Good Doctor
I.III.V
GOOD DOCTOR
It was during that rotation that I realised I wasn’t as good a doctor as I thought I was. And that was all thanks to Dr Sugar. In fact, what follows is something akin to a love letter to her. From now on, whenever I mention her, I want you to picture my eyes all teary with adoration. She is everything a doctor should be.
You see, Dr Sugar values teamwork unlike any other doctor I had ever worked with. She’d always emphasise that we’d go for coffee right after the ward round. Not only did she like coffee, she prioritised it. A match made in heaven. I was genuinely in love with her. She’d insist it was a team-building activity, and that no team can be a good one without such bonding experiences. And so, every day, despite our time constraints, we’d have a cup of coffee together and talk about anything and everything.
About our patients and how we could help them, about our plans for the weekend, about hobbies and drama and gossip. It took me right back to my days in Cambridge. I remember that was exactly how things were done there. It was as if there was no concept of hierarchy. Everyone was on the same level – from med students to consultants. The familiarity of that sense of inclusion felt so odd in this hospital.
But it wasn’t just that which won me over. Back in med school, our ethics teachers would always yammer on about the so-called biopsychosocial approach – meaning that we must take note of a patient’s biological, psychological and social needs. Sounds very fancy if you ask me. Just mentioning it in an exam would earn you all kinds of points and respect. Simple, right? Not so much in practice.
If a patient’s hand is slowly becoming necrotic and threatening their life, the books tell you to try antibiotics and debridement and, if these fail, that amputation might be the only thing left to attempt. Medical textbooks will also tell you that the patient can later be fitted with a prosthetic. But think about everything that can go wrong. Peri-operative complications such as bleeding, infection, and, oh yeah, death, for starters. Then there’s the entire healing process, during which all kinds of things can go wrong. And at the end of that, if all goes well, they’ll be left with a stump – one that can hopefully be fitted with a prosthetic. But again, that prosthetic has to fit the stump snugly – otherwise it will itch or pinch or tear the skin. And if that too goes well, they’ll have to learn how to use it. And then they go home.
But can they really cope? Can they eat and drink on their own? Can they undress, shower, and get dressed again? What about driving or carrying their child? And how will it affect their sex life? What will other people think when they see a plastic hand? Will they still be able to do their job? And what about phantom limb pain? Will it be controlled with regular meds, or will the patient end up in Narcotics Anonymous?
All these things medical textbooks either fail to mention or gloss over in a one-liner that’s about as inconsequential as people who dislike coffee are to me – and to a med student.
But not to Dr Sugar. Dr Sugar was the Biopsychosocial Queen. It wasn’t just the medical condition she treated – she treated the patient as a whole. I know this shouldn’t even be up for discussion and that it should be the mainstay of patient care, but, as I’ve already mentioned, it’s all too easy to become desensitised to that. In reality, with the vast workload everyone’s faced with, it’s no wonder that some elements of patient management go unnoticed. But with her? Never. She’d go above and beyond and push us to do the same – kinda like having our own personal cheerleader.
With every new patient we saw, she’d go over all their medical needs and manage them accordingly. Then she’d assess their mental state and see how they were coping. And then she’d make sure their social situation was as good as it could possibly be. And you know what made it even more special? The fact that she valued everyone’s input – the patient’s, their relatives’, and any healthcare professional involved in their care, including mine – something most seniors didn’t do.
She also made full use of every hospital resource that might benefit the patient. In modern medicine, there is the concept of multidisciplinary management – involving different healthcare professionals such as physiotherapists, occupational therapists, specialist nurses, social workers, dieticians, and many others, so that the patient can truly be managed holistically. My brief stint in neuro had ingrained within me the importance of this approach – but on busy general medicine firms, this was usually too much of a luxury to even consider.
Dr Sugar was truly the exception. She showed me what it means to be a human doctor. To connect with patients as whole people. To connect with the team. To be a valued member of the firm. She not only made me a better doctor, she made me a better human.