Dr Jack Gerbodach
If I hear that joke again about what the difference is between God and a consultant, I’ll scream. Yes, yes, God doesn’t think he’s a consultant.
But can you blame consultants for thinking they are God? They work superhuman workloads. Many consultants have 60 patients to see at a half-day clinic, admittedly helped by junior doctors but most patients still need to be seen by the consultant. I don’t understand how they can do it. Just think, merely saying hello, making a welcome comment and shaking the hand of 60 people will take up 60 minutes of a three-hour clinic. The consultant then has to take each patient’s history, examine their notes, order the appropriate tests, diagnose each case and make a plan for future care in a matter of minutes.
A surgeon scrubs and opens a patient’s abdomen. Within minutes he is operating on the abdominal aorta. With a slip of his hand the patient might die. The anaesthetist finds that the patient’s cardiac output drops and has difficulty elevating the blood pressure to a safe level. Correct management will determine the survival or otherwise of the patient. Neither doctor shows their inner stress. Both do the job as well as possible and try never to show any cracks in their demeanour to their team or to their patients.
A consultant must tell patients devastatingly bad news – “you have cancer” – “you have motor neurone disease” – “you have about six months left to live”…and then must go home, play with his children and not bring the emotions of his day’s work with him.
A consultant may be in his deepest sleep at three am but when the phone rings he must be able to make a life-and-death decision within seconds. Unlike a judge, a consultant cannot reserve his judgment for six months and mull over it with his colleagues; the patient needs a decision now.
A consultant is on call tonight and is telephoned three times for advice. Each time he is woken up and finds it difficult to go back to sleep again.
Not only is he expected to work the next day as usual; no one has any sympathy for him because he didn’t have to get out of bed. He is exhausted but he knows that the quality of his work is expected to be top class as usual.
A consultant is temporarily overwhelmed by the stress of his work and is rude to a patient or a colleague. All hell breaks loose. “How dare the consultant say that?”
“How arrogant he is!”
He must apologise at once or he will be reported to the Medical Council. The doctor knows that the Medical Council has little understanding of his plight, that it has no sympathy for him and that it will adopt a punitive approach. The doctor puts on a brave smile, apologises to all concerned and goes back to work.
Consultants must definitely be God.
Dr Jack Gerbodach is a pseudonym for a retired Irish consultant who spent years working in the UK and Canada