Reflections... ...snoitcelfeR

I'm starting to seriously question whether I can cope with Medicine. I don't think I'll have issues with it intellectually. In fact, I cannot wait to start with the textbooks and labs and research journals...

But I do worry about coping emotionally.

I've been a volunteer on a medical ward at my local hospital for fourteen months. I love most of the staff, and occasionally I enjoy the afternoons I spend there. I'll admit that I relish the afternoons when the F1 on call adopts me and lets me shadow for a few hours (last time, I got to listen to aortic regurgitation! Whoosh! Whoosh!). Mostly I clean stuff, and tidy up, and run the odd errand. Mostly to send sample off to the lab, or fetch stuff from other wards, or, on special occasions, to get ABG results (I got to use the machine myself! I think the bloke who demonstrated it thought I was just a dumb doctor, rather than clueless volunteer), etc.

There is the occasional shift where I come home emotionally drained.

Memories of spending hours with a chap who had advanced Parkinsons, trying to persuade him to stay in his chair. He was so strong that once he was stood, I was powerless to stop him, so it was a case of prevention by distraction. I can still see him turning slowly around the centre of the ward, dancing with his wife.

A succession of shifts doing one-on-one work with a bloke in his 50's who'd had a stroke. He was physically fine, just prone to confusion and wandering. I used to sit in his side-room with him and read Heat magazine, or play draughts, or chess. We'd sit for hours and listen to the music chart on the radio. I'd mock him gently for wearing his trackie bottoms half-way down his bottom like some young chav.

And today.

I heard the yells and screams from the staffroom, where I'd escaped to in order to text R (and S - we haven't been for that coffee yet). I could also hear moo-ing. I returned to the ward to find an exasperated bank nurse. She had a distressed old dear in pain from terminal cancer that was refusing to calm down.

I spent the following two hours sat with this woman, holding her papery thin hand, stroking the velvet skin, softly in fear of tearing open the fragile veins. Telling her everything was ok; telling her that she needed to stay in bed to gather her energy; telling her that the nurses were looking after her, doing their best to get her well again.

I could see the tumours. A massive swollen abdomen, like a full-term pregnancy. A mass the size of her head protuding from her chest. Every so often she would shift, writhing from the pain in her bones, riddled with metastases.

She refused her tablets. Refused the soluble paracetamol I proffered. And sobbed. Cried. Dry tears, with a desperate plea in old eyes. Help me. Let me go. Let me die. And begging, in a low mutter 'I give up. Let me die. I just want to go. Let me give up. Let me die. Help me. You're a volunteer. Help me with this please. Just help me die.'

She'd spent the early afternoon telling every other member of staff to go away. Only once did I get told to leave, and that was when, against my better judgement, I was trying to get her to drink the paracetamol while the nurse gave her a Clexane injection. Every offer of tablets, painkillers, insulin; all met with a polite, but firm 'No thank you.'

She drifted in and out of sleep by the end of my shift. I sat by the bed, one hand gently clasping hers, my smooth tanned skin against her wrinkled bruised. Her eyes, once bright with sparkle, were dull, half-closed. I read, analysing an article that a nursing student friend had had published recently in a prestigious journal. I was thinking of my future, of a career in medicine. She was thinking of the past. She has no future.

One thing she said will stick with me for a long time. 'You don't know what it's like to be like this'.

She's right. I never want to experience the pain of metastatic cancer. I don't want to pass away in pain. I don't want to be so alone at the end that a volunteer sits with me.

But, when I get to that point, I want to be that defiant. I want to be as polite, yet firm. I want to wind the nurses up, yet be the type of person that they still care about even after their shift ends.

I don't know if I want to die on my terms. It got me thinking about euthanasia, and I don't want to go into it here, because I will just go round and round in circles, but how is it fair that I can walk out of here because of a petty argument and kill myself if I want to, yet a lady who has lived her whole life and wants to end the pain that she's in, can't?

I left her asleep, calm. Serene, compared to how I'd met her earlier. The nurses thanked me. I wanted to thank her, for letting me in, allowing me to see beyond 'death by cancer' and learn.

It's still haunting my mind. There is no way of walking out of the hospital doors, leaving everything there. I bring that emotional baggage home.

How do I cope with this? Will this get easier to deal with? I don't want to end up as an emotionless drone just to save myself from falling too deep into the lives of my patients. Is it humanly possible to emotionally connect with another human being and then walk away unattached?

I don't want to lose myself in the emotional trauma of the job, though...