The privilege of caring

Never underestimate the impact we have on patients and their lives. Life can change immeasurably in the blink of an eye and after that moment nothing will ever be the same again. As a colorectal surgeon I spend a lot of my time telling patients they have cancer, and it still doesn’t get any easier. It is a life-changing diagnosis and the way the news is delivered will have a lasting impact on the patient and may have an impact on the doctor-patient relationship. Although some may have been expecting the diagnosis, they still hold onto hope that they are wrong, that you are going to tell them that everything is going to be ok.  To hear the word “cancer” spoken out loud makes it frighteningly real.

My job is to help them understand, to make treatment plans and to answer their questions to the best of my abilities. Being honest and specific with information allows the patient to start making sense of things and can provide a sense of relief as the detail can create boundaries to contain the patient’s fears as it is all too easy to imagine the worst case scenario. But there are some questions that I don’t have the answer to and, although my patients ask them, I’m not sure they really want to hear the answers. We can only make generalisations and we all have patients who have defied the odds and are still alive several years down the line despite widespread disease. I feel we walk a very fine line between not giving false hope but not dashing hopes completely.

My job as a surgeon is both an honour and a privilege. I see people at their most vulnerable and they have to trust that I will do my best to treat them. Patients often comment that I look awfully young to be a surgeon and I sometimes wonder if they find it harder to put their trust in me and what I can do to help.

I was reminded of this impact that we have by one of my patients who I treated for a rectal cancer last year. He wrote a poem about his experience of diagnosis and dedicated it to me (it has been reproduced below with his permission). I was so humbled and moved by this. It’s easy to get caught up in the routine and go through the motions but we should never forget, that for our patients, their appointment will change their life forever.

The Surgeon

We waited outside the consultant’s room

Waited to be called, pale & expectant

When the call came we entered the room

The surgeon, a focal point

The essence of her filled the space

Surrounded by assistance

The number in the room

Compounded the gravity

She seemed young, younger than us

But essential, assured, unhurried and prepared

A thousand years visible in her eyes

She was older than all of us

Behind her, a nurse sat and watched patiently

One of a kind devoted to stemming

The endless stream of cance

Acknowledging the inevitable

A dispenser of hope

‘You’ve seen the scans?’

I stared at the snapshot in her hand

The tumour, round, white and red

Like a moon round Saturn

Alien and deadly

Stared back at me

‘It has blocked the bowel here and there

We will cut that bit out and then with care

Join what’s left, careful to keep a blood flow.’

I assented, white as the tumour

With a nervous smile bereft of humour

I stared at the snapshot in her hand

The same hand that held the knife

The same hand that held my life

One thought on “The privilege of caring

  1. A truly emotive piece, and as a nurse i see daily the importance of communication in the patient/surgeon relationship and the effect this can have. It is my pleasure to work alongside those who encompass the holistic approach, in particular,… those who wear stilettos and hold a scalpel…

    Liked by 1 person

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