One of the good things about GP was that I could call my patients back for a review. For the most part, they were easily contactable and happy to come back to see me especially if I’d started treatment. It meant that I could build on previous consultations, I got to know the patient better and they weren’t lost to the wilderness the moment they left my room.
One particular patient I saw a few times over the course of the four months. She had depression and was currently taking antidepressants. In one of our consultations she told me she was fed up: she felt the medication wasn’t doing much, she was going through a particular bad patch and she felt like no one was helping. She told me she had given up on the GPs and preferred to see me because she felt like I listened. This immediately made me feel more important and it made me want to give her even better care.
But, the last time she came to see me, it left me feeling a little frustrated. She was still in a rough patch. We had a really long talk about her life and she talked about all the things that were going wrong. She felt stuck and trapped in her own life. I tried my best to offer advice, but how much could I really do? I felt like I could at least try to tackle her depression. But she resisted all my suggestions. She didn’t want to change the antidepressants to a different type. She wasn’t willing to increase the dose of the one she was already taking and she wasn’t willing to try CBT or counselling. Essentially, we were stuck.
I became a bit discouraged and talked about it with a friend of mine. She said, that though I’m trying to help, I’m her doctor, I’m there in a professional capacity. I can help her by providing medical advice. It isn’t my place to take responsibility for her; she had to take responsibility for her own life.
And it made me realise why I was frustrated. As much as I wanted to help, her issues were mostly social and family-related made more complicated by her depression. The depression was the part that I could help with, but she refused all my suggestions. I thought I could make a difference and help ‘fix’ her issues. But I couldn’t help her, if she didn’t allow me to. And that made me feel stuck. So, what did I do? I left it up to her. She has the resources, the advice, the information she needs to allow her to make her decisions. It’s up to her now.
It made me realise that I needed to step back a bit and realise the boundaries of my professional capacity. I’m not a life coach. Or a friend.
It’s a bitter pill to swallow to realise that I can’t help as much as I’d like to.