When I first became a doctor my greatest goal was to be an amazing diagnostician.
I would fantasise about diagnosing some really rare condition which had stumped great minds. My conversation with patients would tend to be one sided and in all honestly my patients contribution would preferably be some good physical signs and an ability to answer questions with a yes or no.
My heroes were Sherlock Holmes or Inspector Morse. I was most excited about patients who presented with rare and exotic symptoms whom could be diagnosed solely through taking a history and an examination. I don’t think I was particularly keen on impressing everyone about how clever I was, I think it was simply that I enjoyed and still enjoy solving puzzles.
The people I least respected were philosophers, ancient and modern. People with funny names who would think for ages about the ‘bleeding obvious’ and tell us what we already knew. The only solace was that philosophers appeared to be peripheral to real life and invariably ended up going mad.
Now my conversations with patients are very different. I still get excited about unusual presentations and diagnostic challenges but I find myself increasingly enthusiastic about … philosophy!! I now realise how important it is to think more deeply about almost everything but especially about where life if leading you when times are hard.
I am in the privileged position that people often come to see me when times are hard. The stresses of modern life can result in lots of physical problems, such as chest and abdominal pains, shortness of breath, headaches and so on. I no longer strive to make wonderful diagnoses but try to enable people to view their problems a little differently. Sometimes this comes from reflecting back to them their own words which in turn reflect their own subconscious thoughts.
Words such as ‘should’ carry enormous power and guilt and occasionally simply making patients aware that they use such language can be the beginnings of changing their lives. Sometimes I reflect on my own or others experiences, not in the sense of saying what should be done but to normalise the problem – often patients can feel isolated and knowing
that others has trod this path before them helps. And sometimes I turn to philosophers and poets.
I will recommend that patients Google a particular poet – the process of searching for themselves is more valuable than having the answer presented to them on a plate. One of my favourite poems is The Road Not Taken by Robert Frost.
Two roads diverged in a yellow wood
And sorry I could not travel both
And be one traveller, long I stood
And looked down one as far as I could
To where it bent in the undergrowth;
Then took the other, as just as fair
And having perhaps the better claim
Because it was grassy and wanted wear;
Though as for that, the passing there
had worn them really about the same,
And both that morning equally lay
in leaves no feet had trodden black.
Oh, I kept the first for another day!
Yet knowing how way leads on to way,
I doubted if I should ever come back.
I shall be telling this with a sigh
Somewhere ages and ages hence:
Two roads diverged in a wood, and I –
I took the one less travelled by,
and that has made all the difference.