During our lives we blow content, in the form of experiences, moments of love and sadness and the mundane in between. If we stop to reflect IN life we see the beauty of the translucence, the perfect curve and the reflected rainbows within the bubble. As the content increases so does the fragility of that bubble. Then it bursts, physically evidence less, into the ether.
Empathy the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also : the capacity for this (Merriam-Webster dictionary)
This is an "unscheduled" blog. I only intended on writing one a week. I have been thinking and reflecting all day. Why? Because this lunchtime we had intended to visit a respected relative/friend/GP who has been incredibly resilient in his battle with cancer. We intended to visit him at lunchtime at his home, but instead we attended his funeral.
- He was of my generation
- He has left behind two teenage children and a devoted wife
- He was a Birmingham GP
This, amongst other factors, made this funeral particularly difficult for me. His father spoke in a broken, weak voice. He pleaded that we pray for his son. These words reverberate in my mind. No parent expects to bury their child. A man who bathed his cherished infant was now washing the body of his son, whose body has been consumed by a parasitic cancer.
Of course Dr F professionally knew death;
" The doctor is the familiar of death. When we call for a doctor, we are asking him to cure us and relieve our suffering, but, if he cannot cure us, we are also asking him to witness our dying. The value of the witness is that he has seen so many others die...He is the intermediary between us and the multitudinous dead. He belongs to us and he has belonged to them. And the hard but real comfort which they offer through him is still that of fraternity"
Berger J and Mohr J. A Fortunate Man. 1967
But he must have had an entirely different experience being a patient. My curiosity led me to do an Internet search on literature on dying doctors. I found an interesting article in the Guardian.
The sentiment resonates with some books I am reading at the moment. Matters of Life and Death by Iona Heath takes a critical look at the state of medicine today,
" Science does not know when to stop"....and I wholly agree with her in this context.
Dr Heath's book should be essential reading for all GPs. She bravely and sensibly presents eloquent examples from the humanities about death...and what a good death might look like. I hope for a good death, when the time comes. I want my patients to have "good deaths" too. John Berger contributed to Dr Heath's book. He wrote A fortunate man, quoted above. This provides a fascinating insight into the life of a country GP in the 60's in Ireland. This conveys a certain professional wisdom and benevolence that I feel needs to be discussed and explored in modern Med Ed programmes.
Debilitating empathy - has it ever happened that a doctor has had so much empathy for a patient that they lose the ability to think objectively? It would be considered unprofessional I suspect. So as doctors we put up barriers to protect ourselves. Only by reflection can we tell if we get the balance right.
Tenuous link to the fact that I have had to read the GMC's new guidance on Good Medical Practice, which "goes live" on Monday 22nd April. The reason I have read this is:
- I have to, it is my professional duty to do so
- I am involved in a teaching session on professionalism next week
- It forms the basis of revalidation
Anyway, whilst reading it something struck me. Statement 16c says:
- Take all possible steps to alleviate pain and distress whether or not a cure may be possible
This perturbed me as I had only just read, and agreed with page 37 of Iona Heath's book:
" You need pain so you are aware you are alive. Everyone says 'do you have any pain' anxiously. It should be the other way round" ( Julia Searle speaking about a good death)
Heath describes that Gadamer felt that biomedical technologies relieving many of the symptoms of dying, deprive patient of the experience of their own dying.
Surely, if we aim to offer truly individualised care we should at least ask the patient how much pain they wish to tolerate?
So, in this late night deliberation I decided to "follow" @gmcuk on twitter, and in only 140 characters describe this conflict. I await their response.
Thank you for taking the time to read this blog. Please interact, I would really love to hear your thoughts on the issues raised and the blog style itself. Forgive my intellectually naivety, for I have words, which I feel are a spectrum racing around in my head. There is a connection, not just linguistically but also in my own personal direction in life.
Life
Death
Humanity
Humanities
Humanitarian
signing off with Lao Tzu's words:
" Just realise where you come from: this is the essence of wisdom"
" Just realise where you come from: this is the essence of wisdom"
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