Inevitable when meeting new people the subject of our respective jobs always occurs. I must confess, many of these are perplexing to me, I will nod my head as someone tells me they are a digital marketing manager. I understand all three of these words individually but put together I have idea what this person does for 40 hours of their week. For years I thought my job tittle “doctor” was comparatively simple and understandable. People know what this is right? However I have come to realise the word is wrapped up in a glorified myth which average folk think they understand because they often haven’t thought twice about what we actually do day to day. I think us doctors also buy into these myths.
Doctors fix people
Maybe this was once true, I don’t know. In the 21st century the things doctors can fix are minimal. Most fall into one of the following categories.
The self-limiting; for which you don’t need a health professional at all.
The minor injury, for which a physiotherapist can help more than a doctor.
The chronic long term illness (from arthritis to depression) for which we can certainly help, but realistically the vast majority of the time you will be dealing with this without a doctors help.
The terminal (from lung cancer to heart failure) which we have lots of and lots of drugs for, but certainly cannot fix.
Not forgetting the large groups of diseases which wouldn’t exist without the label we give them (from fibromyalgis to ADHD) which I do not think any doctor will every cure.
Last but not least, everyone has to die at some point.
When some-one presents with a completely understandable desire for a fix, this dissonance can be extremely disappointing for both parties.
Doctors know everything
Some of my colleges are very disparaging about our patient’s googling things (personally I am a fan). The secret is we do this all the time too. There is simple too much to know of the top of your heads. Plus we ask each other things all the time. So the most frequent response I have to medical questions in day to day life is “I don’t know”. If it is an emergency I’ll probably know the rough answer, if it is about a long term condition, it probably came up at some point in medical school ten years ago, but I wouldn’t want you to trust my response.
This doesn’t even include the things that no-one knows. It is very frustrating to hear the certainty people have regarding whichever diet is currently on trend. A superficially biologically plausible mechanism and a dubious study and this is now fact. However, we are guilty of this too, selling our treatments to patients with a certainty that simply doesn’t exist.
We are not superheroes
Occasionally, on telling people my job, I get this uncomfortable, disproportionate respect verging on awe. I feel uncomfortable because we are so fallible. We get tired, we make the wrong decision for the wrong reasons, we rush things when we want to get home.
We need to check these responses, and need others to check them for us. I want my colleges to tell me to go home when I am sick, I want it to be acceptable to not make decision in the last hour of a night shift when we are most fragile and I want my patient’s to ask me “ are you sure” and for me to be able to say “no, let’s check this.”
Doctors are the most important health professionals.
The nurses do the real work. Just in case this isn’t clear I will say it three more times. The nurses do the real work. The nurses do the real work. The nurses do the real work. The experienced ones can diagnosis 95% of what we can, they actually give the treatments and they see the response. On top of that they will give you the hug that is needed when none of the medicines are working.
Not forgetting the army of specialist with degrees and experience coming out of their ears. From ambulance crews through dieticians to psychologists. They do all the many many things us doctors will be completely inept at.
Hmm. I have only said this ironically at work, after the completion of some menial task or another. My friend who is now an oncologist said it best, “not saving lives, but maybe delaying death for a bit.” Which is a crucial difference in mindset. I’ll leave the lifesaving to the superheroes.
So, next time after engaging in some casual work chat outside of work. Maybe I’ll point this all out. And maybe, if I can jump down off that pedestal that I get put on occasionally, it will make interactions when some-one does need a doctor that bit easier, and make us just a little bit better at what we actually do.