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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Wednesday, 27 August 2014

Singing songs and other human things

On popping home recently, I bumped into a very old friend - someone I hadn't seen for years. I always find myself embarrassed by myself in these situations - there's something about saying 'Um... so I'm a doctor' that has the potential to feel like you've dropped a bomb.  Out of the resulting crater can spill out a whole bunch of emotions, as it did in this instance.  My friend had close family who were going through the complex map that is NHS-and-social-care and they were deeply frustrated.  Doctors crooking their heads and telling them what they thought was best, despite being a quarter of the age of the patient.  An a-amotional stream of medical types who had fifteen minutes maximum per day devoted to each of their patients (ward of 20 patients, 8 hour day - you do the maths).

There is always a question in clinical medicine (and I have previously written about the pros and cons of the so-called game face in medicine) - how much of 'you' do you reveal?  Particularly when you're a junior doctor, and, dare I say it, particularly when you're a female junior doctor?  When does 'being yourself' just become unprofessional?

I find myself increasingly leaning more on the human side of things than others might.  My friends roared with laughter when they heard that I sang an entire song from my childhood to a patient (and their family) because I thought it might make her smile at an otherwise rather difficult time.  I regularly tell tales and memories of my grandparents, and my (still living and going on mightily aged 93) grandmother is frankly famous from the number of patients I have told about her as an example of age just being a number and focusing more on what people can do rather than the date on their birth certificate.  If patients or relatives sigh at me and say 'you doctors just don't know what it's like' with complex discharge planning regarding their elderly relative who lives 300 miles away from them, I am willing to share their frustration with my own family's experience of exactly the same thing.  I talk German to my patients who are German.  I only introduce myself as 'Dr Purshouse' when the situation requires it (e.g. official-dom) - the rest of the time I'm 'Karin, one of the doctors'.

You're probably reading thinking I'm marking myself out for sainthood, but these are not beliefs and practices held by everyone.  Some people (and my colleagues) want doctors to maintain a more professional manner.  One of my colleague always introduces himself as 'Dr So-and-so' so there is no confusion later on about who he is, and to a degree also set the tone - he is a professional, giving his professional view.  Frankly it can be just confusing to patients, and a more formal approach can make it easier to understand who everyone is.  Some doctors prefer to keep their private lives to themselves, absolutely all of it, and part of that is also self-preservation and not getting too emotionally involved with their patients.

Trying to be a 'serious doctor'.
My take on this?  I am a doctor, and I ask for the same professional respect as I afford every human being (patients, colleagues, anyone), but if I wanted to be an emotionless robot, I would have picked a different job.  Obviously I judge every situation on its merits, and being super-casual is not what showing your human character is about.  Sometimes I think I should be a bit more formal at highlighting my role though: one of the questions on a confusion questionnaire screen is 'what is my job' - and if I had a nickel for every time someone said 'secretary'....

Hmm.  Perhaps I should try it for a while.  Keep the singing, but instead do a trial of 'Hello, I'm Dr Purshouse but please call me Karin' as a compromise?

Oh, it's tricky being a doctor and being human!

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