Dr Rob Park

FEW weeks ago I became a dad . Obviously many things have changed , but the resounding difference is that I now survive on less sleep than is required for daily functioning .

In addition , my appreciation for the emotional complications of the surprisingly complex task of breastfeeding , the constant oppressive internal question ‘ am I doing the right thing ?’ and the nagging idea that ‘ I should have appreciated my previous freedoms ’, has exponentially increased .

Most importantly , I believe it will change the way I practice medicine as it ’ s made me realise how important personal experiences are to the care we offer patients and to the doctorpatient relationship .

I ’ m book-smart and I know what ’ s advised to manage parental and newborn medical challenges . But the textbooks do not describe the feeling of sheer exhaustion at 2am when this crying , beautiful baby , despite all your protestations , begging , pleading , and appalling singing , just won ’ t go to sleep .

My new perspective has given colour and emotion to the blackand-white clinical skills I previously used to manage these patients . I have a deeper understanding of the emotional complexities surrounding breastfeeding .

I can appreciate the tired mother who has not slept for a few days , and needs reassurance and validation ,

not medication and a psychologist . I understand the parental frustrations that go with purple crying / colic and can provide reassurance that this can be normal , and that , like a category five cyclone , it will pass .

This newfound insight makes me cringe when I remember a conversation I had with two nurses years ago .

I was listening to them discuss their difficulties with menopausal symptoms and one suggested that the other should : “ Go and see the new young male GP in town as a patient ,”

glancing cheekily in my direction .

The other nurse laughed and said : “ What would a young man know about menopause ? He has never gone through it .”

I thought for a moment and wittily replied : “ No that is true , but I have also never experienced a heart attack . And the gentleman I just treated for cardiac arrest seemed pretty happy with my emergency care .”

I ’ ll be honest , I felt pretty smug at my clever response . But reflecting upon that conversation , perhaps there was more to what the nurse said than I appreciated .

We are taught at medical school to

acknowledge transference from our patients and to not allow it to influence our medical care . However , it is naïve to believe that simply noting these feelings makes us immune to their influence .

For example , if a patient comes to you , describing how they have been getting drunk and angry at their family , and your father was an alcoholic who was aggressive to you as a child , then let ’ s be honest , this will affect your ability to offer impartial care .

Conversely , a patient who presents

MY NEW PERSPECTIVE HAS GIVEN COLOUR AND EMOTION TO THE BLACK-AND-WHITE CLINICAL SKILLS I PREVIOUSLY UTILISED .

with pain in their cheek , similar to the pain you experienced prior to a diagnosis of parotid cancer , is likely to lead you to order a rapid and possibly unnecessary ultrasound .

Both these responses are human — neither is right or wrong . Our actions are based on our previous learning and experience , and as doctors , we should embrace the positive affects of that and ensure the negative effects aren ’ t detrimental to our patients ’ care .

There ’ s one patient , I often reflect upon now — a young mother with a beautiful new baby . That baby was very unsettled , screaming from dawn

until dusk with that ‘ in pain ’ cry that to a mother sounds like glass scratching deep into a chalkboard .

We sent bub to appointments with paediatricians , specialist paediatric gastroenterologists and sleep clinics — which led to a myriad of diagnoses and a menagerie of explanations for the crying .

The mother — confused , exhausted , and feeling inadequate in her ability to provide for her child — I diagnosed with postnatal depression and referred her for help .

She continued to struggle for many months and when I reflect upon their care , I don ’ t feel that they ever received a satisfactory or comforting response .

The experience was medicalised , confused with multiple inputs , and led to significant anguish for the family and baby .

Do I think that anything I did was medically incorrect ? No . Do I think I would have treated her differently now with some of our shared experience ? Absolutely .

I may have been able to build better rapport , gain her trust , and perhaps say the things she needed to hear at the right times .

In medicine , nothing is certain , the retrospectoscope can be cruel .

I will continue to treat patients in the best way I know how , based upon my medical knowledge and skills , and also my personal experiences . Dr Park is a GP on the Sunshine Coast , Qld .