“When we read alone and for pleasure, our defences are down – and we hide nothing from the great characters of fiction. In our consulting rooms, and on the ward, we so often do our best to hide everything beneath our avuncular bedside manner. So often, a professional detachment is all that is left after all those years inured to the foibles, fallacies, and frictions of our patients’ tragic lives. It is at the point where art and medicine collide that doctors can re-attach themselves to the human race and re-feel those emotions that motivate or terrify our patients. We all have an Achilles heel: that part of our inner self which was not rendered invulnerable when we were dipped in the waters of our first delusion. Art and literature may enable this Achilles heel to be the means of our survival as thinking and feeling human beings.
If it is true that all the great novels, songs, and drama defy any single interpretation it is all the more true for the patient sitting in front of us. If we are not getting very far it is because we are using light when we could be using shade – or harmony in place of disharmony, or we are only offering a monologue when what we should be risking is dialogue – and the forging of new meanings.
The American approach is to create Professors of Literature-in-Medicine and to conjure with concepts such as the patient as text, and most American medical schools do courses in literature in an attempt to inculcate ethical reasoning and speculation. Here, we simply intend to demonstrate, albeit imperfectly, in our writings and in our practice of medicine, that every contact with patients has an ethical and artistic dimension, as well as a technical one. ” – Oxford Handbook of Clinical Medicine.
The third year – the beginning of a future physician’s clinical years – is an important milestone in this five year highly challenging, nerve-wracking, the caffeine-ridden journey of piles of anatomy textbooks and several rounds of general physical examinations. You experience the world outside of the very precise terminologies of Guyton and Robbins. You see walking diseases that cannot be simply cured by your torn and tattered Katzung Pharmacology Review. Welcome to clinical medicine!
You see a baby being delivered for the first time, and you are simply overwhelmed – I was, at least; it was magical – that tuft of black hair coming out of a human, crying, leaving its home of nine months – and it made me both happy and sad; happy to have witnessed the birth of a baby – a miracle in itself – and sad because we, humans, grow from the size of a seed into a five-feet-something-inches mortal that lives with authoritative pride instead of genuine humility, always trying to belittle others, hurting others, being unappreciative of all the countless blessings, and living as difficult patients of the illnesses of the heart and soul.
You see a Schizophrenic patient walking into the family medicine clinic, accompanied by their caretaker. You walk up to them to take their history so you can quickly present your case, mark your attendance, and go and hang out with your friends as soon as you can. But as you start talking to the patient’s attendant, you don’t realize how quickly time flies because you are so engrossed in listening to them tell you how their average day goes, how emotionally taxing it can be and how they often neglect their other family members and, sometimes, the Schizophrenic beloved as well.
Walk into a pediatric unit and it will suddenly dawn upon you that these adorable young people could be the next Einstein or the next Sadequain or the next Shakespeare.
As we go further down this path, dear readers, we also realize that hospitals are not always gloomy. As the famous saying goes, “…and the walls of hospitals have heard more prayers than the walls of a church.” You see families reuniting, you see prayers being answered, you see faith healing, you see the undeniable power of love.
Every patient that we encounter is not merely a living disease; they are teachers, our best teachers, and learn we must! And with a firm belief in that, we bring to you our ‘Docs’ Diaries‘ – a column to document and share your clinical stories with everyone. An incident that inspired you? Brought a smile to your face? Restored your lost faith in humanity? Induced an existentialism that you feel needs to be expressed? Any experience that you have had during your clinical rotations and practice that touched you in any way, will be very proudly published on our blog and in our magazine.
As you will see, or rather, read, ‘Docs’ Diaries‘ will feature a good many of Dr. Haider A. Naqvi’s profound observations from his clinical practices. Dr. Naqvi is a respected professor at the Ziauddin University’s department of Psychiatry and a Consultant Psychiatrist at the National Institute of Blood Diseases and Bone. He has been generous enough to allow us to publish his clinical notes, and we are extremely grateful to him for giving us this opportunity.
Dear readers, we hope that you will look forward to contributing, and to reading, ‘Docs’ Diaries‘ as much as we look forward to featuring your heartwarming stories that will teach us all a lot more than just medicine.
Keep living, keep reading, keep writing!
M.B.B.S., Batch XX