After three days of lectures, I’ve now started my medicine of the elderly placement on the ward I’ll be based on for the next four weeks. I think it’s going to be a bit mixed – I know that I’m going to like spending time with patients, and medically, it’s going to be very useful as they’ve all got about fifteen different diseases and are on a shedload of medications, so I’m learning a lot, but it’s also made me think about the doctor I will be, fairly soon. The team I’m attached to are lovely, they really are – but they are also very pragmatic in their approach to some of the more cognitively impaired patients. I know that when you’re rushed off your feet, there’s not much time to tell someone for the thousandth time that no, they’re not going home, or no, they’re not in Florida, they’re in the hospital – but it’s not that busy a unit, there’s a lot of coffee breaks and long lunchtimes, and when they just whip past someone, I find myself questionning it.
I’ve done more than enough volunteering on MOE wards, in this specific hospital, that I know how difficult and frustrating it can be to have circular conversations with folk that don’t go anywhere – but I don’t want to be someone who just walks by because they think explaining yet again is a waste of time. I want to be someone who makes time. I want to be someone who never forgets that every patient here is a mother, a wife, a sister, a father, a grandparent. My grandparents received atrocious care in the hospital they both died in; if the staff couldn’t be bothered to spot overwhelming sepsis, I very much doubt they took the time to sit and talk to my grandparents when they were in there. None of the staff when we visited knew their names, let alone who we were. Sometimes I think that it’s only by prioritising the little things that you will remember to do them – a little bit ‘look after the pennies and the pounds will look after themselves’, as my gran used to say. I don’t want to be someone who shuts the door of the doctors room for a bit of peace and quiet, I don’t want to be someone who passes a patient by because they are confused enough that they won’t remember the conversation. I want to be a doctor who knows the names of their grandchildren and how they met their husband or wife, who takes the time to say, every time, over and over, that they aren’t going home just yet, and why. I want to be the doctor who obviously knows them, when I talk to the family, and isn’t scrambling for their name, or diagnosis. I want to be a doctor who is known for compassion. I don’t want to forget.
So – what have I done so far? I’ve done an MMSE (test of memory) on pretty much every patient with pretty variable results, had three of the old men ask for my hand in marriage (respectfully declined), and as I didn’t have anything timetabled this afternoon, spent it watching Jeremy Kyle with a lady of 96 (her choice, not mine, classic comment ‘in my day, marriage was for life and intercourse was for marriage, what do they think they’re doing?’). My heart breaks for some of them – the ones who are so very desperate to go back to their own homes, but will never get that as they’re too ill and too confused, the lady who asks repeatedly for her husband, who died 20 years ago, the man who cries as he can’t write a sentence anymore, after a massive stroke – they are our future, our family. It makes me so angry that there are so many cuts to services for the elderly – it takes about four weeks for a referral to social services to come through, and after that, a similar amount of time to get care packages in place so that they can leave hospital. We should be honouring them, we should be proud to lighten their load and care for the generation that brought us peace and freedom, and then kept it. I, as a young woman training to be a professional, owe a lot to these older generations.
Learning to be still 