A Day in the Life of a Family Doctor
Health promotion and prevention are part and parcel of a family doctor’s daily work. As Henry de Bracton wisely said many years ago, “An ounce of prevention is worth a pound of cure.”
In treating patients with heart diseases, a good family physician not only competently manages patients’ conditions, but also strives to prevent them from worsening. Smoking is of course one of the key preventable risk factors of heart diseases, and doctors typically advise patients who are smokers, to kick the habit.
The following is a vignette by Dr Tan Su-Ming, who shares the difficulty of getting her patients to quit smoking. She wrote her thoughts and experience based on a drawing by medical students who reflected on their posting to family medicine. This is an excerpt from Being Human: Stories from Family Medicine, published by Adjunct Associate Professor Cheong Pak Yean and Dr Ong Chooi Peng.
The Girlfriend from Hell
In this drawing, a doctor tells a patient he needs to quit because he has had a stroke, an amputation and a heart attack. The patient’s wife and daughter react with joy when the man says that he has. Actually, the fellow continues to clutch on to his cigarette but keeps it out of sight of his family!
I love it when my patients have an Aha! moment.
I met a twenty-year-old man who had a cough he couldn’t shake. We got to talking about his smoking habit. He’d smoked his first cigarette when he was twelve and he was smoking twenty a day now.
“You ever thought of quitting?” I asked. “Sure,” he replied, “but it’s very, very hard.”
The cigarette was like his girlfriend from hell, I told him. This girlfriend would take everything from him – his health and his money, and give him nothing good in return. If he tried to break up with her, she wasn’t going to let him go so easily.
“Exactly,” he said. “Damned hard to break up with this girlfriend of mine.”
“What is your girlfriend’s name?” I asked.
“Winston*,” he smiled, not missing a beat.
– Dr Tan Su-Ming
*Winston is a brand of cigarettes.
“I spend much time telling my patients to quit smoking, eat healthier, start exercising, learn to relax, and enjoy life. I suspect most of us do so, and with limited success.
After twenty-odd years talking about quitting cigarettes with smokers, I now realise that I don’t know what they go through, being a non-smoker myself. I am convinced about the detrimental effects of cigarette smoking, and I think smokers are too. But I have read that because nicotine feeds the pleasure centre of the brain, quitting cigarettes in some can be harder than kicking heroin. I try not to pontificate anymore these days. I just say, if you can, don’t smoke anymore.
How you do it is not important, I tell them. If you can find a good Why to quit, the How is not so important.”
Work-Life Balance
“As one looks on a face through a window, through life I have looked on God. Because I have loved life, I shall have no sorrow to die.” – Amelia Burr
More Choices
I need to be on time. I have to-do lists running a like continuous tape at the back of my mind. I need to function – function well! – and deliver, and care, and fulfill, and not generate adverse feedback.
The drawing shows how we always hope our day does not end. Just before closing time, a patient comes in with a long list of problems to be solved. His list wars with my to-do lists at five in the evening.
My workday ends and I go home. My daughter greets me. I put aside my to-do’s and all the incessant buzzing for a while. How was your day? What was your story today? (How much screen time did you get today?)
We have dinner together on nights when my husband is not working, chatting about the day, discussing plans. What did my sister say? What is she doing about it? How are your brother’s kids? A wife is something to be, not do. Not a list of to-do’s but to be here, to be with, to be beside.
My daughter nags me to play with her. Sometimes, we do puzzles. Or I sit at her restaurant and we count change. Sometimes we struggle through a book or two so that she earns her television time. I shower her. She combs my hair and I comb hers. Bedtime story. Mummy can I have another story?
Me Time!
Sometimes I get none, if I fall asleep too soon. Or I catch Netflix or read a book. The last book was about a fire-breathing dragon. My husband enjoys his computer games, or Chinese kung fu novels. Men are still boys at heart.
My day tries to begin at five in the morning. I try to sneak in some work with my coffee, then my regular Grab driver picks me up. I reach the food court at six-twenty and sit there with paperwork, then I head to the clinic.
It’s hard for me to grasp work-life balance. To me every hour of my life is bursting with mysterious, interesting, intense, rich flavours. I want to live life.
– Dr. Ann Toh
Being Human: Stories from Family Medicine combines the observations of medical practice by young medical students with the reflections of seasoned practitioners. The result is a work that spans the breadth of Family Medicine and gives the reader an honest glimpse into the heart of the family doctor.
