Dark Melancholia

As medical school is very much a sink or swim experience, particularly once exposed to the hierarchy of the hospital system, I as a student, to some degree learnt to rationalize my fears and struggles, and simply soldier on. Or else i simply won’t survive. So much of identity is tied up in being a medical student that to quit becomes in essence, a non-option.I would rather deal with ongoing mental pain than the feelings of failure and shame if it were to all suddenly end. So i deal with this, understand it, and continue forwards. The moment I truly realized how much the system had affected me was taking the history of a young woman in her twenties (my age), who had presented with a nebulous constellation of symptoms and ultimately was diagnosed with an aggressive cancer that had a survival rate of less than 20%. She had three children, a husband, and until that moment, had no idea that her life was about to change completely. I completed the history, felt a momentary stab of pity, and strolled on in search of other patient. I did not stop to think about this patient and the news she was receiving and how that would affect her and the people who loved her until I was on my home. As I sat at the traffic lights and reflected upon her terrible diagnosis and equally distressing prognosis, the question that swam into my mind was this: “What kind of person have I become? And what kind of doctor will I then end up being?” I used to pride myself on my endless empathy, on my ability to engage with people and their problems, and to offer them kind words which came from a place in my heart that truly felt for them. It was part of the reason I entered medical school and much of the attraction of becoming a doctor — it allowed me a scope and place where in a professional context I was allowed to really care.

I find that I am a person who is more concerned about my life as a student, rather than allowing myself to engage with a patient facing the worst news of her life. Doctors are always very rushed. We are stressed, and there is always something else to sign and somewhere else to be. Perhaps the reasons why we stop engaging is simply because our minds have a hard time comprehending the desperate reality of some of the awful truths that we are faced with daily in the emergency department or on the wards. I’m not sure the exact moment was when I started to lose my empathy. Perhaps after one too many exams, or harsh words by a senior. A question I couldn’t answer, or a sterile field I accidentally ruined. Whenever it was, I’m now actively searching for it because I want it back. Fear of exams, of angry surgeons, and of looking stupid is one thing. But fear to engage with a patient, to feel their pain and offer them your comfort — that is something else entirely. For all the medical procedures and lab tests and suture ties I cannot perform as a student, comfort is something that takes no study at all and can be given freely, with almost guaranteed good results. In fact, the act of healing through comfort and empathy is very possibly the one area in which all students can excel, if we allow ourselves the time to perfect it. Which will make us much better doctors, and far nicer human beings.

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By Dr.Himanshu Dubey

3 comments on “Dark Melancholia

  1. well written himanshu….
    proud of u….dat u realized ur reason very soon ..
    dude its always better late than never…!!!
    we know ul soon be the person who really cares for ur patients
    ul be an awesome doctor!!!

  2. Pingback: Dark Melancholia | Dr.Himanshu Dubey

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