Consulting with patients inherently relies on how much they open up to you – all the information you receive represents how much they place their trust in you. Good consultations not only need rapport but they also rely on willing patients.

In my artwork I chose to draw a patient with their mouth sewn shut, the threaded needle in their hand. This image represents the patients who aren’t willing to talk, for a variety of reasons. Over the year, we spoke with a patient who was honest about feeling low, but there are many patients who won’t share this with their doctor. Maybe they don’t feel comfortable speaking openly, maybe they feel embarrassed, maybe they just aren’t ready to talk. People have many reasons to withhold. Whatever the reason, we need to accept that there are patients who will just not feel able to be open.

Furthermore, I decided to only draw the mouth, nose and hand of the patient in black and white. This is to symbolise that anyone can go through this and to also evoke a sense of disconnect. Whether you interpret this disconnect to be between the doctor and patient or within the patient themselves is up to the you as the viewer, but I’m sure we can agree that the drawing, by not being in entirety, leaves a sense of something being missing or lacking.

Last term we explored the idea of ‘yellow flags’, signs that a patient is not confident or hopeful about their treatment and how this can lead to worse outcomes. The hand holding the needle in my drawing represents not just the patients who aren’t able to open up, but the patients who, in some ways, hold themselves back. Once again, there can be many reasons for this: fear something might not help, lack of hope after lots of interventions have been tried or an issue has persisted for a long time, or even lack of motivation.

The power of the motivated, energized patient becomes so evident when we consider how a person’s own mindset can have such a drastic change on their health and outcomes. Just as someone has the ability to close themselves off, ‘sew their mouth shut’, they have the ability to reach out to others, take a step forward, and play an effective part in their own healthcare.

We are taught to follow a structure in our consultations, and as valuable as it is to have something to keep you on the right track and something to fall back on if you need it, it is also important to realise sometimes patients will not allow you to stick to that structure. Patients are people, and hence, will not conform to the neat order we expect them to talk or act in. I have learned that there are many challenges faced by doctors when it comes to helping a patient, and there can be even more obstacles faced by patients when it comes to receiving help. In the future, I hope to be open and understanding of all patients, especially those who are struggling with taking charge of their health or finding difficulty in being candid about their well-being.