Signs

Another brief exercise in wondering what it’s like for patients who meet our kind in certain situations.

The other day a junior colleague described to me, over lunch, a patient who had been admitted with unusual and florid signs, due to a disease that is not commonly seen. I clapped my hands and said, ‘Excellent!’ And then I heard myself, and was embarrassed. The signs indicated advanced disease, but the prospect of seeing them excited me as a clinician. In that staff canteen, far away from the patient, I could show my appreciation for signs that made the patient a sure source of learning for our trainees, and a jolt to the enthusiasm that once motivated my own nervous forays onto the wards as a third year student.

oOo

(From a hospital diary)

I had an inkling, but when I saw him coming I smiled, as I do to any who approach my bed. His eyes darted from my face to my hands (where the rash is) to my abdomen, which was completely hidden beneath the sheet anyway. He must have been told about me. I had overheard a small gaggle of students discussing an imminent teaching session which was due to begin at 11. And time was now pressing, for it was ten to 11. He introduced himself, asked me how I was, and came straight out with it –
“I wondered if you’d mind if I bought a few students along to ask you some questions and…examine you.” I said nothing. It’s happened before. But he was determined. “Just a handful. Is that OK?” It was clearly important to him.

I would rather not have. I mean, what was in it for me? It wasn’t the fear of being made uncomfortable, but I was quite happy reading my book, temporarily escaping my dismal fate. The pleasure of ‘being taught on’, if there was one, would be in observing the revelatory expressions on the students’ faces as they felt organs they had not felt before, or as they recognised lesions that they had only read about in books. But really, I have my own worries, and the education of our future doctors is not one of them.

“It’s alright.” I said, though it wasn’t. I had a duty to be helpful, and he had a duty to press me, for the sake of his students. I suppose.

 

30 minutes later.

They were very nice, each one of them. And the consultant tried to make sure they didn’t hurt me, though one of them did by pressing on my liver like a novice baker kneading dough. Just one thing though: one of the young woman stood up from bending over to get a close look at the rash, and said,

“It’s not classic.”

Well, sorry! I’ll try to develop it, rub it up into a proper horror! My feedback to you – never, say anything negative about another person’s body, even if it is diseased. Isn’t that a basic social skill? But otherwise, no complaints, except for the fact that for all the sense of reward and betterment in the young faces, the fact remains that the ‘learning points’ would not be there unless I was ill. And I am very ill.

 

A day later.

A new admission, into the bed next door. She looks interesting, but sick – bright yellow all over. The teaching doctor came along a couple of hours ago. He glanced at me as he passed, nodded and smiled. No words. He doesn’t need me now. And he approached my new neighbour, and said, after the pleasantries,

“I wondered if you’d mind if I bought a few students along to ask you some questions and…examine you. Just a handful. Is that OK?”

The cheek.

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