I was in a respiratory clinic again this morning with an inspiring Consultant where I learned more about qualities of a doctor. I noticed their reassurance and truthfulness when telling a patient about the severity of their illness – approaching the subject politely and respectfully whilst always reminding the patient the negative consequences of their condition.
I was reminded today of the disastrous impact of smoking when meeting people with extreme reduction of lung capacity – the lowest was 11% (measured using a spirometer). I try to prevent many of my peers from smoking and would love to expand this to the wider community in the future. I noted the patients’ responses to finding out that they have poorly functioning lungs. A particularly interesting response was thinking that they could easily get a new pair of lungs from a donor. This is incorrect as there is a shortage of donors and if there is a donor, the lungs will go to a child with cystic fibrosis due to them having a greater need. I noticed the doctor’s calm response to their patients, explaining clearly the plan for their future relief of breathlessness using medication. Patients often forget about the large risks associated with replacement of vital organs which could completely change their quality of life (for example after the operation they may be bed bound meaning they have a high reliance on other people, or if the organ is rejected they may die in extreme cases).
I found that by using the number (in a percentage) of lung capacity the doctor was able to show the extreme severity of this patient’s lung condition in order to tell them a truthful prognosis so that they completely understood that they were in a bad state.
As a doctor is it extremely important to have a strong relationship with your patients in order to be able to talk to them about anything – even if a little embarrassing in the eyes of the patient. The doctor advised about depression and the effects of being overweight to their patients using knowledge to comfort them whilst telling them about the best medicinal decisions for their future. Telling people they are overweight is sometimes extremely difficult and therefore whether it is acceptable is being debated at the moment within our NHS due to extra bodily weight leading to health conditions in itself, for example type 2 Diabetes.
I saw a hernia which was the intestine sticking out due to intense pressure around the lungs – hernias can be found all over the body. I will be writing another blog about a condition called Sarcoidosis as this condition particularly interested me in the clinic today.
Structure and function are the key to understanding every disease. Structure is determined by doing a scan eg. X-Ray, CT scan, MRI and function is determined by tests eg. blood tests, lung capacity test.
I was particularly interested in hearing about a new innovative surgery which allows patients to have less invasive surgery of the heart to fuse arteries by a small incision in the side of the body (a new type of keyhole surgery).
In the afternoon I spent my time in the AMU ward with a Consultant where I saw lots of patients with respiratory problems. I enjoyed looking at and learning how to interpret CT scans and X-Rays and listened to the Consultant advising Junior Doctors about which treatment to use for which patients. Everyone respected the Consultant’s wishes for their patients as the Consultant was leading the way for the chance of a healthier future for everyone.