[Previous entry: "Every bit but one"] [Next entry: "Internet recommendations 1: two GP blogs"] The general tone of my fellow medical students' writing tends to follow two themes: "medicine is awesome" and "the academics are really hard". Part of medical school is being exposed to the sharp end of humanity, though, and writing about the more challenging experiences is generally done on private posts to small groups of trusted friends. After all, we're going to be doctors, right? We're tough! We've seen it all before! Virtually nothing can surprise us, or gross us out, or force us to step back and forcibly re-examine ourselves.

Sometimes there are chinks in our armour. Sometimes the sharp end of humanity turns out to be pretty sharp.

Unfortunately there's a good reason that we keep these experiences pretty private. Part of it is that it's incredibly difficult to write about them without coming across as either flippant or overinvolved - finding the balance between empathy and clinical detachment is hard enough to get right when you're among colleagues and superiors, never mind outsiders. This is why I don't read the blogs of many students I don't know.

I've also found that non-healthcare (or even non-medical) people often Don't Want To Know - whether it's your elation at having someone's stomach in your hands or the terror of realising that there's absolutely nothing that can be done for one of your patients. It is easy to forget that people are squeamish, or that they might be more sensitive about things that seem commonplace after a few days in the emergency department.

Thirdly, it's very hard to protect patient confidentiality, avoid compromising the image which so many people seem to have of our profession, and still discuss the experiences which challenge us. I feel uncomfortable with the idea of telling friends that I have seen their relatives in hospital, so disclosing medical details in a public forum, no matter how anonymous, is not something I'm willing to do. For example, I don't want to tell the stories that precipitated this post.

Finally, being forced to confront our own fallibility is unsettling, particularly with the image that many students, doctors, and outsiders have of medical professionals. I heard a psychiatric registrar giving a talk on how the suicide of a patient affected the healthcare staff who had come into contact with them, and she freely admitted that she found it hard during the process to play the part of the strong one: "being the doctor". It's the first time in four and a half years that I've ever heard someone say it, but I'm sure it's not uncommon to feel like that.

I hope not, because it's happening more often than I'd like.

Thankfully, I know there are things I can do - e-mail my mentor, talk about it with my registrar, and write this blog post to try and explain why my answer to "how's medicine?" will almost never be the truth.

One comment

chinks :: Monday, August 18th

speaking of "chinks in the armour"

http://www.news.com.au/dailytelegraph/story/0,,24177814-5006002,00.html