It’s official, I have survived my first month of clinical medicine! Sure, I have been having 3 day weekends most weeks and plenty of coffee breaks so surviving has been no real challenge thus far, but nevermind that minor detail… Among my quest to find a new favourite cafe, I have been spending a couple of days each week with doctors in the community and doing consults with patients. I have learnt a lot, heard some incredible stories and I have been entrusted with more secrets than I ever thought I would! Secrets in Medicine Part of working in the medical profession is confidentiality. Almost all of the things we hear from patients must stay confidential or secret, which is a key part of a doctor-patient relationship. This doesn’t just mean I can tell parts of the story without the name, especially in a place like NZ where there are 2 degrees of separation; almost everything is kept secret, and that takes a bit of getting used to! Some of the things we hear are tragic, some uplifting. Many things are inconsequential and are gone from your mind the moment the patient walks out the door but others are heavy; they stay with you and you can’t quite let them go. This can be pretty challenging, when you are hanging onto something a patient told you and are unable to share the story and the burden with a friend, flatmate or family member. Within the medical field we are able to discuss difficult cases and debrief over things we have struggled to hear, but it is also important to stay mindful of your reasons for discussing a patient. Is it for their benefit? Is it because you need to talk about it to enable you to continue to work professionally and improve in future? Or is it because it is super interesting and for social reasons? There is a fine balance between helping the patient and letting or using the patient to help yourself. Yes we benefit from the patients through the thrill of helping somebody and in the satisfaction of solving a difficult case but care must be taken to not push the boundary into benefiting socially through inappropriate sharing or even telling the patient about our issues. Everyone has secrets This is not a challenge unique to working in medicine; secrets and privacy are a part of all of our lives in some way. Friendships are built on exclusive experiences shared between limited people, families hold shared information that is exclusive to them, priests hold what is told in confession in secrecy, police and other professions within the legal system must keep certain information to themselves. Knowledge is spread through all of society in compartments and hierarchies and this all comes down to individuals who are bound in some way, whether by code, contract or friendship, to secrecy. In light of all this, I have come to the conclusion that our society needs secrets. They are not always a good thing but they are certainly not always a bad thing. Each one of us needs to act diligently in all aspects of our lives when deciding what information we share with whom whether that involves the latest family gossip, the history you just took from a patient, even information about yourself. Taking Secrets to Prayer Although keeping a secret can be the right thing to do it can sometimes be difficult. I have personally found prayer to be the answer to the issue of carrying the secrets of others; I am able to bring all the things I have heard and seen before the Lord and have these burdens lifted from me. I am so thankful that I am able to do this and know that without my faith and prayer life I would be finding my studies a lot more stressful and personally challenging. The place of prayer in my studies has also made me consider whether I am bringing other secrets I am told to prayer and sharing them only with God or seeing them as ‘less private’ simply because they are not in a professional or medical context and therefore fine to just talk to a friend about. So can I keep a secret? No, but thankfully with God I will never have to. View attachment 75c71d9a75a1e3d0d94ac3dd769fa78f.jpg Source
