Dear Doctor..

Dear Mr Consultant,

I came to see you the other day for my final appointment at the end of treatment for breast cancer. I waited an hour in a room filled with elderly patients who by necessity were filled with the War Spirit and happily geeing each other along. I looked around at them and realised that some were probably there for ‘Results’. Sitting there, laughing with strangers in this limbo-like space. Waiting for words that would change everything. The very worst thing you can do to someone with their emotional breath held, is make them wait. Thankfully that was not me, that day.

When you finally came to get me, you barely glanced at my face. When you said my name, it was the last time I would hear it from your lips. You rushed ahead down a long, unfamiliar corridor and I started to feel like Alice down the rabbit hole. Once, you half turned your head to mumble an apology for the wait but I only caught part of it. I felt a pressure at the back of my head to start talking, to reassure you in the gaps, to fill the social holes that launched our interaction. I didn’t feel up to it. We had had a previous encounter once before when I didn’t feel heard, felt dismissed. So I’m already coming into this interaction with baggage. I don’t want to be nice to you. I’ve raised my defences and nothing so far is causing me to drop them.

I remain silent as we enter your office. Your space, your territory. You go straight to the computer and pull up my file. You scan read my life-saving treatments. You are thorough though and open up the report from an ECG I had 8 weeks ago that no-one has told me the results of yet. 60-65% heart function, that’s good you say. I’m relieved and happy you told me the details. I like the details. I like to know as much as I can about my body and how it’s doing. It helps me to feel at least a smidgen of control in an otherwise free-falling situation.

I got encouraged to be curious and asked what that meant, those percentages. You seemed flustered that I wanted to know and half laughed at my misunderstandings of biology. Maybe you were sharing a bonding moment with me. Perhaps you thought a bit of laughter would break the tension. Humour can do both those things. But laughter can also feel mocking and belittling when you feel an inequity in the relationship. Your response made me also question why you had told me the numbers in the first place. Was it to help me understand, to reassure me I was OK? Or was it a way to distance me from you.

Because this was how I was feeling. Distant. I wanted to hug you, to thank you. How could I ever show enough gratitude for the immense act of saving my life. I wanted to bring you cake and a card with all the words I couldn’t squeeze into my allotted time. But action by action, you pushed me away. One micro-detachment at a time.

You said you wanted to listen to my heart and lungs and asked me to take off my ‘top things’. You pulled the curtain and went to get a female nurse. She was supposed to be there to reassure me, to make me feel safe, to prevent any ‘misunderstandings’. I didn’t see her face or hear her voice until she asked me if I needed help getting my bra on after it was all finished. You didn’t ask permission to touch me or take care in that touch. You hurt me where I had been cut open. Your hands were cold, rough and fast. You didn’t ask if you could examine my ‘good’ boob. You just did it. I didn’t even know you were going to examine my scars, my hurt places. The places on my body that had just started to become private again.

When you finished, you washed your hands and I felt violated and a bit ashamed.

I can try to understand why you act this way. You see hundreds of patients, some of them are going to die. All of them are going to suffer. You must need to build up defences to protect your own human feelings. Maybe that’s how it starts. Then little by little, it turns into something meaner, nastier. It becomes self-fulfilling. I must have seemed by an ungrateful, cold person to you. I didn’t laugh at your jokes. I didn’t even say thank you. All your hard work and nothing back. If you’re already detached from me, this must send you a little further towards misanthropy.

It is a tricky thing to protect yourself emotionally while keeping engaged with people. We all struggle with it. The best doctors and nurses I’ve had seem to find that balance. Even if I’ve had to wait hours, they walk me slowly to their rooms. They ask me how I am and listen to the answers. They say my name many times. They look in my eyes and away from the computer screen. They tell me everything they want to do, every examination they want to make before they do it. They ask permission for every touch and apologise for any hurt they cause. They encourage my questions and answer them patiently and thoroughly. They even get energised by it and take me further into their own world of understanding.

They make me feel like the only patient in the world in a world of chaos and pain.

So dear consultant, I wish you that hug and I am grateful for your knowledge and expertise. You saved my body. Please find the strength and will to soothe my soul too.

Yours, in respect and peace.

The patient.


5 thoughts on “Dear Doctor..

  1. Sokari

    Heidi – Thank you for writing this, its so important to express our feelings whether of hurt or joy. Sadly there are too many medical staff like the doctor in this post. BUT there are also many many who are wonderful. I do feel that medical professionals need to find a balance between empathy and protecting themselves and being cold hearted doesn’t seem to be one.

    I wish you all the best from now and thank you for sharing all your experiences over the past 12 months.

  2. Karen

    Wow, Heidi, what a beautiful letter. What an amazing expression of how that experience felt. We’ve also had that experience, both of consultants who are absolutely amazing and take their heroism right through to the gentlest, kindest detail in their tone of voice or eye contact, and then we’ve also seen the brutality of those ones who seem completely detached. I remember sitting with L, waiting for G to come out of his massive scary operation and it was taking longer that we expected and she was completely terrified, and the surgeon walked past us twice in the corridor and avoided eye contact. He could have just said, ‘Don’t worry, he’ll be out of theatre soon’ or even just ‘hello’ or something, but he just ignored her, as if the fact she was waiting for news of her husband’s survival was an inconsequential detail.

    Your beautiful letter says it all. I also loved that you have compassion for the fact that they are doing scary jobs where they have to witness suffering and fear all the time, and yes, it must make them have to build any defences that they can muster. But it feels pretty brutal to be on the receiving end of it. I loved your letter. Beautiful, eloquent, true.

  3. Lisa

    Heidi, this is a beautifully worded letter, and so important. Do you think you might share it with the consultant? Your letter is very powerful and an excellent reminder that we as patients are human, not just the 4:15 breast cancer post-treatment exam. Recently I fired my oncologist and found a new one. The first one, while clinically very good, was not compassionate or warm. As an oncologist, I think they have a greater than usual obligation to be kind to their patients, but also to give hope. The one I fired caused me to be very fearful, even though I know I have a very good chance of being just fine. Now, the new one treats me like a person and acknowledges my fears. Yesterday he said, “When you’re in this office, we can face your fears and deal with them. But when you go home, you can leave your fears in my office.” I nearly cried. And for you, my friend and fellow survivor, I hope the next consultant you see will treat you more compassionately.

  4. Heidi

    Thanks wonderful peeps. It wasn’t a hugely traumatic experience but I couldn’t shake it and writing that out helped me figure out why. I didn’t want to do some moany post so the letter seemed a less whiny option. Something constructive. Karen, I’m sorry you had a similar experience. I think it happens very frequently and those tiny little mistakes feel so devastating in the heightened awareness of fight or flight situations.

    Lisa, I’m so happy you took charge and made that change. I had a very different, very wonderful oncologist before this point. But she isn’t trained in radiotherapy so I had to switch to this guy. I’m gonna ask to switch back. I’m also gonna send my letter to this volunteer group who have contact with advocacy groups who channel feedback into the NHS. Anyway hopefully it’ll get to him without me putting my name to it. Xx

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