constructive thinking. Stuff like "whoah this kinda sucks," and, "is that doctor an asshole, or am I just cranky?" I got a little frustrated that I really had to go out of my way just to get some more water; I got kind of sad that the man being held against his will for what was presumably a psychiatric diagnosis started crying at how powerless he was; I was taken aback by the cognitive dissonance of hearing nurses laugh in the break room while sitting contemplating my health.
At some point during those 286 minutes, I started thinking I would never let patients languish like this without attention, I'll do better when I'm the doctor, and soft skills and emotional comfort are what I do best. I like to think it was a similar thought process to a waiter when they go out to restaurants to eat. And yet, now that I am the doctor, I see how it is so easy to treat patients without actually taking care of them. You round, you examine, you make phone calls, you prescribe, maybe you do a procedure, but it is quite hard to do that extra thing. It is shockingly easy to forget that a patient asked you for some juice, or to ignore the fact that this 90-year-old woman who doesn't know how to use a cell phone is actually just sitting in this bed all day with nothing to do. Boredom.
I laid in a hospital bed for 286 minutes and went through an emotional ringer driven by boredom and fear. Here I am, now on the other side of the exchange, and I know there are patients sitting in wards for daysweeksmonths, stewing, unattended and unentertained, all while wondering what new and wonderful way their bodies might fail them on this particular day. That's fucking insane. What are we doing?
More senior doctors might think thoughts like these are the privilege of the uninitiated; junior doctors are ignorant enough to focus on things that don't matter, right? Maybe they are, but isn't that the problem? I'm terrified of turning into someone who accepts this status quo. Despite this, I find myself sympathizing with doctors who do accept it. Four weeks into doctoring and I've already forgot to bring a patient some juice because my to-do list grew faster than I could get things done. I have already had conversations about this with my first-year colleagues. This is not unique to me, and thousands of bright-eyed-and-bushy-tailed doctors are bumping up against the harsh reality that is working in a hospital. I hate that this happens; I hate that no one is talking about it; I hate that, maybe just maybe but God I hope not, I'm only thinking about this because it affected me one time for 286 minutes.
I do not have a special solution. This is not a diatribe that flows seamlessly into uplifting insights borne from honest introspection. I'm just scared that I will become a good doctor for my superiors, and a bad doctor to my patients. I am typing this out because I hope by saying it explicitly, I will do better.
To patients and their families, know that your medical teams care, they are just not always good at showing it.
To the healthcare professionals, I think we can do better. We just have to start talking about it.