Jobbing Doctor looks at the saddest experience a GP can have - should you retain the professional 'face' or show your feelings?
One of the saddest experiences I have ever faced is looking after a child from birth to death. It is certainly something that happens rarely enough in the era of modern medicine that each and every case in burned onto my memory.
I have seen this several times in my career, and now one of my colleagues is now going through the whole process. It is very hard to cope with all the emotions in the case and still remain professional. I can't do it, and I don't know if my colleague will be any better.
I think the role of a Jobbing Doctor is different from those who are involved in hospital medicine, as the hospital clinicians will have never seen the child well and in their own family and environment: we do.
I remember all the cases I have dealt with extremely well. All the emotions are there, but somehow darker, starker and more intense than usual. The details will always be there with you.
The ill child playing on a computer game, the worried look of the parents as they try and read your face for clues. All of a sudden you realise that you are with them in an absolutely pivotal part of their lives. You are it - the key professional person for them.
Do I hide my own feelings in front of my patients? It is argued that, on the one part they are struggling enough to cope with their own emotions, so they need someone who is objective, dispassionate and emotionally steady in a situation where it is so charged with feelings and anxiety. I am quite persuaded with this view.
Then there is the situation where you do not wish to appear uncaring or unfeeling, and a sense of connection with people is really important. This might involve a few kind words or holding their hands, or just being there: being quietly there. This approach also has its proponents.
Many people might say that by showing your emotions in this kind of situation, you are being self-indulgent and that is not a good thing to be.
However, I cannot hide my feelings. I find it very difficult to hold the professional ‘face', so I do not make any attempt to do so.
I may be accused of self-indulgence, and I would plead guilty with mitigating circumstances. I have been in tears with patients when we face the enormity of their loss, and although it is their loss, I do sense some of the awfulness of their experience.
If you lose a child, is it easier to cope with if the experience happens to other people as well? Your mental pain is your own, although you share it with every member of your own family. But sharing it with people outside?
Jobbing Doctor is well acquainted with this level of grief in his own life, and my patients know this.
One old man had been seeing me for years, and the whole conversation was generally about the mundane and banal. After I experienced my own bereavement, it was briefly in the papers, so my patients knew.
This man came to see me for his routine appointment, and he spent the consultation telling me about his son, who had been killed by a train. It was the only time he mentioned it, ever. It was as if a corridor of love and understanding had opened up between us, and the whole consultation was (even 20 years on) as if it were yesterday.
It is a privilege to be with people at the most difficult moment in their lives.
The Jobbing Doctor is a general practitioner in a deprived urban area of EnglandJobbing Doctor