I woke up feeling tired. My back hurts from the hours of standing the previous day. The last surgery yesterday went on far longer than we anticipated and I closed two hours later than usual. To add insult to injury I had to drive my 5 year old “tokunbo” Honda through dense traffic before getting home at 10pm. I was really hungry. No one had thought to make arrangements for a meal for us at work, my tummy was protesting earnestly. I had run out of noodles so I just soaked gari and went to bed. I cannot afford a noiseless generator and I cannot keep my “I better” on overnight for fear of the neighbour’s curses so I slept in the heat with the cruel mosquitoes that had squeezed through the poorly applied net windows, making a terrible night even worse. I did not have pleasant sleep or rest. So by the time my alarm goes off, I feel like throwing my phone against the wall. Wisdom quickly prevails as I think about the cost of a new phone and advice myself. I get up gingerly with my aching back and prepare for work.
As I arrive at work, I am in deep thought about my situation and how to get out of it. I weigh the two options I have; I can either emigrate or move to a serviced apartment. Even in my mind I am rolling on the floor with laughter. These options are not possibilities for me as I can afford neither on my current salary. A man is allowed to dream though. I barely notice my colleagues as I head straight to the consulting room that serves as my office. I am ready for work today, or as ready as I am going to get. Patient after patient I see. At some point I start to forget to say hello and jump right in asking instead what the problem is. Later in the day, I meet a middle aged patient who seems anxious but I cannot be bothered to allay his fears. I skipped breakfast hoping the clinic would be light and I could get an early lunch but even late lunch hours are slowly passing by. I get frustrated with the patient, though I try to hide it, because he doesn’t seem to be able to follow my simple instruction to lie on his left side and pull his knees up towards his chest. Seriously, how hard is it? Have you really never had a rectal?! My thoughts are unsympathetic as I think about how he had for over a year ignored weight loss and a change in bowel habits knowing that he had a family history of colorectal carcinoma. He’s still not in the position I described and I grit my teeth. Having to do a rectal examination is annoying enough without having a patient drag the process. There are instructions I can give him that will make the entire process more bearable, I know I should tell him but I really am in a foul mood by now so I don’t. When I am done and he is dressing up, even before he gets a chance to be seated after dressing up, I start to share my findings and what they mean. I tell him he is very likely to have cancer and he will need a lot of investigations to confirm this. I ask him if he is interested in the investigations so I don’t fill out forms only to hear him reject everything I have told him. He just stares at me blankly. I am beginning to get irritated because the nurse has just come in and added two case files to the pile of patients I am still to see. He is still staring blankly when I ask again. So I ask him to please sit outside to think about it, while I see other patients. I get up and call in the next patient before he is even out of his chair. I see seven patients before I get the chance to take a break. By this time, I have totally forgotten about the patient I asked to think about what he wanted to do next. As I step out of my consulting room, voices drift toward me and I step closer as I hear my name. It’s my patient; he’s speaking and saying; it did not occur to me that I was sick. I have been on a new diet for about six months trying to get in shape, so I thought it was all related. My wife asked me to come to the hospital just to be on the safe side. There’s a pause, then he says; that doctor is the worst professional I have ever encountered in my entire life. He has got absolutely no empathy. I hear a colleague’s voice respond; I wish I could say you are the first patient to make such a complaint. He’s just as unpleasant to his colleagues, barely if ever, says hello. I am really sorry that he delivered this unpleasant diagnosis to you in the callous way you described. Please accept the apologies of this establishment and rest assured that a formal complaint will be lodged. The patient responded saying; I really don’t care for a formal complaint. I am simply overwhelmed with curiosity; what turned him this way? Would his parents be proud to watch him practice medicine with such disdain? If he has a wife what empathy can she expect from her husband? What light in his soul has dimmed to the extent that he no longer sees me as a fellow human being whom he has only met because of my suffering?
At this point I walked away. I was concerned about being caught eavesdropping. As I did, I asked myself some of the same questions he had asked. When did I become who I am? How did I lose my way? Why was I no longer courteous to my patients? I had so lost my way that even my colleagues were not willing to defend me. The most important question I had to answer was; is it too late for me to find my way back?
Everyday witnesses report callous behaviour exhibited by doctors; towards each other, other healthcare professionals and worst of all towards patients. This essay was written to generate conversations within and between doctors that can lead to more people treating patients better. It is easy to become overwhelmed and dragged under the issues that face healthcare professionals in Nigeria; poor remuneration, poor work conditions, lengthy work hours and poor workplace relationships to name a few, but there is a duty and responsibility to yourself first and then to your others, to be courteous, so put in an effort not to let these hazards turn you into someone you no longer recognise.
Entered into Healthfolk.net 2014 writing competition
http://healthfolk.net/blogs/198/11/who-have-i-allowed-myself-become
