Monday irritability?

Actually, I don't think it was about working on a Sunday after all - maybe I'm just becoming an angry person. Or maybe I always was an angry person, but am only now realizing it. Unsettling thought. I'm not sure if this is the conviction of the Holy Spirit or just an unpleasant insight. What a drag. Knowing this means that I am going to have to work (hard work) on changing it. I don't feel like changing. I'm tired. Sometimes I just think I'm tired of caring.

A few nights ago I was working late (the resident was sick and the cover very inexperienced) so I felt that I had to tidy everything up as much as possible before leaving. Two hours after finishing time (15 hours from starting time) I was just exhausted. All day talking, explaining, thinking, making decisions, explaining those decisions, giving mini-medical educations, etc. Usually I like the educational aspects of my job, but last week I was just tired out. The last family of the day was anxious, concerned about their child (fair enough I don't blame them for that) but the child was clearly quite well and in the resolution phase of the illness. They were insisting on coming into hospital, which in my opinion would expose them to much more illness (hospitals being full of sick people) and would take the child out of her home environment and would expose her to treatments and procedures which she didn't need, and which would be a waste of resources on an essentially well child.

I almost got started explaining all of that, and thought "why bother?". If they want to come into hospital let them. I don't get paid any more for standing here arguing with them, and anyway, why should I care more about the health of their child than they do? Let them have what they want, they'll be happy, and I can go home. I can see why lots of GPs just hand over the antibiotics - much quicker than educating everyone, and you get lots of happy customers. The last parent I spent nearly an hour on educating and teaching how to rehydrate her child in the comfort of her own home ended up saying "lot of good you are!" on her way out, when it became obvious I thought she should take her child home.

People seem to think the hospital is some magic place which if only they can get into it, all their problems will be over. So many times I hear "but you must know" or "there must be something you can do". The days of the pax antibiotica are nearly over. The real threats to health are no longer curable with a tablet - viruses and lifestyle diseases will kill the majority of the patients I see these days. The fears of pneumonia and sepsis are overblown. Their days are over. We can and do treat these, even TB and leprosy are yielding. The days of AIDS and SARS and bird 'flu and Hepatitis Q are coming, not to mention heart disease, obesity, cancer and dementia. People are kidding themselves if they think that giving more money to medical research can save them from these.

More and more these days I think medicine is fighting a losing battle, if the idea is to save life. Medicine can offer pain relief, limited palliation and a small hope to wield in the face of the idea that we are all dying. Our only hope for eternal life lies with God, not medicine. Sometimes I wish I could be a minister instead of a doctor, and do work of eternal significance, rather than this piecemeal patching up of bodies so that people can go on living the way they have always done, and which made them sick in the first place. Does that sound too cynical? I suppose it does, but sometimes I am just too tired to care...