Vaclav Havel (a Czech playwright and president of the Czech Republic) claimed ‘human beings are compelled to live a lie only because in everyone, there is some willingness to merge with the anonymous crowd and to flow comfortably along with it down the river of pseudo-life’.

During my G.P. placement, I met a patient who coped by looking through her illness and almost ignoring it. She saw the doctor as the custodian of her illness and wished to have little or no involvement in decision making. Mrs. Rushib* is a lady in her eighties suffering from pulmonary heart disease and arthritis.

One of the things that struck me the most when speaking to Mrs. Rushib was her lack of knowledge or interest in her illness. She has taken a cocktail of pills every morning for years to soothe her symptoms but showed no desire to know what each pill is for. She also chose to ignore the doctor’s advice when told to give up smoking, refusing to recognize at the time that it could worsen her condition. Rather than acknowledge her condition, I felt that Mrs. Rushib had decided to live a pseudo-life centered around other people’s illnesses such as her husband’s (who became heavily dependent on her due to a debilitating disease) instead of focusing on her own problems.

For my creative piece, I decided to paint a picture of a woman smoking. I put sequins in her hair to represent her impenetrable idealistic bubble, where she could continue to enjoy smoking without acknowledging the effect it had on her health. It was the doctor’s job to control and guide her illness while she continued to act as if everything was as it always had been. In my painting, I have represented the doctor as a hand reaching up to catch Mrs. Rushib’s smoke. The smoke symbolizes her illness (there are words written in the smoke related to her illness and her fears about the future). Although the doctor is trying to catch all of the smoke, some of it slips through his/her fingers as he/she can’t be responsible for all aspects of her illness. Mrs. Rushib needs to be in charge of the areas of illness that the doctor cannot control and recognize her fears, which until she does, will manifest themselves whilst she ‘flows down the river of Pseudo-life’.

* name and details changed to maintain patient-confidentiality