Reviews

Daughter and doctor: two conflicting roles

The most difficult aspect for me about my father's illnessdementiais accessing my feelings about what is happening. My training as a doctor has made it hard for me to engage emotionally with what should otherwise be a time of grieving. I have written poetry and through this discovered all kinds of previously unacknowledged emotions, chiefly anger, but my professionalism had me struggling with the daily events that my siblings and mother seem to be able to process on a more fundamental level. I am slowly losing my father and yet I struggle to find any tears.

I find myself in constant conflict about my roles as daughter and doctor. As I write, we are waiting for a bed for him in a specialist hospital, and there is nothing I can do to make one materialise faster. I find myself rationalising the situation to the family: this is how the service works, and his own doctors have it under control. My mother asks me to intervene, to see if I can speed things up; I am, after all, a doctor. Eventually we hear that they have decided that moving my father will not achieve anything, and I'm inclined to agree.

Until recently my father attended a day centre. He stopped going when, after falling several times a day, we finally saw how immobile he had become. He was slowly becoming dehydrated and no one had noticed. I feel guilty about not having noticed this myself. It was the same sort of guilt I had felt two or three years ago when I finally realisedalbeit belatedlythat something was wrong with my father.

I went to see the general practitioner whom my parents had been registered with for more than 20 years, and asked him if he would consider referring my father to a neurologist. I gave him allowances for finding it difficult to deal with another doctor but expected, out of professional courtesy if nothing else, that he would grant the request. He did nothing. Eventually, after another six months had elapsed, my mother went back to him. My father finally saw a neurologist, and got his diagnosis. The same GP would not prescribe the medication that was suggested by the neurologist. He said he was not willing to take responsibility for it. With a heavy heart at such a blurring of my roles I agreed to provide the prescriptions myself. I finally persuaded my parents to find another doctor. The difference has been amazing.

My anger at their original GP's attitude has not abated, and I still compose letters of disgust to him in my head. Doubtless he would tell me that I am simply upset about my father being incurably ill, and that as his daughter I am simply expressing displaced anger. To a degree he is probably right. But I am also a doctor and as I watch my father slowly disappear and die, I know that what I am also upset about is the fact that I share my profession with doctors who have stopped caring about their patients. And then the doctor in me simply feels shame.

The author is a general practitioner working in London. Her father died recently while still in hospital