In the beginning it happens out of necessity. Even the best prepared junior doctor regularly finds themselves in situations where they are completely out of their depth and where they have no option but to wing it – to pretend they have the knowledge, to know how to react, or to simply pretend they have a skill where they don’t. “You’re a doctor for God’s sake…”, a patient or a colleague might cry, “act like one!”
We get ourselves into character by donning a variety of costumes (white coats, scrubs and suits), and surround ourselves with plenty of props – stethoscopes, opthalmoscopes and reflex hammers. We usually have a captive (and sometimes appreciative) audience and for some, it can be difficult to exist without one. Many take their parts very seriously indeed; like method actors, remaining in character long after it is necessary to do so, they bring their professional persona into every aspect of their lives. You know who I mean.
Presenting a more perfect version of ourselves to our patients helps them have confidence in us and probably helps us believe in ourselves too. Many find their adopted persona less uncertain, more decisive and even more patient than their real selves. This more perfect persona also acts as kind of shield – protecting our true, more vulnerable selves from absorbing too much of another persons pain, unhappiness or anger.
But even the best actor cannot play the same role for the whole of their careers without becoming jaded (certain cop shows from the 70’s excluded) . Staying in character for long periods, no matter how well received the performance, can be exhausting.
I have decided to return my equity card.
Knowing that there isn’t too much that will phase me and having developed comfort with uncertainty has allowed me to drop the facade. Presenting myself as myself has resulted more relaxed, spontaneous interaction with patients. A lot more laughs, (an occasional argument) but a lot more fun.
What my patients really want is not a facsimile of a perfect doctor, but a real person who just happens to be one. Perhaps without the swearing.
Image from ‘Withnail and I’ (1986) , Criterion Films