I have been a physiotherapist working in the NHS since graduating in 2003. The only break I have had is recently as a result of my Hodgkin’s Lymphoma. As a physiotherapist, I was good. I worked hard, empathetic, always strived to get answers and help my patients as best I could, put patients at the centre of my care, planning what they needed around what they told me. I cared…..I really cared and I was good at my job.
However, having cancer and experiencing healthcare from the patients side has opened my eyes to a whole new world and perspective. A world that I do believe is difficult to understand and truly empathise with until you have experienced a taste of it yourself. A world that isn’t exclusive to cancer by any means. I find myself thinking back to patients of years gone by with a whole new level of understanding behind their behaviours, reactions and responses.
I am not talking about the impact that injuries have particularly on your physical body, but the injuries that they cause in your psychological one. How you can be living happily in the present and then one small trigger, that you weren’t banking on can send you right back visualising everything that happened before. You are no longer in the present, you are no longer in control of your emotional response.
Today for example, I had an appointment at a hospital for a nerve conduction test that I wasn’t particularly worried about. I knew what the test involved, knew what it would feel like, and wasn’t overly concerned about what it may show. I drop my son off at my friends, the usual slight raised anxiety about whether or not I will arrive in time through London rush hour traffic and hospital parking, and then as I enter the hospital main entrance, I’M HIT!!
Out of the blue, I am washed with the sensations of stress, fear and anxiety that were present last time I entered the grounds.
I am able to see me and my other half driving into the car park, remembering exactly where we parked on each occasion.
As I walk into the hospital, I can see myself sat at the table with my cup of tea following my first fertility appointment; remembering exactly which table and which seat I was sat at, waiting for our number to come up at the pharmacy and laden with a whole bunch of paperwork that we had to sign for the start of emergency IVF.
I can see myself walking back out following our IVF egg collection.
I can see through the walls and see myself sat beside the trolley in my hospital gown; my long hair in a side plait, wondering if the other ladies around me waiting were as petrified as me.
But not only could I see it all, I could feel it all. Every emotion! The fear, the anxiety, the stress, the panic, the guilt….
As a health professional I had received training in psychology after illness and was trained in some low level support strategies to help individuals with depression and anxiety. But mental health is so much more complex then these broad names, and their presentation equally complex. Before this experience I wouldn’t have thought that such an event as walking into a department would trigger such a response. Even now I struggle to understand what ultimately was a successful procedure, triggers such negative emotional response, although it is likely the precursor events play a major contributing role. But that’s the nuts and bolt of it, we can’t predict! We can’t predict the impact that individual events will have on different individuals. For some they will have no effect, for others they will have a catastrophic effect, and for many there will be a huge range in between.
The significance of this experience though, is that I moved from being perfectly contented in the present, to completely immersed in the past, whilst still moving through the present. I arrived at the reception area to my test barely able to hold back the tears, barely able to keep my emotions in check. To those working there, I believe they thought that I was just a bit concerned about the procedure but the reality was it had nothing to do with the test. Nobody asked to find out and I didn’t bring it up myself, so neither party will ever know. Luckily in some ways, they were running late so it gave me time to talk myself down and bring myself back to the present sufficiently to get through the test, only to then be re-immersed as I returned to the car park.
But this leads me back to reflecting on my role as a physiotherapist. I worked daily with people who had been through hugely traumatic and life changing experiences. How many of them were triggered by the walk into the department? Triggered by a room or piece of equipment that brought symptoms washing back? Were driven by a past experience that was too painful to share? Were functioning in the present but being driven by emotions of the past? Were unable to concentrate in the present because they were concentrating on the past but unable to articulate it?
The fact is I will never know. But in the future, at least I now know to look, consider and ask.