By Dr. Ayodele Renner
Human beings are wired to have empathy. This is probably one of our most distinguishing features as a species. We have the ability to recognise suffering in another and feel the pain in our minds that another feels in their body. And in a sense, this is why I believe medicine is a noble profession. It is out of this spring of human nature that the medical profession probably sprung in all its glory and gore.
However, I must sound a note of warning. Human empathy is neither infinite nor without interest. From before time was recorded, humans have fought with one another for various reasons. Warring tribes, bickering neighbours, nations in conflict with one another, civil unrest; these things have never ceased to plague the human race, all despite our capacity to see and alleviate the suffering of others. It appears that the human race has never suffered more from conflict than it does today.
This means that despite the altruism that lies within each of us, there is also hard-wired selfishness that says “take care of yourself first, take care of your children, and conserve your energy and resources for your family, your clan, your state, your nation”.
It is in the background of this phenomenon that I present to you the human doctor.
I am not talking about the doctor whose parents stood over them with the jamb form in the table with koboko in hand to fill medicine as first and second choice. I am talking about those who genuinely want to help people who suffer, which after all is the meaning of the word patient; one who suffers.
You have to empathise with the woman who brings her child in at 3 am with many episodes of convulsions as well as the man that comes at the end of a long busy shift with a rash that had already started to clear.
You must listen as attentively to the man with insomnia as to the woman who wants her breast to go from an A to a triple D.
Against prejudice, you must be an understanding to the man who refuses a lifesaving blood transfusion as to the man who has had sex with men and needs treatment for HIV.
This must be done in the midst of the worries of the doctor’s own life. After all, as a doctor, he is still human and still needs to show empathy to his pregnant wife. She still needs to show empathy for her struggling husband. They must work to provide for their growing family. They must strive to achieve their own dreams.
I guess what I am trying to say is that the wellspring of human empathy which doctors have is not infinite. From experience, I can tell you that we also burnout. We wonder why we should be concerned with a rash on your thigh that is not causing any discomfort when our children are feeling unwell.
We sometimes wonder why we should feel any kind of pity for you if you drank so much alcohol you fell into a gutter and broke your leg.
If you have ever been to a general hospital you will know that a combination of the dissatisfaction with the working conditions and possible emotional burnout contributed to the less than hospitable welcome patients get in such establishments.
It is well documented that the highest rate of suicide by any profession is amongst physicians. In the US it is estimated that a doctor is twice as likely to dispatch himself to the great beyond that another regular person. Whether it is because they have the knowledge to do it successfully (where to cut, what poison to ingest, in what quantity, which BRT bus to jump in front of) or because they are drained emotionally one cannot say for sure, but it has been found that such deaths have features like depression, mental illness and substance abuse in association with them.
Doctors are called to superhuman perfection in practice. It is a perfection that they have come to expect of themselves, the perfection that patients have come to expect of them and perfection that supervisors have burnished into them with the fire of harsh criticism. It is a perfection that is almost impossible to attain.
Why do doctors have these things you might ask; depression, substance abuse and mental illness.
All I will say is that I worked in the paediatric oncology unit towards the end of residency. A child dying of cancer every other day is an unnatural thing to witness. It showed me my humanity and brought out my inhumanity as well. I wanted to relieve all their suffering every day and had to attend to so many at the same time. At the end of the day, I would be physically mentally and emotionally exhausted. I would snap at everyone around me and snap at the same patients I was trying to help. It was a spiral to hell. By the time I went to my consultant in convulsive bouts of vehement protest he knew it was time for me to go to another unit.
So as doctors, we have to care for ourselves and care for another in a way that we are not naturally wired to. We do what we do in a way that can sometimes be considered heroic; almost superhuman.
However beneath the veneer of all that bravado lies the human doctor with bones, muscle, sinew and that ever imperfect beating heart.
