02:01 PM, Feeling Guilty

One of the things no one tells you about being a doctor is that a major part of medicine is feeling helpless.

I’ve got a couple of patients in my ward who’ve been suffering for a while now and who will be suffering for a while longer and I have no idea how long that “while” might be.

So, when they ask me questions like

“Will I get better with this?”

I say, “Most people do.”

And when they ask, “How much longer will I have to be on medication?”

I reply, “For the next six months…at least.”

And when they question, “Can you treat me?”

I reply, fingers crossed under the table and sending silent prayers over the table, “I’ll do my best.”

It’s a fine line doctors have to straddle between white lies and reality. And the balance over that line is so much more delicate when you’re dealing patients of psychiatry.

There are so many things to consider.

Will this patient stop using the medication if I tell him that there’s only a 50% cure rate? Will this patient give up if I let him into the secret that despite treatment, 50% will relapse? Will this patient lose faith in medicine, in me if I truthfully admit that I don’t really know if he’ll ever get better?

Like I said, the line is thin and the balance is delicate. Handling it with the care it deserves takes more out of you than you imagine. It’ll leave you with sleepless nights where you’re battling guilt over giving those reassurances. There’ll be times when you try to avoid a patient because there’s nothing new that you can tell them and you’ve run all out of the stock sentences. Then, there’ll be mornings when the patient will thank you for your stock reply and you’ll feel like the biggest heel on the planet.

But, at the end of it all, you’re always surprised; surprised by their desire to believe your lies, surprised by their willingness to swallow your bullshit. After all, the only other option they have is to give up. So, they’ll surprise you again and over and again with their hope for their futures, their optimistic questions and their constant reach for reassurance. From you.

See, one of the other things they don’t tell you about being a doctor is that a major part of medicine is feeling helpless and hiding it from your patient.

*END*

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