When you're both the doctor and the patient

Guest post by Ann Marie Gavin


In my early twenties, I was diagnosed with Crohn’s disease. Out of my diagnosis grew my interest in becoming a doctor. Fast forward a few years and I’m now that doctor.

Many people told me being a medical student, then a doctor would be hard and difficult. They were right. But, no one could have ever prepared me for what it would be like to have a dual existence as a medical student/doctor and a patient at the same time. I’m not sure how many of us dual qualification doctor/patients actually do exist, but I know I would have loved to see people who had walked in my shoes when I started out on this journey.

Yes, being a medical student and doctor can be hard. But it is nowhere as difficult as being a patient trying to live and survive with chronic medical conditions. Being a patient has some parallels with being a doctor, but the patient never has time off from their illness. They never can get away from it for a break. They can’t switch it off. My appreciation for how difficult patients’ lives can actually be is what has kept me going through my own difficult times when I was both training to be a doctor and coping as a patient. When I struggled, it was the patient in the bed that gave me the drive to keep going.

But, being both a patient and a medic brings its own set of unique challenges. At times the line between doctor and patient can be blurred. Throughout my medical training I’ve managed to accrue possibly more hospital admissions than some of the patients I’ve met. I estimate I’ve had a minimum of three hospital admissions per year for the past five years during the time it has taken me to obtain my medical degree. However, that does not accurately portray the true picture of the weight of being a patient. It doesn’t include the doctor appointments I regularly attended to keep my head above water. It doesn’t include the things I couldn’t do when I was ill or exhausted. It doesn’t include the days I went to college and hospital placements when I was sicker than the patients I stood in front of.

What none of this shows is the illusion of a medical student that I was to people. I was seen as someone who looked after people who were ill, not someone who was ill themselves. It also doesn’t show the pressure I felt not to be ill. I felt it was acceptable to have a chronic illness, but only for the title. By that I mean, I felt it was ok to have Crohn’s disease provided it was in remission. It was ok once my disease wasn’t symptomatic and didn’t affect my ability to perform as someone working in health care should. This pressure led me to try to push my health to one side, try to ignore my gut instinct, try to pretend I wasn’t ill when I could barely stand. In a world surrounded by doctors and future doctors, I felt incredibly isolated and alone in my illness.

When I began medical school I was always open about my illness, it was what led me down this road. I never felt like Crohn’s was something I had to hide. I never felt ashamed, it was part of me, not all of me. But its impact on me shaped part of who I am today. Being a patient has taught me far more about medicine than medical school ever could. Yet, I began to feel that I had to deny this part of me. I felt I was losing my voice. The voice which advocated from a patient perspective. I eventually learned to silence this voice. The impact of being a patient while training to be a doctor is still with me. But then I remember what it is like to be that patient in the bed, and all I wanted and needed was one person to listen to me. I know I have to be a voice for those who don’t have one.

Part of what influenced me to become a doctor was that I never saw a diagnosis as a life sentence. I saw it as the opposite. Knowing what was causing my body not to function as it should gave me a sense of empowerment. A diagnosis offered the starting point to a solution. However, my journey with Crohn’s wasn’t always smooth. It still isn’t. I’ve been on countless medications for it. Some of these medications have left me with other chronic illnesses that now have more of an impact on my life than the Crohn’s itself. No medication or surgery has ever been a cure or quick fix for me. I’ve had partial responses and side effects to just about every treatment option I’ve tried. My journey to recovery has never been in a textbook fashion. I’ve had complications. I've learned that everyone is different and has a unique recovery path. I’ve learned to try not to compare my illness and life journey to others. Just because one person is on top of the world with their survival story does not make somebody else's struggle a failure. You may just be seeing someone’s highlights.

I’ve learned that it's OK to experience illness and recovery your own way. It's OK to be your unique self. Life is far from textbook.

Through my journey as a patient I’ve learned that medicine in the textbook sense can take patients to a certain point. Recovery and healing requires some element of creativity and flexibility. Medicine is quick to judge anything less than perfect recovery or textbook symptoms, or responses as a failure. Sometimes it is ok for a person to live with an illness and still have a fulfilled life. I earned a medical degree while experiencing the worst health of my life. I learned to adapt, I learned to rest, to listen to me. I learned mental resilience is just often just as vital as lifesaving medication. Quality of life is far more important than lab results and prognostic statistics. I’ve learned never to judge a patient by a label of their diagnosis.

One of the biggest things I’ve learned throughout this journey is to be open-minded and that the patient often has much more wisdom than the doctor. As a doctor, we’re here to help our patients, but we also have to remember to listen…as there is a lot we can learn from our patients.

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