Advanced - Unit 10 - Audio - Track 33

Outcomes Advanced Audio script
Page 92 Unit 10 Track 33
1
Medical dramas on TV here have changed a fair bit over the years. Before, the doctor was
just a saint that could do no wrong, but nowadays they’ll have more flawed characters and the
hospitals are more like my own. My favourite remains House, even though it finished a while
back. It’s basically about this highly unconventional doctor and the team he leads. He’s a
brilliant clinician, but he’s also cynical and downright rude to colleagues and patients alike.
He’s also ridiculously unethical in his approach. In one episode, he gets a junior colleague to
break into a patient’s apartment to solve the mystery of their condition. In another, he totally
breaches patient confidentiality just to prove a point. Of course, this is where the show parts
with reality, but I’ve found it a really useful springboard for my students to discuss ethics, the
processes that should’ve taken place, and how to improve bedside manner.
2
When I see the mass of printouts in their hand, my heart just sinks. I just know they’ll have
been searching the Internet for every possible diagnosis or quack cure you can think of! It’s
like that joke: a man goes to his doctor and tells him he’s suffering from a long list of
illnesses. ‘The trouble with you,’ says the doctor, ‘is that you’re a hypochondriac.’ ‘Oh no,’
says the man, ‘don’t tell me I’ve got that as well!’ Seriously though, these people are often
timewasters and to my mind they’re also kind of undermining my professionalism – 20 years
of study dismissed in favour of Google! My main aim is to get them out of the surgery as
quickly as possible.
3
There’s a cliché that doctors make the worst patients because we don’t take the advice we
would give to others. That’s definitely true. I read a survey that found 80% of Norwegian
doctors had reported into work with illnesses that they would have issued a sick note to others
for. Underlying this is a bigger problem of how we see our role. Our purpose is not to suffer
but to see symptoms, diagnose a disease, treat it and cure it. As a result, we sometimes feel
lost if we come across a disease or condition that we don’t immediately recognise or know
how to treat. We’re good at dealing with definites, not the unknown. The truth is, when we’re
faced with uncertainty, many of us don’t deal with it very well and that can lead to
communication breakdowns. As a sufferer of a major chronic condition myself, I’ve been on
the receiving end of this. It can start from the first encounter, where the doctor starts the
examination without even introducing themselves; to a wrong diagnosis or poor treatment
because they won’t admit to not knowing what the problem is; to secrecy and silence when
there’s a relapse and the news is bad. Being a patient actually taught me the most valuable
lesson: see the person first, not the condition.
4
I started my studies back home in Sierra Leone, but I had to stop because of the Ebola
outbreak. I volunteered to work with the response teams going from house to house
informing people of the dangers and uncovering suspect cases. It made me realise the
importance of communication and education in health. I had wanted to be a surgeon, but now
I’d like to get into community health. I later won a scholarship to come and study here in
France and I should qualify next year.
5
I’ve worked and carried out research in a number of countries and perhaps the biggest thing
I’ve learnt is how you need to be aware of not just the disease but also the person and culture
it occurs in. I remember seeing a guy who suffered from a rare hormonal condition called
Addison’s disease. What happens is that two small organs – the adrenal glands – don’t
produce sufficient amounts of the hormone cortisol, which in turn leads to increased
pigmentation in the skin. Essentially, their skin turns black. That perhaps wouldn’t be so
much of a problem these days, but this was 40 years ago in South Africa when the country
imposed strict racial segregation. Imagine what that patient must’ve gone through?

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Outcomes Advanced Audio script

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