Hitesh Bansal: When the worlds of medical student and medical patient collide

hitesh_bansalA 20 year old male presented to A&E with abdominal pain. The pain was sharp, constant, severe, located in the epigastric region, radiating through to the back, and had been present since waking that morning. It was associated with profuse vomiting, no hematemesis, no change in bowel habit, no history of unfamiliar food, or travel abroad. He was a student, did not smoke, and drank roughly 15 units a week. He was otherwise healthy.

The diagnosis? Pancreatitis. The patient? Me. That diagnosis of pancreatitis, four years ago, would change my life. For better and for worse.

Being a medical patient is hard, as is being a medical student. When those two worlds collide, it becomes difficult to visualise the light at the end of the tunnel. That tunnel is a dual carriageway with two roads: the medical student with the physical illness, and the patient with medical background.

Many medical students and doctors will tell you medicine is a demanding course. All of a sudden it became significantly harder. Studies on prevalence of chronic illness in physicians are limited, and therefore the effects on training are poorly understood. [1] I missed vast quantities of the training schedule, and clinical education is an aspect of medicine that is difficult to “catch up” on. The most uncomfortable aspect of it all was not knowing the cause: idiopathic chronic pancreatitis. Without a cause, one is unprepared for preventing, and predicting a flare up. Preparing for final exams is unsurprisingly difficult. The night before is filled with anxiety, worry, and little sleep. That, unfortunately, was further compounded by the residual fear that I would wake up the next morning, with the abdominal pain that had given me nightmares, unable to take my exam which I had worked so hard for.

Does being a patient with medical insight make things easier? In one word: no. Every time I think about my condition, I see prognosis and complications. The words type 1 diabetes mellitus, necrotising pancreatitis, cancer, and death come to mind. [2] Not only that, but you are treated differently by health professionals. To their credit, they thought they were doing right by me as a medical student, by treating me as such, but at the time, I just wanted to be a patient. I didn’t want to be questioned on the causes of pancreatitis (to which I replied with the text book answer, including the sting of a Trinidad scorpion). [3]

However, I believe that it has made me a better doctor. I realised this recently when my consultant expressed that I was a conscientious doctor. It is possibly because I have been able to develop a true sense of empathy. It is something we are “taught” at medical school, but empathy cannot be taught. To know what an individual is going through, a personal experience like my own gives you raw but valuable insight. By having been a medical in-patient, I know first-hand how depressing hospital can be, how alone you can feel, how it changes your state of mind, and pushes you to breaking point. I can relate to my patients’ ideas, concerns, and expectations. [4] I am prepared to go that extra mile and stay beyond working hours, if that ensures they are getting the care they deserve. Often we see our patients as clinical vignettes from text books, which we must diagnose and treat. Patients are far more than this. Sometimes we need to take a step back, and look at the bigger picture, and realise that everyone has their own individual story. This was mine.

Hitesh Bansal is a junior doctor at Sandwell and West Birmingham Hospitals NHS Trust.

Competing interests: None declared.


  1. Gautam, M., & MacDonald, R. (2001). Helping physicians cope with their own chronic illnesses.Western Journal of Medicine175(5), 336–338.
  2. Kudo Y, Kamisawa T, Anjiki H, et al; Incidence of and risk factors for developing pancreatic cancer in patients with chronic pancreatitis. Hepatogastroenterology. 2011 Mar-Apr;58(106):609-11.
  3. Quinlan, J. D. (2014) Acute pancreatitis.American Family Physician. 90 (9), 632-639.
  4. Cecil, D. W. & Killeen, I. (1997) Control, compliance, and satisfaction in the family practice encounter. Family Medicine. 29 (9), 653-657.