J'accuse...

Sigh. It would seem I have been a naughty boy (see comment on the previous post to find out why). I stand accused of vying with Freddy boy for top the league in arrogance and inhumanity. In fact, in my detractor's eyes, I win outright because mine, alledgedly, is an educated intolerance. These charges arise from my carping on about patients in the first two posts. I feel, therefore, that I ought to write something in way of a defence.

Firstly, whatever Anoymous does to earn their crust, I suspect it is not medicine. Medicine is a very demanding profession that can easily suck the life out of you if you are not careful. In response to this danger, people develop defence mechanisms. One very good defence mechanism is to moan about everyone and everything, and anyone who has ever been in a doctor's mess will know that this is the strategy prefered by almost everybody. Acceptable targets include other health care professionals (nurses for doctors and doctors for nurses is an age-old tradition), management, the government, your seniors, relatives and patients. This is a fact of life - it does not make you any more evil moaning about patients than it would were you a hairdresser moaning about your clients. The simple reason for this is that it does not affect how you actually deal with those people. The whole point of my moaning about people presenting sick on the ward is because, no matter how late I have to stay or how busy I already am, I know I will still see them and try my best to sort out their problems. If I didn't moan about it though I might just explode or, far more likely, fizzle out with a whimper.

Nor just because I moan about people does it mean I don't actually care for or pity them. Humans are complicated things and resentment about work which is vaguely associated with somebody is easily compatible with concern for their well-being and a desire to attempt to fix their problems. As I sit writing this, there are two bottles of wine on my desk from patients to thank me for my care and understanding so I suspect I cannot be that cold and disinterested. That said, in must be recognised that some people are actually not very nice and, especially whilst working in A&E, I have been shouted at, spat at, punched and kicked. And surprise, surprise: I still treated all those people for their medical problems as well, though perhaps without the smile my oncology patients get.

As for my little tangent on relatives hoping for the patently impossible, it was not intented to imply that they were stupid for doing so but to reflect on the innate human capacity to see hope where there is none. In addition, as I pointed out, this deficit or quality (depending on how you view it) is just as obvious in we doctors who occaisionally - and unfortunately - reduce the quality of a patient's remaining life by giving chemotherapy when it is not appropriate because we hope that they might tolerate it whilst everything points to the fact that they will not.

Finally, there is also the fact that what I have written below is also tainted by own sense of humour, which is largely based on exageration and irony (this is an English euphemism for sarcasm, by the way). You surely wouldn't believe that I thought my boyfriend's breathing had 'all the charm of a dripping tap', would you now?

So, in sum, I reserve my right to moan about whoever I want, including my patients, because I know it does not affect how I deal with them. And, like it or not, there is a whole world of difference between moaning about somebody and actively campaigning for the death penalty for them!