Note: All the names below have been changed for confidentiality. Any resemblance to persons as a result of these changes is entirely coincidental and unintentional.

“God, all I want to do is to be healthy again. This sore throat, tight chest, breathing problem, it’s slowly taking over my life. I’ve been to seven different GPs and they’ve all just given me more pills but they make me feel worse! I honestly don’t know what to do… I can’t keep living like this anymore.”

My mind begins to whirl, processing the information as I think about what I should do. Dyspnoea (shortness of breath) could be due to cardiovascular or respiratory causes. Should I ask about coughing to clarify this? Or ask about her past medical history to get a better understanding on what’s going on?

These thoughts are running through my head as I sit in the corner of a small room, amongst three others. It’s my first day on GP placement and I’m currently sitting in the middle of a consultation as a first-year medical student, where my role is to simply observe. In front of me is my supervising GP Dr. M, as well as a young French couple. A few weeks ago, Daphne (the patient), immigrated to Australia from France, ready to start a new life with her partner. However, as soon as she arrived, she developed chest pains, a sore throat and trouble breathing which have worsened over time despite various medical interventions, eventually leading her to us.

I sit quietly and wonder how Dr. M will respond. Seconds pass and to my surprise, Dr. M simply sits facing Daphne quietly, prompting her to continue. A stiff silence emerges and begins to grow, until Daphne breaks it.

“Please don’t give me any more pills… I really can’t keep living like this anymore.”

Daphne breaks down and the room now fills with quiet sobbing. I turn to stare at Daphne’s bursting bag of prescriptions on Dr. M’s desk – a menacing bag, one only weighing a few hundred grams, but carrying heavy connotations of sickness and vulnerability. The silence begins to grow again until finally, after what seems like an eternity, Dr. M stirs. And what happens next I can’t describe as anything but magic.

It starts off with a recognition of the pain that Daphne has gone through – a simple nod, an apology for the trouble that the supposed ‘treatments’ have caused her. “It must be very difficult for you,” Dr. M gently expresses. “To come to a new country hoping for a new life, only to be met with illness.” Teary-eyed Daphne looks up, surprised. “I only came to Australia a few years ago myself,” Dr. M continues. “So I can relate to some of the stress you’re feeling now.”

The tension in the room immediately dissipates. Daphne sits a little straighter and leans a little closer to Dr. M as the questions start coming out. They talk, not just as a doctor and patient, but as fellow people. People with stories unique to themselves, but with surprising and beautiful similarities to others. As Daphne’s explanations become more detailed and emotive, I wonder if this is the first time she truly feels heard. After a few questions (including, to my satisfaction, coughing and past family history), a few examinations and many explanations, a treatment plan for Daphne’s illness is transpired, with clear instructions to come back if the symptoms don’t get better. Daphne looks relieved and I can see a glimmer of hope in her partner’s face.

As Daphne and her partner get up to leave, Daphne turns to me. “I hope you become a doctor like this when you grow up.” I nod and smile in response as they leave the room.

Aftermath

“You know Dr. M, the way you approached the start kind of surprised me. I thought you’d go straight into asking history questions.”

Dr. M smiles as I ask the question but doesn’t stop typing up her consultation notes on the computer. After a few seconds, she turns and addresses me.

“Sometimes, the best thing you can do for a patient isn’t to ask more questions. Often, just being with them, giving them the space to speak and recognising the pain they’re going through goes an incredibly long way. It’s something they don’t really teach you in medical school – the art of empathy.”

Later that day, I think back to my default response to Daphne’s presenting problems. How eager was I to get to the underlying cause of her problems whilst giving Daphne herself no thought? How many of her previous GPs had done the same and caused more harm than good? The art of empathy: by no means an easy or decorated practice, but one which is crucially important. It seems that ancient adage finally makes sense: Treat the patient, not the disease.