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I look down the clinic list and spot her name. Perhaps we are not supposed to have our favourites? But with some patients you just click.
Maybe there’s a shared experience or understanding? Or perhaps they remind you of somebody from your non-medical life? A friend, a loved one. Either way, there’s a positive doctor-patient chemistry.
She’s 36 and has been struggling with her disease for several years. It’s been a battle to get her symptoms under control. Over the last year we have worked hard together to get things right.
It’s not always been easy. We have celebrated together; an improving test result, a reduction in medication, commiserated together; her struggles with fertility perpetuated by chronic illness, and cried together; her third miscarriage in as many years.
But I am always pleased to see her and, that of all my colleagues, she chooses to see me.
But today, something is different. As I stand to welcome her in, her gaze drops and her usually bright expression clouds. The moment is brief and she recovers quickly. But I see it. That flicker of pain.
Because as we sit down there is a barrier. One that has not been there before. My swollen belly and the life growing inside, protrudes into the space between us.
She looks away and starts to talk of the side effects with her medication, but her voice is tight and words stilted. I can see she’s fighting back tears.
For in that moment, I have everything she longs for. I remind her of all her losses, her great longing and her overwhelming sadness.
I want to acknowledge the hurt she is feeling. I want to tell her I’m sorry. That I understand how hard it feels to be on the opposite side of that swollen belly and to worry that it may never be possible. A Baby. A family.
But she blocks every entry and closes every window of opportunity. It’s a place we cannot go together.
As she hurriedly escapes the room, her eyes avoid mine and the consultation is over. I am left alone, contemplating the unspoken anguish that has just past between us.
I could never wish away my own happy situation, but I do wish away her pain. Today I don’t feel like a very kind doctor.
Two months later her name appears on the list again. But by the end of the clinic, she has not entered my room and I know that she has chosen to see one of my colleagues, and not me.
Perhaps it’s just her means of self-preservation, and even a small part of me is relieved. But I can’t deny the rejection doesn’t sting a little.
As I tidy the case notes into a pile, and manoeuvre my expanding self out of the clinic room, I can but only hope that one day soon she will choose to see me again, this time with her own happy news.
Emily Claire Vincent is a gastroenterology registrar. She writes under a pseudonym
I realise this is more about the interpersonal relationship but the the north east there is an IBD fertility service. Is there something near you that might help her. This may not be the right thing for that patient. If so ignore.
The opposite scenario also holds true. When I was going through years of infertility treatment and doing a weekly antenatal clinic was overwhelming.