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Care-Givers: The white coat brigade

They are the last hope for many of us. When we enter their space, we, as patients, run the gamut of emotions. But what happens in a doc's mind? What are his or her fears, hopes and aspirations?

Gulf News

They are the last hope for many of us. When we enter their space, we, as patients, run the gamut of emotions. But what happens in a doc's mind? What are his or her fears, hopes and aspirations? Vasanti Sundaram goes behind the white coat and stethescope to feel the pulse of a doc's life

We know they wear white coats, and walk around with a stethoscope, probably a tongue depressor, even an invisible wand to shoo all ills. We know they seldom laugh, almost
like the mechanical car cleaner who goes about his job with an inscrutable expression. We also know that they have the most incomprehensible handwriting.

What we don't know is the mind behind the mask, what we cannot hear is the throb behind the sterile armour, what we cannot see is the tears behind the probing eyes, and what we cannot feel is that imperceptible tremor in the comforting hands.

We think we know them, but even the most candid ones only tell us what they want us to know, and reveal only what they want us to see.

Friday unravels the enigma of medical practitioners... Do they cry? Who do they turn to when they fall sick? Are they the best spouses?

As four doctors prepare themselves for an intensive probe into their psyche, they were asked to confess the first thing that came to their minds in relation to their practice of medicine.

No vacation

Dr Muhtasib... my clinic is my home.
Dr Hiba Muhtasib, obstetrician & gynaecologist, American Hospital, surprises with her revelation that she does not remember taking a vacation for the past 15 years, and she does not regret the fact.

"I love my job, this is my life, my clinic is my home," she says, with an intensity in her voice. It's been just over three months in Dubai for Dr Hiba. Leaving behind a successful practice in the United States, her primary worry is getting to know the system of medical practice in Dubai.

"I am very new here, and although an Arab myself, this is the first time I am dealing with Arab patients. I want them to learn about me faster, so our relationship can get on to a more solid footing."

Dr Andre Wessels, consultant cardiothoracic Surgeon, Welcare Hospital, Dubai, speaks about his mindset each time he walks into the operation theatre. "I have conducted more than 3,000 surgeries so far, yet I have the same flutter every time I walk into the OT. Obviously I am a lot more confident than my first operation, but you never lose that gnawing fear or apprehension of the unknown."

A consultant physician at Al Zahra Hospital, Sharjah, Dr Trevor Gebbie mentions the notes that he makes while seeing a patient. "I learnt this from an older doctor that whenever I check a patient while I'm tired, I make a note on his record, saying "Tired, re-examine.''

"There is a vast difference in examining a patient when you are feeling good, the sun is shining, and it's the beginning of the day, to tackling a problem when your energy levels are on the ebb."

Dr Paulose P. Thomas
Dr Paulose P. Thomas, specialist nephrologist, Belhoul Apollo Hospital, Dubai, elaborates on the stresses that a medical practitioner experiences.

"Your stress levels go up when you have problems that you can't do much about, and when patients' expectations cannot be met. A patient expects you to cure him and looks up to you as his final hope. I have found that, especially in the UAE, patients' expectations of a doctor are very high. They somehow feel let down when you have not been able to cure a problem, unlike other places where they easily come to terms with their condition."

Treat us like humans, not as an all-powerful being, plead the doctors. "A lot of problems arise when patients think doctors can never falter, or fail. No, we are also human, we all fail from time to time," appeals Dr Hiba.

Supernatural power
Engaged in a profession that attributes logic to almost every syndrome, do doctors believe in the inexplicable phenomenon of a supernatural power? "Yes I do," admits Dr Wessels, "I believe that as doctors there is only so much that we can do, there are certain things completely out of our control, and if you have kept your part of the bargain, if you have worked to the best of your ability, the rest is in the hands of God."

Dr Thomas agrees that the turnaround in his patients sometimes defies understanding. "You know it's not you, there is someone else. On conventional wisdom, you think it's incurable, but somehow that situation just changes. You always feel there is someone else intervening, or the person's faith has worked miracles for him."

But miracles don't happen all the time. Agony and vulnerability assail doctors when complex cases leave them wondering which way to go. What happens then? Do doctors ask for help? Or, having been trained to solve problems themselves, do their egos prevent discussion?

Dr Wessles considers it arrogant for someone to think he knows it all. For Dr Hiba, reaching out for another physician's perspective is a sign of strength. "If you are weak, you won't admit it, but if you are strong, you would say, 'yes, that wasn't the right diagnosis, I need to verify and set it right'."

Dr Gebbie... treat us like humans, doctors advise patients.
Dr Gebbie believes that one of the greatest skills a doctor would need to cultivate early is to accept the fact that he won't always have some of the answers, while someone else could, and asking for help without any ill will is never a sign of weakness.

Dr Wessels divulges that it's easier for a doctor to admit failure to himself than to his patient. "You have to be honest with your patients. If things go wrong, then it's no point hiding it from them, or their families. Camouflaging the truth will get the doctor nowhere for truth always comes around. However, that does not negate fact that encountering or admitting failure makes me cringe."

Concurs Dr Gebbie, "I think we all find it difficult to accept failure, but in medicine you have to learn to do that if only to yourself. When you try to solve biological problems, it's like a lottery, you have so many alternatives, and you pick the best option which you think is good. You follow that line of enquiry, sometimes you reach the end of that line, and find you are completely wrong, and there is no time to start again."

"In medicine," continues Dr Gebbie, "you are continually faced with problems that you cannot solve, and the least you can do is try and ameliorate them. But, the success rate isn't always as good as it should be no matter how hard you try.

"So, doctors end up feeling guilty all the time, wond