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Being On the Other Side: Part Two

So Dr. Budd is now Dr. Patient. I've never had the greatest health, so I've been the patient before; but never to this extent. It's an enlightening experience that's for sure! In the same week I also find I'm once again Dr. Relative, with my Dad undergoing major cardiac surgery. This is a role I ashamedly do not play well (especially when I disagree with the plan), but also one I have had to play too often. This time there was added frustration, anxiety, and an unfortunately drowned out sense of empathy as I was trying to stay involved from the confines of my own hospital bed. To be honest I'm not good at playing either role; and I'm enjoying it as much as a kick to the jaw.

We'll start with Dr Relative. I have what I can only liken to a love-hate relationship with this particular persona. In one way I feel super confident and assured that I know what I'm talking about, not just because I'm a Doctor but because I'm his daughter. I know my Dad. I know what he's like and how'll he'll respond to what you say. 'Do as much as you feel you can' is not the thing to say to my old man… because having had his sternum cut through, ribs splayed open, heart actually stopped, cut into and restarted... he still felt a 200m walk the day after discharge (less than a week from being sedated and incubated in ITU) was completely okay. Stubbornness. It seems to coarse through our families veins. There were other examples where I wasn't particularly happy either, like getting him out of bed less than 6hrs from coming off the ventilator. Of course I might have been being a little over cautious and irrational. It's possible. Just a maybe. Okay! It's most likely that I was. But of course I wanted them playing as safe as possible, because it isn't play; It's my blooming Dad! People including doctors ourselves often forget that simple factor. Doctors are mortal creatures just the same as anyone. Human. We have human weaknesses. I know I'm gonna be difficult when my loved ones need medical help, but that's exactly why we aren't supposed to treat our loved ones. Our judgement is affected. I know I should trust the staff; but I also know that I'm gonna challenge the rationale behind each decision; because I want the best, because I love this precious individual. To the staff it's annoying, it's nit picking and argumentative and challenging. All they should see is I'm just scared. Like any relative. The fear in my case is also driven by knowing too much. I know mistakes happen. I know complications happen. Sometimes without explanation or reason. I know risks and prognosis. I know death actually isn't the worse possible outcome. Sometimes morbidity trumps mortality. ( p.s. I also hate how President trump has tarnished a childhood game, eurgh sorry tangent). A few years ago I had almost convinced myself that I'd lose my dad early. It was around the time he started showing signs of heart failure; at first I was scared, then angry he wasn't looking after himself and then I just dedicated myself to spending time with him, and encouraging him to do anything and everything that made him happy. And now there is hope again. If his recovery goes well and the op does as it should, it doesn't have to be that way; maybe he’d get to see his grandkids and enjoy retirement. I know a lot, but not enough and sometimes, at least when it comes to specific or specialist areas. It's maddening and very lonesome being the only one in my family that appreciates health issues in the light that I can; it's then difficult to explain why you're so worried. I was once told by a relative that visited my Grandad a few days after his billionth emergency admission, 'Christ George!, you made it sound like he was dying! He seemed alright enough to me.' Well that's because he was more stable those few days in, but it had been close, and he wasn't out of the woods yet either; failing kidneys, pneumonia, anaemia. A month later he was dead. At the same time people - family, friends, anyone who knows you're a Doctor - want advice; often off the cuff, often not even in person. It's a slippery slope, and while sometimes I'll give general advice, the I’m all too aware of the concequences and default to ‘you should get in checked out’. The thing is my decision to peruse a medical career is linked to helping family. When my Gran died I was 16. I can remember this knot of guilt and sadness that I hadn't known enough to be helpful. That I couldn't save her (as stupid as that sounds) or recognised things earlier, fought for her, made sure everything possible was done; or at least explained what was going on to my family. That's what pushed me to keep going; so that next time when someone I loved was sick I didn't feel so powerless. However, I've come to accept when it's your family you're always powerless - even when you try so hard to believe that you're not. You're the relative. You're on the other side.

Dr.Patient is no less of a smorgasbord of emotional pit falls and learning curves. I really try to be good. I am ultra aware of the well-known fact medical professionals make terrible patients. Having been part of nursing teams as well as a Dr, I know how such patients are spoken about in handovers. An onus is put on caution out of fear of complaint or challenge over treatment plans, but this caution and fear of reproach means we forget this 'type' of patient is also a person first and just as scared, confused and vulnerable as any other. Being a patient in my case is also hard because of knowing how hard the staff work, meaning I often don't wish to bother them. I don’t want to be the patient they moan about in handover. Sometimes this means I try and do stuff I might not 'technically' be supposed to do, but carry on because 'I'm 26 and a doctor. I can reposition my own goddamn pillows… reach that bottle of water…’. Eventually I see how stupid that is. Stubborn like Dad I guess - but that wasn't me admitting it. I'm also conscious of seeming like I'm dictating my management, or being too nosy - wanting to see scans and understand the reasons behind changing the plan... but then also it's my f***ing management, it's my spinal cord, my legs and my future. I deserve to know. I deserve an explanation on whichever part I'm concerned over. I may be a doctor but I'm no spinal expert. I'm scared. It's like the day of the assessment the time the plan first changed. The day of the neurorehab ward round in the main hospital I was in is Thursdays; and that Thursday it just so happened to be the day after Dad's op. He'd only recently been brought round and (no offence Dad) he looked like sh*t, he was so pale and out of it. In hind sight maybe FaceTime was a bad idea; ignorance is bliss they say. He was so drowsy he'd barely been able to speak or keep his eyes from closing back up; and yet they were about to get him out of bed. I was so angry and scared. I just wanted to be there holding his hand and probably being a thorn in the side of his consultant. The point is, I was understandably upset and unfocused when the team got to me. I tried to concentrate but that was about as easy as jumping out my bed right now. I didn't really care what they found. This probably altered the clinical impression of my progress. A decision was taken to sit me up and once again I was in a situation where a little knowledge could terrify you. Most people would probably of thought 'Great! They are sitting me up! I must be ready for that, I must be progressing'. But I knew enough to know it was unusual this soon. I did question why they were doing it so soon and was given the option of sticking to the original plan, but then I thought if a patient I was looking after didn't take my consultants advice I'd think them a fool. So I agreed. He's the expert. But I’d skirted round the bigger blunt suspicion in my mind. 'Are you doing this because you are giving up on the bed rest helping?' I felt stupid because I couldn't bring myself to ask. I was scared. I was the patient and I wasn't ready to digest that possibility, but at the same time wanted to know if I was right. Instead I let them go without asking. The nurse offered to get them back but I just couldn't deal with having bad suspicions confirmed. Not that day. It turned out it wouldn't be long until things would change. Monday morning came and suddenly there was a bed in the Rehab unit. I wasn't ready, and I don't just mean that my stuff was everywhere, and no one would be in that early to help me pack - I just wasn't ready. I'd made friends and relationships with the staff and my 'room mates'; even the cranky one who complained about everything, was in actual fact sweet really. These people had for the most part been with me from the accident. Through every shit minute. They'd met my family. They knew and cared about my dad. They had made me feel at home and now I was being ripped away from them. I wasn't ready. I'll admit I cried saying goodbye (to the ones I could say goodbye too, I just had to hope the thanks would trickle through). I knew deep down this was a good thing. It was progress. But was I ready for this? I'd been saying all along I was excited to get started, but for the first time I felt I was okay with routine, rather than the unknown. I didn't want to have to fight again just yet. I wanted that reprieve. When I moved I remember feeling so vulnerable again. New nurses that didn't know me. Going through that whole first phase of not wanting to be a burden. My stuff was dumped 2ft from me. I desperately wanted to sort it out and know where things were but I was scared to ask someone to unpack my own stuff. I felt small and useless. I wanted to go back to where I knew people wouldn't mind helping. People I'd proven that I wasn't a difficult, demanding, up-her-self doctor, but a frightened and regretfully dependent 26 year old who's life was in turmoil. The plan then changed again and I'm back on bed rest. I could have been disappointed and upset at being forced further back into dependency; but being honest there was only relief. They knew I wasn't ready either. My body had shown them I still wanted time to heal. That I could do this - but not yet. I'm now a week into life here and I'm settling. I'm still not completely assimilated, but I'm getting used to it. I'm making friends again. People who I'm cheering for and are cheering for me. I'm sussing out the nurses and they're getting used to me just the same; I like them. It's like moving job or moving school.

The thing that I always thought would be my biggest problem being the patient was my medical mindedness. That understanding the facts, likelihoods, prognosis etc would effect my ability to stay hopeful. Maybe knowing that it's unlikely I'll walk again would lean me towards a stark realism that, rather than inspire me to be that 10%, would discourage me due to the odds. I'll admit it's a balancing act; a conflict within me. I don't want to ignore my knowledge and training. I don't want to set unrealistic goals and be devastated when I fall short. I've had enough of crying and I don't want add to my distress… but at the same time I don't want my pragmatic side to limit me. I've always been a dreamer. I always planned, believed, given my all. I'm stubborn and determined. What I decided was that I'm not thinking about end games right now. I'm just doing my best every day. Keeping smiling. Keeping on encouraging the people around me. Keeping on planning for the future, with the possibility of a wheelchair but the hope of walking, even if it's only part time. I'm concentrating on what I can do. And here's what I can do... I can write and maybe one day publish. I can fundraise with my tribe and help keep myself independent. I can stay positive and look forward, bit by bit. I can study and enhance my career so when I resume, I can be a better doctor because of this experience.

I can get involved in teaching; with more time to invest and maybe even get a teaching qualification. And most importantly I can give my all into getting better. I can try my hardest. I can do my best. Each day I can try.

And you know what that's good enough for me.

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