Still got it?

Recently, I’ve had a few jobs both on the road and on the ward that have really made me start doubting whether I am still as caring a person as I used to be, or at least think I was. I blogged about a couple here and here, but there have been plenty more from “big sick” patients that haven’t troubled me to welfare issues that I’m unfazed by, making me think whether I’m turning into a cold, callous and heartless bastard.

However, today I regained some faith in myself. We’ve got a patient in, about my age, with a severe allergic reaction. They’re atopic, suffering from allergies, eczema and asthma, with mental health conditions secondary to the above. And I really felt sorry for this patient.

The one issue I have here is, did I feel sorry for them because of the state they were in, or because, to be blunt, they reminded me of me (and I’m a horrible narcissist)? Do I care about them in the same way I care about any other patient, or do they get an extra portion of care and empathy from me because of the similarity of their condition to mine? I fear it might be the latter.

But still, an improvement on how I was feeling! Once upon a time, I got really emotionally involved with “patients” – be they people I came across through work, St John, or just people who needed my help in “normal” life be it friends or strangers. The homeless man I could do nothing for at Notting Hill Carnival, the suicidal friend, the recovering drug addict in the pharmacy. Through time, I’ve become more detached from all this. I wouldn’t say “learnt to become more detached” as I was about to – it’s more just developed through time without any concious effort. But I guess as Chapati kept saying, it’s not necessarily a bad thing. In some ways, it’s made me better medically, from being able to keep a clear head during the distressing situations to just not being taken for a ride by the homeless person after a bed for the night or the attention seaking addict trying to score some drugs. As long as I can keep hold of some humanity then if being detached means I’m able to better look after people then it is fine by me.

Update: Unfortunately, the kid never regained conciousness and died. Hearing that news upset me far more than any of the rest of the saga did, perhaps because I’d convinced myself that there was going to be a happy ending since I saw that sinus ECG rhythm in resus. Maybe I’ve watched too many episodes of Casualty. I guess that the fact I’d managed to convince myself they were going to be fine despite my head saying that there was a negligable chance of survival, given how long they were without oxygen, shows that I did care about the poor little thing after all, and it was just my all too effective psycological coping mechanisms cutting in at the time. Which is, as far as I’m concerned, a good thing.