Am I really a "Specialist in Life"? - Dr. Louise Stone

I’ve always felt uncomfortable with the “specialist in life” campaign. It’s not just that slogans don’t sit easily with my vision of complex General Practice, it’s because there is a part of life that General Practice doesn’t reach. 

It is an enormous privilege to be with people during their most vulnerable moments. To share their grief and loss, their pain and despair and even sometimes their joy. To be with them when they are born, and when they die. To tolerate uncertainty, and unfixable suffering. To understand exhaustion: not just from long hours, but also from the relentless compassion we need to dredge up at the end of a long day when our empathy stores are low. We know what crisis is, and we are often the people who don’t get rattled by the small things in the world. I value the wisdom I’ve gained, day by gruelling day as I try to find words with patients who have lost hope. Curing is often hard, but comforting always Is harder, because dealing with your own helplessness is very, very challenging. General Practice is hard, but we do have capacity to recover at the end of a long day because there is purpose and meaning in what we do. 

When we look at recovery principles, it helps to consider the Scottish recovery framework summarised as CHIME: connectedness, hope, identity, meaning and empowerment. Within our professional roles, we have a number of these covered, although our professional identity is currently the subject of a lot of community debate, and we do feel quite disempowered by multiple changes in government policy recently. However, connectedness is precious, and for me, there is no greater meaning than to ease suffering. Having a sense of purpose ingrained in our work is a great gift. We also have a gift with hope: we have seen recovery, often in the face of extreme and unrelenting trauma. 

But General Practice doesn’t teach us how to live a good life outside of our consulting rooms. Sometimes our professional identity swamps our personal one. We know who we are inside that consulting space. But as we spend more and more time being patient centred it’s easy to lose a sense of a personal identity. For me, this was hardest when my life flipped between being patient-centred, learner-centred and child centred. Although each of the roles were part of me, an important part of who I am and what I value, there was a bit missing. 

I’m not a great advocate of “me” time, only because of the way it tends to be marketed. But I do need to find a personal identity outside the four walls of my medical life. Of course, values cross over; compassion, empathy, social justice. But it’s more difficult and layered as a “civilian”. The world we live in medically is high drama and high stakes. Finding meaning, identity and connectedness outside that world can be hard. Especially when medicine occupies so much time, energy and resources. And when vicarious trauma gnaws its way into our consciousness. 

So I’m not a “specialist in life”. Life is hard. Harder than medicine. Harder than the vicarious living I experience through the small windows I access into my patients lives. I struggle with the same questions everyone shares. What is the purpose and reason for living? Why do bad things happen to good people? And of course, how do I live my best life?

We all have something to add to this discourse, but for me, I’m happy to see myself as one of many voices, a conversation among perpetual apprentices. Always learning, always growing.