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The Slipper and the Shoe
Sarah Saunders
I have based my montage on one particular patient that I had the privilege of meeting on a home visit, whom I shall refer to as Charles.

Charles needed little encouragement to talk about his life and chose to start at the time of his own birth and take us on a narrative journey finishing at the present day. If I am honest, my first thought was that what he has going to talk about for the first 30 minutes would be irrelevant and a bit pointless. In my mind I willed him to get to the ‘good bit’ about his operation and recent experiences of cancer.

In this art piece I have tried to show how Charles told us his story like a journey he had been on and to illustrate his emotions and important people in his life. Charles started talking about the effects of his mother’s early death, passing away before his 10th birthday and his consequent bad experiences with a step-mother who he would ‘rather not talk about’. To illustrate this I have pieced together a black part of the path of his life, followed by a transition into white. I chose this because I noticed Charles’s mood lifted as he began talking about his wife, getting married and having his children. Charles spoke a lot about his wife; his love for her over their 50 years together came across to me very strongly, so I chose to represent her as reds and pinks.

Charles has been told that he is in the terminal stages of cancer and as he waits for his appointment with the consultant for more news, he refers to this period in his life as one of ‘reminiscence’. This is why I chose to portray a path representing the past behind his feet and his future as a cascade of yellow and red, ahead of him.

The centre piece of this portrait is Charles’s feet. When I entered the living room where Charles was sitting I was aware he was wearing one slipper and one, shiny, polished shoe. I rationalized in my head that his ankle and foot on one leg were indeed too swollen to fit into another shoe but could not understand why he didn’t simply wear a pair of slippers. Upon reflection of my sixty-minute insight into Charles’s life, I feel this can be explained by the fact that through all of the adversity he has faced in his life he has remained a man of pride, dignity and respect. I think that the slipper and the shoe are a symbol of Charles’s attitude to life, never to give up. He asked my colleague and I not to think of him as a ‘brave man’ and rather to take something away that could help us and our future careers as doctors.

During tutorials before we began GP placements a colleague asked the tutor what she should do if a patient she was with started crying and she felt she was going to cry too. I remember thinking that I was not worried about that and assured myself I would be able to control the situation through ‘detachment’. However as Charles started to talk about his cancer, and the mood in the room changed. Almost without warning he began crying and I did not feel the sense of detachment that I had so hopefully thought I would. In the art work I have shown this part of the interview by a transition of blues running down the board. I have included this because I felt that it was an important moment for Charles and for me, as I think we both thought that we were strong enough, in very different ways, not to break down.

On reflection, I am embarrassed by my initial thoughts about Charles telling his whole story – since I can now see now, the early experiences of our lives and the people we are, shape the person we become. For example, Charles told me that his early experience of losing his mother has helped relieve some of the anxiety about his own prognosis.

In my future clinical years I anticipate that I will meet people who, at the first upset in their lives will crumble and lose themselves. Equally, I will encounter those, like Charles, who refuse to be beaten and who continue to live their lives with sheer determination and courage, even when faced with the worst prognosis imaginable. Whoever they are, I hope I remember to appreciate that everyone is unique since we all grow out of different experiences.

Thinking about other patients I have seen both in the surgery and at home, and indeed about my own life, Charles’s philosophical attitude towards the wall of adversity he has faced and continues to face, was truly inspirational. By making this montage, I hope to show the way in which Charles has walked through his 77 years of life, and how he is now at a point to look back and reflect at the journey he has taken.

G.P. Attachment