On being a doctor

Abstract

‘You need to unmute yourself’, I blurt out as I watch my patient pantomime on the computer screen in front of me. Her face draws nearer as she scrutinizes her screen icons, juggling the microphone that slips off her head and when it hits the floor, a loud bang in my headset tells me that we have established an audio connection. It takes a moment of silence to recuperate and then we move on with one of the online video consultations that have replaced some of the regular patient visits to my office during the Covid-19 pandemic. The spatial boundaries between a remote doctor’s office and the patient’s private sphere have become fluid and blurred. In a literal sense, when some patients appear with fuzzy faces due to bad connections (‘they told me the Wi-Fi had been fixed’), but also through multiple distractions, like jackhammers and sirens from the streets (‘it is the big city, you know’), the pets and children parading across the screen (‘so this is Janice and here is Ricky, no, not yet ready for school’) and here is Henry, our cat, (‘Oh don’t walk over the keyboard, look what you have done’), as an error message pops up and ordinary household sagas (‘What is that smell? Oops, sorry, have to run’), it pauses and interrupts our conversation. It is not only the stressors of maintaining our online communications, ordinary health issues, or disease threat that become apparent. Apart from the health concerns associated with my specialism, added tensions, at times oozing from the screen, are tangible as people are facing isolation and loneliness, balancing childcare and professional lives, losing jobs or even loved ones, and coping with uncertainty about the ways the pandemic will unfold. Many people show great resilience in coping with these kinds of challenges… but some are at risk of depression or post-traumatic stress.