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Why hold back the tears?

Where is the line drawn between being yourself and being your doctor-self? Is there a line? Is there a barrier, like a 12-foot impenetrable wall that can’t be scaled, to protect our own emotion and our own weakness?

I have only ever cried in one consultation. I am a sentimental soul – I cry at films, childhood memories, when my kids are sad or ill. I am a crier.

But apparently not when I am at work. I have witnessed a man’s last breath and not cried. I have locked eyes with a 12-year-old patient dying from a brain tumour, and when she asked me if she would die, I didn’t cry. I once delivered a baby on the floor in my GP surgery: a healthy perfect baby whose accidental early arrival brought my waiting room to tears. My heart raced for days but I didn’t cry. I have seen fragile babies bruised from child abuse and felt irate, but never cried.

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So why do I now sit in front of Derek and struggle to hold back the tears? He is worn out by COPD; the inhalers give little comfort. He has been thrown out by his wife and he is homeless, sleeping in a garage near what used to be his home. He is working, but he can’t afford rent and the housing department is not interested in him.

There appears to be no way out of the situation, no path for us to forge even together to pull him from despair, no way to tackle the idiocy of a social system that has left a working man homeless. I have a fleeting thought of giving him money but it passes. So I am left with nothing for him. No flash of idea. No golden ticket. All I offer him are my tears.

I’m not sure I will ever know why I cried in that consultation. Possibly it was the desperation we felt, my own sense of powerlessness or inadequacy.

Perhaps I wasn’t crying for Derek at all.

Perhaps I was selfishly crying for myself and the realisation that I too am weak, and I can’t always help people.

Perhaps I cried as the remnants of any faith I may have had ebbed away. 

Maybe my tears belied the immense responsibility of being the only human this man had to hear him.

It changes you to cry in a consultation. It changes your position and role in that clinic room when you sit proudly as a professional, as a rock, as someone in control.

That is a good thing. It opened up a vulnerability I was always aware I had in my personal life, but which we all try to mask at work.

And I learned there is no wall. There is no barrier for me. Most of the time it will appear to be there – the fence will seem high.

But deep down there is no difference between who I am, and who I am as a doctor.

Dr Ellie Cannon is a GP in London and a columnist for the Mail on Sunday and Woman magazine.

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