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Rhiannon is a fourth year medical student at Cardiff University School of Medicine
One of my favourite lecturers on my previous course was my biochemistry lecturer. He wore fantastic superhero t-shirts and had a number of witty anecdotes that would have us belly-laughing mid gluconeogenesis lecture. He’s a rare breed who can make biochemistry bearable. One of his most used phrases, when discussing the cell and its contents was “My favourite 20 letter word in the English dictionary – Compartmentalisation!”
Four sentences in and I can hear you wondering what on earth this has to do with medicine?! Well, I’m pretty sure that this lecturer, and in particular this sentence, helped me get into medicine. When asked at interview “How do you deal with difficult situations?” I panicked.
Rewind back a few years…
I was 19 years old and on placement on a respiratory ward. A man in his 80s had been in a side room for several days, he had lung cancer, and on top of that an infection, and he was on end of life care. He said he wanted to die at home and his family wanted him there too. The motions were set in place for him to go the next morning. Unfortunately however, these things don’t always go to plan and not long after the family had left that afternoon, he passed away. Two nurses went into the room and invited me in. I followed, confused. “He’s gone”, I thought, “what can the nurses do for him now?”
I stood in the corner and observed as the nurses put away the patient’s belongings, folding his dressing gown, making sure his dentures and glasses were in the correct cases. I watched as they removed the needles and wires from the patient’s skin. They gave him a sponge bath, changed him into a fresh set of pyjamas and combed his hair; these simple acts transforming him meant he no longer looked like a patient, he looked peaceful. Throughout all of this, the nurses spoke to him as though he was still alive. “We’re just going to get you dressed now John.” Once they had finished this process, one of them opened the window, we said goodbye and left the room. They told me afterwards they always open the window; it was to let his soul out, so he didn’t have to stay in that side room any longer.
I left the ward and went to lunch. I sat with friends and we laughed and joked like any other day. When I returned to the ward, John had already been taken to the chapel of rest by the porters and a new patient had been moved into his room. I continued with my placement tasks, shadowing the team and helping out where I could, seemingly unfazed by what had happened earlier that day. I’d just witnessed my first death, no big deal! At least, that is, until I got home. That evening I shut my bedroom door and sat at my desk. I opened the box in my mind where I had locked the events of the morning and reached into it. Tears rolling down my cheeks. I cried long and hard. Tears of sorrow for the man and his family, tears for the nurses who cared for the man so beautifully even after his passing, and tears for myself because I hadn’t gone into placement that morning prepared for death.
I asked the interviewer to repeat the question. “How do you deal with difficult situations?” “Compartmentalisation” I said. In day to day life, and especially on placement, I have learnt to put things in boxes. It enables me to carry on professionally throughout the day, and when I have time to revisit the topic I can reflect, and if I need to, I can cry. Accepting and reflecting on the difficulties allows us to be human, and allowing ourselves to be human allows us to be better doctors.
How do you deal with difficult situations?
A profound and thought provoking article. Thank you
It's important to revisit the "boxes" before too long- sometimes with help to lift the lid!
The reaction to death the reflection on the reaction to death the caring nurses treated the patient with degnity and reflection of the young doctor was what humanity is
Thanks for sharing that, Rhiannon; it is very beautiful. I hope that John's soul went back to his home and family, where he wanted to be and where they loved him. I'm glad that he could slip away knowing that the decision was in place for him to go there.
I'm glad that you and his nurses regarded him with love, too; and I'm glad that you can keep those feelings in their place, so that you can be the clear-headed doctor that people like John need
Simply beautiful, I am shedding all those tears just now , which had been locked away in the ' compartments ' in my mind.
We agree. Rhiannon has done a fantastic job in writing an honest account of an experience that will stay with her throughout her career. Well done Rhiannon.
If anyone is interested in sharing their experiences through a blog post, please email [email protected]