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Writing Our Stress Away

06 July 2021 - Dr Jan Orman

James Pennebaker and his colleagues from the University of Texas in Austin began researching the psychological impact of writing decades ago and showed that even stream-of-consciousness writing, practiced for short periods daily, had a positive impact on mental health and wellbeing.

Health practitioners are often keen writers, albeit lapsed as work, and the rest of life, takes over. I would very much like to encourage you to find the time to write for your own wellbeing.

Writing is one thing – that’s all you may want to do and all you really need to do for self-care, but getting published is pretty good too!

Here’s something I wrote just recently based on an anecdote told to me by a country GP. We’re publishing it here for your enjoyment, but also to encourage you to try doing something similar with your stressful experiences. We’d like to publish your work too if that would be something useful for you.

Please contact us if you are interested in contributing.

Here’ my effort:

Swab Duty – Jan Orman

I was on swab duty. There are ten doctors in my practice. We run a rotating roster for swab duty. Three of us are on swab duty on any given day, doing the swabs in the car park for anyone who is symptomatic for COVID.

I’d been told that, although it wasn’t my turn, it would be good if I could take this one as the other younger, less experienced doctors on the roster were unlikely to be able to handle it. I dreaded to think what that meant!

I approached the car with trepidation. Nice little BMW cabriolet, roof off for maximum sunshine, a child in the back seat mesmerised by her i-pad and a thirty something guy in the driver’s seat, suited up, on his way to something important.

We’ve been doing this for nearly a year now, as has every general practice in the country in one way or another. Anyone with symptoms that could be COVID is asked to stay in their vehicle and call reception. They are then told a doctor will come out to see them as soon as possible. They are told the same thing on the phone if they ring for an appointment. There are signs on the fence, on the door and at reception. “If you have a runny nose, fever, cough or any other symptoms that indicate infection, stay in your car and ring reception. The doctor will come out to see you in your vehicle.”

Reception had been worried when they called me out to see him.  This guy had got as far as the waiting room before they saw him coughing and blowing his nose. The child’s runny nose was obvious. He either hadn’t read the signs, or he’d ignored them. Either way, he needed to go back to his car, pronto!

Imagine it - this guy waltzes in, despite all the warnings, sits in the waiting room with a bunch of vulnerable oldies, two pregnant women and a toddler and ignores reception’s request for him to go back to his car. It’s only thanks to our terrifying practice nurse and the general antipathy in the waiting room that he eventually complied, dragging the reluctant screen-struck seven-year-old back out to the car await my arrival.

I’d glanced at his notes before I went out to the car park – thirty-seven, tradie son of a well-known local property developer, works in the family business, newly married (for the second time) to a long-term patient of the practice who has a one child from her previous relationship. No significant medical problems. Vaccinations up to date. No allergies. No medications.

At the car, things started well. Pushing his sunglasses to the top of his head he began by apologising for his “mistake”. He explained that he was preoccupied as he “had a lot on at the moment”. He then said something about this being an easy one for me because he just wanted some antibiotics for himself and “the kid.”

Well, if you know anything about life as a GP you’ll know that this is not going to be an “easy one”. In fact, that starting point is usually the beginning of a long conversation about the purpose of antibiotics, the reasons we don’t always prescribe them and what else we can do to help with the symptoms. There’s also need for an examination and a diagnosis before prescribing. And, of course, these days it’s even more complicated. There’s COVID to think about too. If he wants antibiotics for anything that could be COVID he needs a COVID test as a priority.

“Not a chance” he says. “I’m not buying into any pandemic conspiracies. What a load that is! I’ve had this thing for a week and I just want to get rid of it. The kid brought it home from school and she’s still sick. This weekend is important. I need to be well.”

I paused for a moment to gather my thoughts and decide which way into this conversation I needed to go. He didn’t let me decide.

“Honey,” he said, glancing over his shoulder at the seven year old. “Do you want a COVID test?”

“No” she said firmly to her i-pad.

“There, see, neither of us wants a test. Now let me have the script and we can go”

How much time and energy, I asked myself, was I going to spend on this? I couldn’t prescribe for him unless I examined him and satisfied myself that antibiotics were warranted.  I couldn’t do anything until he had agreed to a test.

I began to try to explain. I tried the public health argument but that was met with more conspiracy talk. I moved on to the story about antibiotics not being useful to treat viral infections. (I knew better than to talk about development of antibiotic resistance by this stage because it was clear this man didn’t give a care in the world about the health of the general public.)

I told him that it was the law that he have a test, that he needed to self-isolate until he had a negative test result and his symptoms settled. This news did not suit him at all.

“No way Doc! I’ve got huge weekend coming up. This pandemic thing cancelled my wedding last year – we had a tiny 10 person shindig that did nothing for the business. We’re having a first anniversary party this year with two hundred guests and nothing is going to stop it now. The business needs the public relations. This whole COVID thing is rubbish and I just want some antibiotics to fix this cold and stop the kid from sniffling.”

I rose to my full five foot three inches beside his fancy car and said “no”. No to the idea that the child was old enough to have a say, no to the antibiotics and no to the medical certificate that he then demanded for reasons I couldn’t fathom and that he refused to explain. I didn’t back away from the need to have a test either, but I did move back a little when he suddenly revved the engine and drove at speed out of the car park.

I think I’ve done the right thing, but I’m pondering how I’ll feel if the next wave starts in that fancy venue they’re celebrating in this weekend. What else could I have done?

Could I have had him arrested?

 

If your writing is helping you get through, that’s great. If you’d like to see it published contact me at j.orman@blackdog.org.au. We’d all like to see what you’re doing in the way of short fiction pieces (up to 1,000 words) or poetry, taking care to de-identify your characters of course.

If writing is not your thing and support is what you need check out TEN - The Essential Network for Health Professionals or the Hand-N-Hand Peer Support Network. 

 

 

Dr Jan Orman
Dr Jan Orman

Jan is Sydney GP, private psychological medicine practitioner in Sydney’s inner west and a GP educator for Black Dog Institute.

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