{"id":43875,"date":"2019-01-16T12:03:47","date_gmt":"2019-01-16T11:03:47","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=43875"},"modified":"2019-01-23T12:27:45","modified_gmt":"2019-01-23T11:27:45","slug":"kate-evans-questions-we-cant-answer","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/16\/kate-evans-questions-we-cant-answer\/","title":{"rendered":"Kate Evans: Questions we can\u2019t answer"},"content":{"rendered":"<p class=\"standfirst\"><span style=\"font-weight: 400\">How do we find the balance between connecting with the pain of our patients, while remaining professional, asks Kate Evans<\/span><\/p>\n<p><!--more--><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-43876\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/01\/kate_evans.jpg\" alt=\"\" width=\"150\" height=\"173\" \/><span style=\"font-weight: 400\">\u201cHave you ever been bereaved?\u201d She looked me straight in the eye as she said it.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I blinked, paused, took a breath.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I work in a busy urban practice in the north of England and many of our patients are not afraid to ask personal questions or pass comment. Typical topics covered include: your age and whether you look it, your accent, outfit, accessories, marital status, kids, whether you\u2019ve gained or lost weight, been on holiday, and what they really think about the new d\u00e9cor in the waiting room.<\/span><\/p>\n<p><span style=\"font-weight: 400\">But I can\u2019t remember a question that\u2019s ever disarmed me quite like this one did.<\/span><\/p>\n<p><span style=\"font-weight: 400\">She\u2019d lost her elderly mother days before. It had happened suddenly, with no warning, right in front of her. She\u2019d come in about something else, but the consultation had soon turned to this loss. I heard the story and all its little details. I listened while she told me about her mum and what she was like (strong, independent, never ill.) We\u2019d talked about the shock, the grief, the guilt. She was trying to make sense of what she was feeling. She\u2019d never experienced anything like it before. \u201cIs this <\/span><i><span style=\"font-weight: 400\">normal<\/span><\/i><span style=\"font-weight: 400\">?\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">That was when she asked the question: \u201cHave you ever been bereaved?\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">My mum died when I was 11; metastatic breast cancer. She was 40, there were four of us, my youngest brother was 5. My dad died when I was 34; very suddenly from a dissecting aortic aneurysm on New Year\u2019s Day. He was 65, just retired. <\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cCan you still be an orphan when you\u2019re 30?\u201d my sister had asked. <\/span><\/p>\n<p><span style=\"font-weight: 400\"> I was blindsided by the grief. The shock. The guilt. I grieved for both of my parents in a way I hadn\u2019t been able to grieve for my mum as a child.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I\u2019d read about it of course\u2014bereavement and the stages of grief. I was a GP by then. I\u2019d counselled others, but never known the tilting and shifting of your whole world that happens with a sudden death. I\u2019d never experienced anything like it before.<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201cYes. Yes, I have.\u201d I looked her straight in the eye as I replied.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I didn\u2019t tell her the details. I told her simply that I\u2019d lost both my parents. I didn\u2019t tell her how I\u2019d nearly unravelled at the time, how I\u2019d wondered whether I\u2019d ever feel normal again, whether my world would tilt back on its axis. I steered it back to her story. It was her consultation, not mine. We talked some more, and I ended with the offer to come back if she needed it.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Like it or not, we all bring all of ourselves to the consultation, not just our medical training. We bring our past experiences, good and bad. They probably influence us more than we realise, but are often unspoken, even unconscious. <\/span><\/p>\n<p><span style=\"font-weight: 400\">How do we navigate the consultation, allowing ourselves to connect with the patient but stay professional? Where\u2019s the balance to be found in empathising with the pain of our patients, but staying emotionally detached enough to be able to be objective and also look after ourselves? How much should we share?\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">I still don\u2019t know the answers to these questions.<\/span><\/p>\n<p><em><strong>Kate Evans<\/strong> is a salaried GP in Liverpool.<\/em><\/p>\n<p><strong>Competing interests:<\/strong> None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>How do we find the balance between connecting with the pain of our patients, while remaining professional, asks Kate Evans [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/16\/kate-evans-questions-we-cant-answer\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":43877,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-43875","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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