Being the patient…

One of the best ways to learn how to be a better doctor is to be a patient. Whenever you do those ridiculous ‘What learning style are you?’ tests in orientation sessions (I mean for shits’s sake I’m almost 40, have done 3 degrees and taught myself medicine – if I haven’t worked out how I learn by now then what the hell have I been doing?) I always come out as someone who learns by doing (which I knew anyway but I’ve had  this rant already in the last set of brackets). Which is good because I had a textbook pregnancy and birth. And when I say textbook – I mean I basically got everything in the textbook.

If you’re about to switch off pre pregnancy moan I totally forgive you – and yes I am going to sort of go into my (cue richly-hued southern american accent) ‘Birth Story’.. but I promise there’s a point to this. And feel free to come back another time instead.

So during my pregnancy I learnt how it feels to vomit continuously for 22 weeks (like a bad hangover without the fun and embarrassing snogging), about carpal tunnel syndrome and de quervain’s tendonitis, about haemorrhoids and pelvic floor instability (I now have infinitely more empathy for my patients with incontinence issues, after an infamous sneeze outside the British Museum). I learnt how it feels to have reflux all day and all night and how heavy a bottle of gaviscon is to keep in your handbag. I learnt how it feels to dread walking up stairs, about how long it takes to get anywhere when your legs won’t work properly. About what people actually mean when they say ‘just around the corner’, about where all the public toilets are in a three mile radius and how long it takes to get there. I basically learnt how it feels to be an arthritic, incontinent 80 year old patient, and it was a sobering lesson.

And I learnt this for a long time, because my pregnancy went on forever. And then, finally, 8 days overdue, after not peeing for 3 days and swelling up like a melon, I had a 12 hour headache that wouldn’t respond to paracetamol and I knew that pre-eclampsia finally had me in it’s clutches. I booked an urgent appointment with my GP and he sent me in to hospital for induction.

Having spent 6 months living in the O&G department of our local hospital, it was a bit like going home to your parents after leaving university. There was a lot of catching up to do with everyone, and quite a lot of ribbing about bothering them. We went up to the mess to put a ready meal in the microwave and watch some tv. My boyfriend likened it to having a backstage pass at a festival. I’d rather have been at Glastonbury – but at least the loos were clean and the drugs easily available.

They gave me propess to ripen my cervix and sent my boyfriend home to get some rest, and then things started to come undone. I won’t go into intimate details (watch me as I go into intimate details) as it’s boring as hell for anyone who hasn’t given birth, and terrifying for anyone who’s about to, but the next 24 hours turned into a shitstorm of enormous proportions. My temperature went through the roof, my contractions were too strong, my cervix wouldn’t open. The baby wouldn’t descend. After 24 hours of regular strong contractions and a billion epidural top ups, I was given an hour to push, managed to push out some piles the size of my fist, but no baby. Into theatre for a trial of ventouse. Baby wouldn’t budge. Non-reassuring fetal blood samples. Fetal heart rate through roof. Conversion to emergency c-section. Bed broke. Baby out. Brief moment of calm. It’s a girl! Into recovery. Baby drops temperature and blood sugars. Baby rushed to neonates for septic screen and IV antibiotics. I’m sick. She’s sick. My 3 days not peeing catch up with me. Kidney function goes awol. My bowel stops working, my belly swells up to an over 9 month pregnancy size, they worry my colon will perforate. I’m put nil by mouth until I move my bowels. I’m peeing for Britain and desperate to drink. I eye up the hand gel dispensers. My poor boyfriend stalks the hall between labour HDU and the neonatal unit, not knowing who to look after. The IV antibiotics get on top of my sepsis, and my blood pressure starts to rise. And so it goes on… Eventually the storm settles and we’re all reunited. We’re shipped to postnates (the land that time forgot), and (due to aforementioned backstage pass) am lucky enough to fester for a week in a sideroom. Then eventually we’re released (oh the sweet smell of rain on tarmac!).

So what did I learn from this and why the hell am I detailing my birth story despite previously promising not to?…

I learnt that being a patient is shitting scary, and that you’re not in control of anything. I learnt that a kind word, and someone acting like they genuinely give a shit about you counts for far more than any medical intervention. When the O&G consultant (who I’d worked with previously in London as a registrar) held my hand and told me how brave I was being, it was better than all the oromorph in the world. When the midwives and nurses patiently helped me out of bed for the millionth time, or emptied my bedpan, or burped my baby because I couldn’t stand up, it made everything ok.  When I terrified the new, incredibly nervous, paediatric trainee, by standing naked, with piles and swollen genitalia on full display, attempting to burp my baby as he avoided eye contact, and tried to help me keep the dignity I had so wantonly discarded, I was incredibly touched. And when the nurse cackled like a banshee with me about this, I felt like a normal person again. In short, I learned again that being treated as a human, who deserved care and attention, was better than any drug.

There were less positive lessons that I learned – being made to feel like a junkie by some of the midwives on postnates, as I desperately attempted to manage my pain relief, for instance. But this just made me remember how I have treated patients with multiple unexplained symptoms or chronic pain disorder in the past, and to endeavour to do so differently in the future (I’ll fail – I’m only human – but at least I might think about it before failing.)

Anyway I’ve blathered on for too long about something I promised I wouldn’t write about, and breast milk is leaking all over the shop.  So I should stop and attend to the tiny alien who is passed out on my shoulder and making me type with one hand. But I basically learned that to be a good doctor, you need to have been a patient.

Next time I promise to stop navel gazing (hello navel -it’s been a while – you really need some lady maintenance) and write about other people. If you’ve made it this far. Thank you for listening…

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