18 OPINION
18 OPINION
19 APRIL 2024 ausdoc . com . au
Insight
Denying our own illness
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Dr Craig Lilienthal GP and medicolegal adviser in Sydney .
You are no good to anyone if you are sick .
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SUSPECT that , like me , most GPs tend to battle on with their work — even when they note signs and symptoms suggestive of personal ill health .
I recently experienced a bout of influenza A , followed by a touch of food poisoning , and despite sound advice from my nurse wife , I continued working .
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Okay , I did do telehealth consultations from home while I had the flu , but I went to the surgery as soon as the D & V subsided .
What illogical thoughts drive us to continue helping our patients when we suffer from the same illnesses they do ? They run as follows :
• Denial — I am not getting sick ;
I love him beyond all reason , and care for him above all else .
it is some minor physiological process that will pass . Just keep working .
• Bulletproof — I must show that I am strong and reliable and will not succumb to the illnesses experienced by mere mortals . Patients get sick , not doctors .
• Control — Of course , I am in control of the situation .
BECAUSE THEY ’ RE TOO IMPORTANT
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• Sense of duty — I have patients booked in to see me , and I cannot let them down .
• Professional jealousy 1 — My patients will be annoyed if I am not available to see them .
• Professional jealousy 2 — I do not want my patients sneaking off to see other doctors . They might not come back .
• Cannot let the side down — My busy colleagues will be pissed off with me if they have to see extra patients .
• Professional recrimination — My colleagues will be pissed off with me for having to spend extra time looking after my patients ’ abnormal path and imaging reports and having to work out how important these results are and what to do with them ( just like I become pissed off with them when they take time off ).
Your health should take priority over everything else .
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MINIMUM PRODUCT INFORMATION EpiPen ® Adrenaline Auto-Injector 0.3mg / 0.3mL EpiPen ® Jr . Adrenaline Auto-Injector 0.15mg / 0.3mL . The following are not a complete listing : Indications : For the emergency treatment of anaphylaxis ( acute severe allergic reaction ) due to insect stings or bites , foods , drugs or other allergens . Contraindications : Contraindications are relative , as this product is intended for use in life-threatening emergencies . Certain arrhythmias , cerebral arteriosclerosis , vasopressor drug contraindication , shock ( except anaphylactic shock ), certain types of general anaesthesia . Precautions : Sulfite allergy , intravenous administration , ventricular fibrillation , prefibrillatory rhythm , tachycardia , myocardial infarction , cardiovascular disease , organic heart disease , cardiac dilation , cerebral arteriosclerosis , prostatic hypertrophy , elderly , individuals with diabetes , hypertension , narrow angle glaucoma , hyperthyroidism , organic brain damage , psychoneurosis , phenothiazine-induced circulatory collapse , Parkinsonism . Avoid injection into hands , feet , ears , nose , buttocks , genitalia . Use in Pregnancy : Pregnancy Category A . Excreted in breast milk . Use with caution when maternal blood pressure is in excess of 130 / 80 . Interactions : CNS medicines , alpha and beta adrenergic blockers , some general anaesthetics , hypoglycaemic agents . Adverse Effects : Anxiety , restlessness , tachycardia , respiratory difficulty , tremor , weakness , dizziness , headache , dyspnoea , cold extremities , pallor , sweating , nausea , vomiting , sleeplessness , hallucinations , flushing of face and skin . Psychomotor agitation , disorientation , impaired memory , potentially fatal ventricular arrhythmias , severe hypertension which may lead to cerebral haemorrhage and pulmonary oedema . Angina may occur in patients with CAD . Dosage : Single intramuscular injection into anterolateral aspect of thigh , repeat as directed if symptoms recur or have not subsided . Adults ≥30kg : EpiPen ® Auto-Injector ( 0.3mg adrenaline ) Children 15 – 30kg : EpiPen ® Jr . Auto-Injector ( 0.15mg adrenaline ). The prescribing physician may choose to prescribe more or less than this amount ; please refer to relevant guidelines .
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• Inconvenience — The practice manager will be annoyed with me for having to ring around all my prebooked patients .
• God image — My family and my colleagues will think I am weak and realise I am an imposter .
• Misplaced workload — My workload will still be there when I return to the practice and will make my return to work even more difficult , so why take the time off in the first place ?
• Blind man ’ s bluff — I can hide the fact that I am not well and carry on without triggering any of the above as long as I keep my mouth shut when I cough and wear a mask to cover up the obvious .
• Self-treatment — Anyway , I can self-treat with sample drugs .
• God delusion , again — See , I can cope ; I am not an imposter . It is bad enough when we deny we are ill , but the problem only gets more complicated when we finally accept that we need to seek medical assistance — and we do not have a GP to consult .
Get your priorities right . Your health should take priority over everything else — and this includes our patients .
You are no good to anyone if you are sick . Get your own GP , and be a patient .