April 13, 2021

Working as a doctor, living as a patient - Monocular Doctor

I’ve been a patient in the NHS as long as I can remember. I was diagnosed with congenital glaucoma and congenital cataract within my first months of life.

Working as a doctor, living as a patient - Monocular Doctor, Dr Harriet Stark

So began the following few years of hospital visits, operations, eye drops and patches. At that time, my parents did not know what vision I would have or what sort of life I would be able to lead. Despite this, they instilled in me that I was capable and that I could do anything I put my mind to. This has always stayed true to my heart. I’ve remained under ophthalmology to this day and had other diagnoses from other specialities along the way. No matter the list of my past medical history, I have always remained focussed on what I COULD do and what I wanted for my life. 

"I’ve been a patient in the NHS as long as I can remember"

Almost every decision I made from taking my grammar school entrance exam to which A-levels to select was targeted at my dream of becoming a doctor. 11 year old me was so sure I was going to make it, that I told my friends “When I qualify as a GP, I’m going to fly to Paris and buy a Louis Vuitton bag on the Champs Elysee” (Please don’t ask me why, I’m still not completely sure.). But sure enough, aged 22, I qualified as a doctor.

 

From then on, I have lived in both worlds; as the patient and the doctor. 

 Dr Harriet Stark

As the patient I can chat openly with my doctors, using all the “jargon” we are always taught to avoid in medical school. Sometimes this can make a conversation easier for both parties. I can also feel a greater sense of confidence managing my own conditions, medications and symptoms at home. Being a doctor does not mean I prescribe myself medications, I still follow the usual pathway, just as any other patient. I also have things that I do not understand as the patient and if anything, I can worry unnecessarily or over-think things because I am more aware of the differential diagnoses. I’m sure I am not the only doctor who does this! The human body is vastly complex and no-one understands every fine detail, so I still need to ask for help and advice, seeking guidance from those with more specialist knowledge and experience than myself.

 

As the patient I can chat openly with my doctors, using all the “jargon” we are always taught to avoid in medical school

Being the doctor who is also a patient also comes with many advantages. Receiving good care matters to me as a patient; how healthcare professionals treat me as I arrive for appointments, discuss a new diagnosis or deterioration of a condition and how they involve me in choosing the pathway of my care. Every interaction, every smile, every effort to make contact with me all matter.  So, I endeavour to give that care and attention to my own patients. I can note how a phrase, tone of voice or explanation impacted me. I then either utilise it in my own practice, or choose to practice differently, depending on how it made me feel. 

 

Having actively been in the same shoes as some of my own patients, I can truly empathise with the way a diagnosis or deterioration of a condition can impact not just your physical wellbeing, but also your mental, social and environmental wellbeing. For this reason, I am particularly passionate about a holistic approach to care. I am very much enjoying the expanding fields of Lifestyle Medicine and Social Prescribing and utilise this in practice where appropriate and available.

I do not feel it is necessary to be a patient yourself in order to have good communication, empathy and rapport with a patient. I cannot speak of how my practice might differ if I had never been a patient myself. I can only hope that if that were to be the case, I would continue to offer the same care and kindness I currently endeavour to practice with.

 

Dr Harriet Stark

 

My condition was obvious to those around me, essentially appearing as a “doctor with a disability”

 

For the majority of my career as a doctor, due to my childhood, my eye never looked “normal”. It made my condition obvious to those around me, essentially appearing as a “doctor with a disability”. I was not perceived negatively for this, however. Quite the opposite, occasionally receiving praise for this label. Comments from my patients inferred it was of some comfort to them that their doctor might empathise with their medical struggles, having evidently got their own. From the feedback of my colleagues, they have mostly been interested; asking questions, using me to practice fundoscopy and generally wanting to understand what it was like to be the patient and be visually impaired. This last year, during the pandemic, I have undergone eye surgery (a right eye evisceration/removal) and now have a prosthetic eye in place – giving the eyes a much more equal appearance. No patient has made a comment thus far and my colleagues have been incredibly supportive of my journey. I continue have mild limitations as a doctor with my vision, despite my appearance changing, but it simply makes me more aware to know my limitations and ask for help when I need it.

The most important thing I could ever encourage anyone to do, is to be unlimited, go after your dreams and believe in yourself. Do not be afraid to ask for help to get there either. 

This year will mark my completion of GP training (all being well) and when we are able, I’m going to fulfil my 11 year old dream and book that trip to Paris! 

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