Why do I feel so guilty about this?
Declan McDonnall
The nurse pages me to the ward. She informs me that Mr Arim* was about to succumb to the final stages of his throat cancer. She informs me his family have been called and were on their way. I make my way towards Mr Arim’s room, shielding my eyes from the sun’s rays as it shines in the window at the far end of the corridor.
I enter Mr Arim’s room as the nurse’s assistant is leaving with a bag full of old bed sheets. His departure leaves me alone in the room with the patient. His breaths are shallow, oxygen saturation is falling, he’s definitely dying. He looks at me. I think he realizes that his time has nearly gone. I put my stethoscope to his chest, his heartbeat is slow and his lungs are wheezy. I give him two, possibly three minutes. He reaches up and grasps my hand. Should I pull myself away and pick up his chart? I tell myself that I had better read his chart, just in case. In case of what exactly? Oh Dec, admit it, you felt slightly uncomfortable that another man tried to hold your hand. But Mr Arim was just seeking comfort, He knows he is dying and merely wants someone to be there with him so he doesn’t feel alone. Oh, Dec, put down the chart and hold his hand.
Being a doctor isn’t just about making the diagnosis and prescribing the correct drug, it’s also about being there for your patients.
I put down the chart. Mr Arim has stopped breathing. A slight feeling of guilt hits me.
This piece really struck me as it is so simple but I think it can teach a lot. As medical students or doctors there will be times when there is nothing we can do for the patient except be there, perhaps Declan’s reaction was that of a safety mechanism, to hide behind his chart so as to not make an emotional connection. This career would perhaps become too much if we make a personal emotional connection with every patient but I think it is important to remember that we are treating real people and when medicine has no more to offer a simple hand can be enough.
This piece resonates with me because there have been many times where you ask, “could I have done it better? Should I have done better?” There are some things you do not have a chance to redo, and end up feeling regretful. This is especially the case for emotional wrongs and result in heavy feelings of guilt. As medical students and future doctors, I believe we endeavor to help people, yet when instances like this arise we can succumb to our fears. Fear of what? Maybe Dec was fearful of emotional connection as his first duty is that of the doctor, but sometimes when medicine can do nothing, it is the humanity within us that is all that is needed. We thread the fine line between professionalism and compassion, needing to exhibit both in the right amounts without unbalancing our scale and affecting those around us who work with us or need us to work.
For this specifically, knowing what was right, but not having the strength to do it in time, the situation ended itself. This particular piece reminds me that while normally it is within our power to make certain decisions, we do not always have the luxury of deliberation to ourselves, ultimately we are at the service of others and should do for them what they not only deserve, but need.
I have chosen this piece of prose to talk about because of its beautiful simplicity but also the strength of emotion that is conveyed, that I feel makes it a piece of art. This piece resonated with me because guilt is something that everyone will inevitably face, but in this context the guilt is surrounding the fine line between what is expected of him as a Doctor and what he believes Mr Arin needs as a person not a patient in that moment. This professional internal conflict is something that we as medical students will undoubtedly face at some point in our medical carers, which only adds to it’s impact. I also feel as though this piece highlights that despite good intentions we may not always get it right. This is due to Declan coming to a decision but then being unable to follow through on it because he had come to it too late, which is ultimately the source of his guilt.