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Do not communicate, it interferes with hospital machinery



I’ve always sworn I’d never resort to one of those ‘How my illness made me a more empathetic doctor’ pieces – not least because they’re typically as riveting as listening to someone else’s dream, and often come across as sanctimonious crap.

But that was before I was a) unwell, and b) on deadline.

Which sets the scene for me being in a surgical assessment unit with left iliac fossa pain. Riveting, eh? Worse still, with pain that is increasing and which tests have annoyingly failed to confirm as either of my clever self-diagnoses, diverticulitis or an impacted stone. Bugger.

And, boy, does being on this side of the hospital fence give you some insight. Of course, everyone is efficient, busy, kind, caring etc and, yes, I do realise we’re in the middle of a pandemic that is tarnishing everything, including our right to suffer non-Covid illnesses.

But still. The hours tick by with long tumbleweed phases interspersed with sudden random and unannounced activity, including history, examination, obs, cannula, bloods, scan – though not necessarily in the logical order I’ve just listed them.

The really significant bit missing here is the glue that should hold this lot together – which is any sort of meaningful and ongoing communication. I am in a big machine that, it seems, can do everything but speak to me. I’m utterly bewildered about where the process starts, stops and what’s happening in between.

At one point, I realise I’ve had no interaction with anyone for nearly two hours. I’m desperate for some sort of information. Anything. What do they think, what have they found so far, who are the various people I’ve seen, what’s happening next, what’s the plan, can I go for a pee, can I eat or drink, can I have a painkiller, what’s the Pompey-Doncaster half-time score? Somebody. Speak. To. Me.

And then, out of the blue, they tell me I can go home. Er, brilliant… I think. Tests inconclusive. Nothing obviously serious.

On discharge, you should be given an info goody bag containing the likely diagnosis, the plan for follow-up, the purpose and duration of your meds, who to contact if you’re concerned and the name of your consultant. And if you’re not, you should think to ask. But I don’t, because by this time, I’m tired, anxious and – after just 10 hours – institutionalised. In short, I have turned into a patient.

And that’s how my illness made me a more empathetic doctor. No longer will I reflexly view patients as curiously gormless and passive when they try to sort out post-discharge issues with me. Because now I understand. The hospital process does this to you. It involves loads of compassion but little communication. And at the end, you’re simply ejected, dazed, confused and helpless. True, I will still direct patients with post-discharge queries to PALS, but I’ll be positively dripping with empathy as I do so.

Sorry if this comes across as sanctimonious crap. I still have the pain, by the way, and I have no idea what to do about it. Call my GP, I guess.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield

READERS' COMMENTS [3]

David Church 11 November, 2020 7:36 pm

Very good Tony;
and did you take-home-in-your-hand discharge letter contain just your demographics and the single additional word ‘admitted’ ?

James Cuthbertson 12 November, 2020 5:04 pm

All joking aside, it’s unacceptable. The policy of “try to rule anything out with tests then discharge the patient ASAP before they ask any tricky questions” is a way of trying to cope with overwhelming demand, sometimes made worse by total lack of interest.

David Patterson 12 November, 2020 5:51 pm

I’d never thought to bounce them back to PALS! Thanks for the tip!!

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