BLOG: The other side of the stethoscope
Alisha Allana is a new member of our editorial team and has written our very first blog post about a crucial topic in medical education - the patient perspective. From first-hand experience, Alisha reminds us about some of the most important components of good patient care.
"As a Foundation Year 1 doctor, I have spent the better part of the last decade in a hospital, and like many other health professionals, have gained a feeling of security in a building that for so many others breeds fear, dread and apprehension. As we progress through clinical studies into the infamous world of working as a junior doctor, we subconsciously acquire a sense of place, of belonging, of confidence and eventually power, that we can walk anywhere within the hospital with a clear role and purpose. It is very easy to forgot what it is like to be on the other side of the stethoscope, until you are there.
One Sunday morning I woke up absolutely fine, with a bit of a sore throat and backache but otherwise fit and healthy as normal. Come that evening, I had a fever, rigors and a severe headache that radiated to my neck and worsened in bright light. Being a doctor, I knew these were not good signs. But, being a doctor, I was reluctant to go into hospital.
Why was I so reluctant to go to a place where I went to every day, a place that would make me feel better if I was unwell? It was because I was far too aware of the long waiting times in A&E, of the countless times my blood pressure would be taken, of having a cannula and drip in my arm, and ultimately of losing my independence and dignity. I didn’t want to entertain the possibility of having to stay in, wearing a hospital gown and eating hospital food. Yet this is what our patients face on a daily basis; facts that are quite difficult to forget when experienced first hand. Often it is not the disease or illness that cause a patient’s distress, but rather something seemingly more simple and easier to solve – such as not getting a cup of hot tea, or not being able to shower when they want to.
However, my family took me in, and so began my journey on the other side of the stethoscope, a journey that would show me what life is like as an inpatient. This experience has taught me much about medicine, things that neither medical school nor practising as a doctor ever could.
I was seen in A&E by a number of different doctors, who each asked me their own questions and examined me in numerous different ways. I subconsciously responded to some doctors better than others, based on how empathetic they were, or based on their firm nature or the urgency that I detected in their voice. Since some form of meningitis was suspected, the doctors requested that a CT head and lumbar puncture be done – both of which I have seen and done in practice but never undergone myself.
Never would I have imagined that I would be scared of having a CT scan, but being wheeled along corridors alone and moved from bed to bed whilst in a great deal of pain was a horrific experience, especially when my cannula got caught in between the bed rails and no one noticed. A gentle hand makes all the difference compared to being handled roughly. Because I was young, it was assumed that I could mobilise easily – but I felt so dizzy and was in so much pain when I was standing that it did not feel safe. Yet it was very difficult to convey this to anyone. Everyone was too busy focusing on getting the job done so they could move on to the next person on a very long list of patients.
The lumbar puncture was a procedure I never want to have again – but now, when I have to do one, I will have a much better understanding of how the patient is feeling. I’m not sure whether it was a good or bad thing that I knew about the procedure beforehand, but I did know how painful they were meant to be. It is not a myth; it was excruciating. It did help that the doctor explained the procedure as we went along and calmly just told me to keep strong.
The next few days in hospital were a bit of a blur, from being moved in the middle of the night to a different ward, to developing a severe post lumbar puncture headache. I never imagined how unbearable and agonizing the headache would be. It immobilised me for days – I could not even sit up without feeling like someone was drilling inside my head and feeling sick. I was prescribed a cocktail of drugs – including tramadol, the side effects of which were horrific. I felt scared, anxious, panicky and as if I was floating away from earth – I had no idea how bad the side effects could be and will think twice before prescribing it myself now.
Small things like moving the table close to patient’s bed make all the difference – and that’s what this experience taught me. It’s not all about being the hero who gets the diagnosis of a rare condition hidden in the depths of a medical school textbook; rather, it’s about making sure we remember that we are treating people like ourselves. Doctors and medical students are no more protected from illness than anyone else – so the next time you’re treating a patient, remember to think about the perspective of the person on the other side of the stethoscope as one day it could well be you."