This is a very beautiful quote of Thoreau and the relevance of this will be clear to you by the end of this blog.
Remember that annoying lady who always comes in the middle of the night in ER with some silly complaints like vaginal discharges?
And that one woman in your outpatient clinics whom you’ve seen several times shopping around for different doctors?
Then there is that one lady whose complaints never end and they never answer your questions straight away, instead bring in a whole set of different problem.
Once in a while, there is that woman also who enters in your clinic quietly, doesn’t complaint much and leaves your clinic quietly just shaking her head to anything you’ve told her. This sort of scenarios are encountered in every part of the world, every culture and every class of the patients but more often these are the less educated/illiterate women who come from a less privileged class of the society.
What do you do with these women?
In the busy clinic settings or emergency room, they most often just feel like a ‘waste of time’. But have you ever thought that this woman is coming all the way from her house, dragging with her a family member and while coming to the hospital she has no idea on who will be doctor she might see and what would be the doctor’s mood. She has come all this way to share her intimate problem with a total stranger, a doctor; who might have had a terrible day in OR, might have just delivered a fresh still birth or might be having some personal issues. For the doctor she is just one more addition in number of patients at work, but for her that doctor is just one person whom she is seeking for a rescue for her problem.
The question to ask yourself here is: why on earth would someone come to see a doctor all the way, has waited in a long queue and just without any specific or alarming problem?
Well, to be honest with you, this alerts me more. Such a patient rings a bell in my mind…. ‘HIDDEN AGENDA’. Thanks to MRCOG that while preparing for this exam I realized how commonly we encounter such women but they exist only in guidelines, text books and OSCE exam stations just because we fail to see them in our day to day life.
Recall the presentation of Domestic Violence, Chronic Pelvic Pain and other such issues and this is what is highlighted there in the guidelines. And when you feel annoyed or overwhelmed with such a patient, have you ever tried for a few moments to switch places with her, put yourself in her shoes and think what brought her here to you? This is the well-known ‘empathetic approach’, again that appears everywhere in the guidelines and our answers but rarely in practice. Go at her place, look through her eyes and you might see that she came in late hours of night just making an excuse of a simple silly problem because she might be wanting an escape from the environment she was in. She might be going from doctor to doctor in different clinics because she haven’t got an answer to her concerns. Don’t judge her based on her education level or social status, every person has their own concerns and they often feel ashamed to ask them directly to the doctors thinking they would be considered as fools. (recall the guideline of Chronic pelvic pain and check out what is emphasized regarding dealing with these patients) And that quiet lady… oh never miss on them and never assume your consultation went very well. Beware of the underlying psychiatric causes like depression, or again the Domestic Violence etc.
The bottom line of all this speech is that the MRCOG exam has not only made me a highly qualified doctor in my field, but has made me a much better human being also. Only if you apply those guidelines in your day to day practice with empathy (instead of sympathy that we do very commonly) it will be very easy for you to pass the exam and also will give you such a sense of fulfilment that no words in this world can describe.
Try it! And the whole concept of your being will take a new dimension.