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Tired all the time

Tasneem Khan is a GP in Bradford

Tired? Yes, so am I. It could be the post-viral fatigue.  Let’s check your bloods for anaemia. How is your mood? Cancer?! Ok one step at a time. Life sounds complex, I’m listening. Let’s make a plan, and let’s see you again. I don’t know the answer. But I think I’m feeling the same. I’m exhausted, but I won’t tell you that. It’s a conveyor-belt of emotions. Next customer please! Except this is not transactional. You have a story, and it’s my job to decipher that. In 10 minutes. With limited resource. Did I mention I am tired?

The most important thing I’ve learnt – to balance how much of myself I give, with how much of myself I protect.  I’m not a salesperson, and you’re not a customer.

‘All I’ve ever wanted is to help people.’ The naivety of Medical school applications.  I am helping, I think. I’m scared of compassion fatigue, but equally feel moments away from overwhelming empathy. The ten seconds of deep breathing between patients helps. Hey, it’s an ear infection, thank goodness for that! The spot diagnoses are great, its xyz, give myself a pat on the back, ‘thankyou‘ Year 4 pathology, off you go. Wait, let’s not be naïve. You have shingles, you have pain, you are worried – work, finances, responsibilities. That lump looks sinister, and I need to refer you.  I think you might be having a stroke, let’s call an ambulance. Spot diagnoses are great, but it’s never just xy and z.

The most important thing I’ve learnt – to balance how much of myself I give, with how much of myself I protect.  I’m not a salesperson, and you’re not a customer.  I am a listener, I am impartial.  I am a detective, I must think. I am a fountain of knowledge, but also uncertain.  I discover, I share, I plan. I take risks, lots of risks. I care. And I make sure you know that I care. But I’m not a friend, let’s make that clear. I am a sounding board, the listening, thinking, planning is for you. The focus is for you. Whilst I continue to balance – how much of myself I give, with how much of myself I protect.

Time is the limiting factor. Or is it? This conveyor belt is not transactional, 10 minutes of detective-work, and then we start over. Sorry for your loss. No antibiotics its viral. Congratulations on the pregnancy. I think you might be diabetic. Your father is dying. I need to send you to the hospital. Are you sure you feel safe. It’s an ear infection. Eczema. Pain. COPD. Conjunctivitis. It’s a urine infection. It might be your heart. I need to call Safeguarding. Have you heard of Parkinson’s disease? Well done on the weight loss. That blood pressure is dangerous. Cancer. Dementia. I’m sorry. And breathe.

Tired all the time? Yes…so am I.

 

Featured photo by Sydney Sims on Unsplash

The BJGP is the world-leading primary care journal. At BJGP Life we add multi-media comment and opinion for the primary care community.

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