Source: The Guardian – Ranjana Srivastava.
Doctors nearly always internalise insults that patients fling at them. This can have serious consequences to the quality of the healthcare they’re able to provide.
One day, I realise that it has been months since I saw a patient whom I was closely involved with at the time of his cancer diagnosis. He was pale and shaken during our first consultation, his wife having retreated into a silent world of her own; it took several meetings to tame his fears, plan treatment and return a semblance of normality to his upended life. I felt relieved when our last meeting ended on a calm note and he expressed gratitude for my concern.
Remembering those conversations, I wonder why he has not returned to see me. Perhaps he switched doctors, clinic days, or healthcare networks, a common occurrence in a burdened public hospital where patients do not have a primary specialist and describe considerable stress navigating the healthcare maze. Or perhaps we forgot to send him an appointment and he fell through the cracks. The last patient who kept waiting to hear from us came to attention far too late and died shortly thereafter of disseminated cancer. Another woman who failed to attend was eventually discovered by a community nurse in a derelict caravan, starved, confused and incontinent. On my final visit with her in hospice she wept with joy at having a clean bed and a warm meal. I was consumed with guilt that we hadn’t searched for her more urgently.
Although healthcare professionals tend to focus on those in front of them, such cautionary tales routinely shape our daily concerns about our other patients. Therefore it is with apprehension that I look up my absent patient. Reading his notes I discover that his disease has recently advanced and another oncologist has prescribed chemotherapy. Knowing well how upset many patients feel at their perceived abandonment by their original oncologist when their illness becomes terminal, I immediately call him to express regret at his recurrence, and ask how he is doing. Somewhat cautiously, he replies he is okay. I wish him luck and hang up feeling relieved that he has not been lost to follow up. Our entire exchange must have taken a minute. The repercussions would reverberate much longer.
The next day an email lands in my inbox. In it, the patient curtly tells me to get lost. He alleges that my call upset his equanimity because the time for me to demonstrate my caring had lapsed. He accuses me of intruding on his privacy and signs off on an angry, even threatening note. It would be an understatement to say that I am blindsided by the vitriol…read the full story.