Last week I had to break bad news. I have previously discussed the emotional impact of hard cases and the change in perspective that can come from our interpretation of events. In this case my job was to tell friends of a deceased patient of their friend's passing. I didn't expect that I would be able to connect so meaningfully with people I had never met.
These days it seems that in medicine there is an expectation placed upon staff to act in a certain manner. We are asked to appear empathetic, sympathetic, professional, strong but also compassionate, interested but balanced. We are asked to be ever developing machines, ambassadors for the underlying ethos of healthcare which sometimes is hard to grasp. Sometimes being in the NHS is like being asked to play a role and read a script.
The historical aspect of role playing is well documented and numerous studies have shown that when placed in a specific role, people will act up to it. One easy example to reference is that of Zimbardo's famous prison experiment, where stooges where asked to play either guards or prisoners. It became quickly apparent that the stooges truly believed their role and actually abused the role significantly.
When applied to medicine we ask doctors, nurses and other healthcare professionals to act up to a role that has been carved in the public perception and tailored by healthcare management to represent the best aspects of care. Often newspapers will create their own picture of healthcare but we have to remember that the goals of the NHS and those of newspapers are different. One is to provide healthcare; the other is to provide news that will sell.
What can be useful to remember is that each member of staff you will encounter has their own reasons to be doing what they are doing but the central theme is giving up your time to help others. I have met many people with different reasons for what they do, and most are noble and in healthcare to fix a problem they have been exposed to before. A friend of mine wishes to spread the care that her late sister experienced, whereas I hope to bring public perception of care to a realistic level and enable working together toward realistic goals.
What can be forgotten in the vortex of headlines, sensation and expectation is the realisation that in the end your healthcare provider is simply another person who has taken a different path. I have previously discussed the role of narrative and how our interactions are placed as antagonistic or protagonistic , that healthcare interaction is simply another page in the story. I have found that the best relationships I have built have been based through emphasising the specific aspects of my personality that are natural, appear human and in the end exist regardless of whether they should or not.
In the end communication is natural and central to good care. It cannot exist without personality.