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Volume 3, Issue 2
Summer 2007:

Consider Compassion (excerpt from In Our Hands: On Becoming a Doctor)

Diane Clapham

Cell 2 Soul. 2007 Summer; 3(2):a9

Linda Clarke and Jeff Nisker - In Our Hands: On Becoming a Doctor

From the book In Our Hands: On Becoming a Doctor

I am inspired to share a moving encounter during my medical training that has had a lasting impact on my career as well as me personally. I am amazed by the extent to which our role as a healer is so much more powerful when we draw on our own life's experiences. — Diane Clapham, Resident, Community Medicine, Toronto, Ontario

Consider Compassion

Diane Clapham

A lady whom I will call Mary was an unassuming woman who frequented the psychiatric facilities at an urban hospital. Her primary issue when I saw her was psychiatric nature but she had, by some unfortunate hand of fate, developed multiple debilitating chronic medical conditions for which she was prescribed the pharmacopoeia. She lived her life alone. The community arm of our health care system had pretty much abandoned her once they cut the hours available for the then Home Care program. She had abandoned her family for unforgivable acts some had committed and others had condoned by their inaction. She had no one else but us, her healers, who saw her from time to time and welcomed her in to help her stand up again after another fall.

I had just become a member of this community myself and chose to start my clerkship in psychiatry. I thought it would be a great way to ease myself into this rite of passage, or so I had heard — little did I know, as they say. Psychiatry was hard. It was physically easy but intellectually and emotionally demanding, probably because I cared too much, as some fresh to the profession are apt to do. A few years later an excellent psychiatrist told me what he believed to be the secret to the profession — to be a great psychiatrist you have to be a psychopath yourself. That is the point at which I knew this was not the profession for me. But I still thought back to Mary and how she had told me that I had saved her life.

Mary became one of my first patients. I flipped through volume three of her chart to familiarize myself with her story because I laid eyes on her. I found it hard to fathom how all of that information could be attributed to this one woman. How could it be that this one person had to deal with all of these serious medical problems and take all of this medication? It didn't seem fair and Mary didn't think so either. She had decided to take control and end her life once a certain time came. The mystery was the date — it had not yet passed - so this was not the reason for her admission. She had not disclosed this date to her psychiatrist or anyone else for that matter.

I met her and we chatted. I was determined to find out this mystery date. We met daily and I devoted quite some time to her and so we naturally developed a certain connection. I delicately broached the subject of her planned suicide — she didn't want to talk about it. I am not one to give up easily. It was not about triumphantly uncovering the information that remained elusive to everyone else; it was about the fact that this woman planned to take her own life because her perspective was that it was not worth living and that no one would care if she were gone. I tried to address these concerns, and I did not realize the impact that my presence had on this monumental decision until she finally felt comfortable confiding in me. She planned to kill herself when she could no longer walk. The reason that this was so significant was that she was telling this to me as I sat there in my wheelchair unable to really walk myself.

At that point in my training I did not know very much about psychiatry or clinical medicine; however, I did know what it was like to be healthy and then one day be diagnosed with a chronic illness and then deteriorate to the point at which I needed to use a wheelchair. I could comfortable and confidently speak from that position. I understood how she felt.

When I was first diagnosed and I though of life in a wheelchair I didn't think it would be much of a life to live either. I appreciated her fear of the unknown. I told her that it was a very different life, living with physical limitations and with pain, but different does not necessarily mean bad. I did not lie to her and tell her that it was easy and that I loved being disabled. I did tell her that I am thankful that I have my wheelchair because it has enabled me to pursue my life goals, one of which is to practise medicine, and to be independent. I tried to relay that your life doesn't have to change as much as your perspective does. We continued to talk and she was discharged on my last day of the rotation. She left me with a lovely card which she made for me herself and that I still keep with me. It certainly put my lacrimal glands to work — I felt like on life had breathed easier because of me. I did not realized until that encounter just how enabling a disability can be in medicine.

My degrees are still in their envelopes stuffed in between books awaiting their summons to a wall. The cards that I have received from my patients, the ones who have helped shape the physician that I am to become, are displayed on my desk beside my bed. To me they represent the fruition of endless hours of study and toil. My wheelchair is there when I need it, ready to take me to see my next patient.

I still see Mary around the hospital halls and we exchange smiles. I wonder if she knows just how much she influenced my life.

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