Beyond white coat: Untold stories of doctors’ fears, struggles as patients
From the anxiety of the outcome of test results to the struggle of seeking help, IDOWU ABDULLAHI writes on the emotional and physical toll doctors battle when they fall sick and become patients, facing the same fears and uncertainties as their patients
As he laid on the trolley being wheeled to the theatre room, Prof. Oluwarotimi Akinola’s mind flashed tenuously and reality starred him in the face that the tables had turned.
The astute Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, soon realised that his white coat and stethoscope that distinguished him as healthcare provider had been changed to sterile surgical gown and had suddenly transitioned from physician to patient waiting to be cut open by surgeons.
Prof. Oluwarotimi Akinola
His journey to the theatre in 2005 wasn’t for an emergency situation. He had knowledge of what ails him and was, in fact, afraid not of the outcome of the procedure alone but the post-surgery reality of the tumour that was to be removed inside him.
The sight of the surgeons and operating theatre staff in surgical gowns reminded him of how fickle life is.
Undergoing the surgery was scary for the former President of the Society of Gynaecology and Obstetrics of Nigeria despite his vast knowledge in the medical profession and many years of experience as he could not predict the outcome.
This, he acknowledged, opened his eyes to the challenges of the ‘patient condition” which necessitates the need for doctors to show empathy when providing care to patients.
“To be sick is to be humbled by one’s own mortality. I mean we all like to bounce about but it is only when you are sick and you are on a hospital bed that you realise that your mortality is playing games with you,” the don said.
Behind diagnosing illnesses, prescribing treatments, counselling and offering comforts to thousands of patients, Akinola realised that even doctors, including himself, were not invincible.
“About 20 years ago, I was on a trolley being wheeled in for surgery. I had undergone a preliminary investigation and knew that the tumor I had was, in fact, cancerous. So, while I was being taken into the theatre, I knew the reality,” the gynaecologist said.
The frailties of human nature never fail to show up and when it does, it’s a stark reminder of our mortality, which many seem to forget, particularly doctors who had been so buried in the task of caring for others.
“I mean, when you are sick, you are no longer that person that you thought that you were. Illness disturbs the body and the soul,” the don recounted his experience at the recent Scientific Conference of Lagos Medical Guild.
The Medical Guild is the association of doctors employed by the Lagos State Government.
Revered professionals
PUNCH Healthwise gathered that despite being armed with knowledge of several diseases, with powers to bring healing, pain, death and destruction, these couldn’t shield Akinola, and other doctors from illness and fragility of their own bodies.
Speaking with several doctors, our correspondent learnt that while physicians are held in high esteem by patients and society for their contributions, they are still affected by and subjected to the same reality as their patients.
Of course, they are dedicated, compassionate and thorough professionals whom society hangs its fate on as not just healers but guardians of life, but when the stethoscope changed hands, the physicians have no choice but to adjust to their new status of being a patient.
Akinola’s experience mirrored the situation of many doctors, whose words carry weight and appearance commands respect for their commitment to their sacred calling, of also needing healings albeit afraid of stigma and struggles that comes with seeking healthcare in the country.
Despite families, society, government and stakeholders speaking of them with reverence, and countries leaning on their knowledge in times of crisis as evidenced by COVID-19 outbreak, they also succumb to the very thing they are trained to prevent or treat in most cases.
Life after surgery scared me
While Akinola’s surgery was successful, the apprehension of what lies ahead filled his head. The mental calculations of what could be based on his experience as a medical professional denied him succour.
“So, while I was being taken into the theatre, I knew the reality. When I came out of the theatre and looked fine, people congratulated me, saying I was okay. But as a doctor, I knew that was just the beginning of the problem.
“While others were celebrating, I was thinking about survival rates, which I knew were only 56% over five years. Thank God this was 20 years ago. Basically, it’s a big deal as a doctor when you find yourself on the patient’s side,” the don recounted.
Surviving cancer scare
The professor explained that he survived the cancer scare because he had listened to physicians, including his wife, who diagnosed and treated him.
He admitted that he had to jettison all his knowledge and years of experience and listened to wise counsels by avoiding self-diagnosis and following his physicians’ prescriptions and advice religiously.
“I remember when my wife, a radiologist, looked at my scan and disagreed with the initial diagnosis. Thank God I listened to her because she contested the findings, and further investigation proved her right. If I hadn’t, I might not be here today,” the don said.
Bound by oath
Doctors are bound by an oath which spells out the physicians’ obligations toward patients, society, and each other, especially when a doctor becomes the patient.
The most popular of them is the Hippocratic oath, an ethical code attributed to the ancient Greek physician Hippocrates, which has been adopted as a conduct guide by the medical profession throughout the ages and is still used in the graduation ceremonies of many medical schools.
For the benefit of patients, the medical profession has long subscribed to a body of ethical principles. The four principles of medical ethics are defined as: Autonomy – respect for the patient’s right to self-determination; Beneficence – the duty to ‘do good’, Non-Maleficence – the duty to ‘not do bad’, and Justice – to treat all people equally and equitably.
Among others, doctors are also bound by oath not to self-diagnose or treat themselves. They must present their case to another physician who must examine them and give proper prescriptions and treatments.
“A medical or dental practitioner can offer first aid treatment to members of his family. Severe ailments are best referred to colleagues who can treat the afflicted person with a mind devoid of distracting emotions.
“Similarly, a doctor should avoid self-treatment and self-medication unless the ailment is clearly minor or there is no access to a colleague,” part of the code of medical ethics in Nigeria read.
Doctors fall sick, drop dead
Our correspondent gathered that despite spending years telling others to listen to their bodies, doctors sometimes ignored their own bodies’ pleas for help, and this has led to fatalities.
This, among other tales of doctors facing their own battle, had become a stark reminder that beneath the titles and expertise, doctors are human too who fall sick and can drop dead without sign.
“The white coats we wear—coveted and respected—do not exempt us from illness. We are all prospective patients awaiting our turn.
“All of us will fall sick; it is possible also that everything is fine and then suddenly you just stop breathing. It reminded us of the reality of life. May life not happen to any of us, and when it does, may God take us through it all,” Akinola said.
Sharing an incident involving a colleague with PUNCH Healthwise, a public health practitioner and past President of the Medical Women Association of Nigeria, Lagos State, Dr Dumebi Owa, explained how a colleague collapsed on duty with a patient only concerned about the health of her child.
“Some years back, a doctor overworked himself and collapsed. The patient he was treating started crying, saying, ‘Why didn’t the doctor treat my daughter before passing out?’ Imagine that. The reality is that our jobs are very demanding, yet we are overworked and underpaid.
“Last year alone, we lost a lot of doctors in Nigeria. I’m on different platforms—state, national—and a lot of these deaths are attributed to stress. Doctors are always on call, sometimes working two to three days straight without rest,” the physician told our correspondent.
Dr Modupe Adedeji
To clear the air on doctors’ presumed superhuman attributes, a Consultant Gynaecologist and Obstetrician at the Lagos State University Teaching Hospital, Ikeja, Dr. Modupe Adedeji, argued that the only distinguishing factor was that physicians study medicine.
“To start with, doctors are also human. The only thing that makes us different is that we actually went to study medicine. We get tired, sick and get admitted to the hospital, go for follow-ups, and doctors have their clinic days for appointments and all of that,” she said.
Fears of complications
For Adedeji, the fear of complications when the placenta didn’t come out on time after she delivered her baby sent shivers down her spine.
The maternal health expert said because she was aware of what could go wrong, she started having palpitations.
She said, “Obviously, as a woman and being married, I had to have my kids and all that. I remember when I was pregnant with my first child. I was a resident doctor in a hospital, and I had just attended to several women overnight. I was exhausted and fell into labour the next morning, finding myself in the position of a patient.”
She recalled her experience saying, “ I was shouting my head off because of labor pain and all that.
“After I had just been discharged from the ward, another patient who saw me attending to patients throughout the night said, ‘Doctor, I didn’t know doctors could shout. Why do you tell us not to shout at night?’”
During her ordeal, she explained that her colleagues didn’t give her any special treatment.
“They handled me as a patient because the process must go as it should until the baby comes out. And as God would have it, I even had a slight complication. The placenta didn’t come out on time, so I had to be taken to another room for the procedure.
“Immediately, when it was noticed, I started having palpitations because I knew the implications. That meant I could bleed a lot and might have to be given blood, which doctors dread because we know the implications and complications that may come with it.
“Nevertheless, it was necessary to save my life. These thoughts were running through my mind until I woke up. I was sedated, and by the time I woke up, I didn’t see anyone around me anymore. They had done what they needed to do, and I was fine,” Adedeji said.
Prof. Mike Ogirima
Prof Mike Ogirima
On his part, a former President of the Nigerian Medical Association, Prof. Mike Ogirima, said whenever he was subjected to lab tests as a patient, fear built up in him.
“I have been a patient before and during that experience, I was afraid when I was subjected to lab tests. So, I was apprehensive about what the result would be.
“As a surgeon, I subject myself to tests regularly to know my status because of my constant usage of needles and other surgical equipment. You know, when you operate on suspicious cases of retroviral disease patients and you are involved in the care of such patients, you will be scared every year when it’s time to check your HIV status,” the professor of Orthopaedic and Trauma Surgery, told our correspondent during an interview.
Being knowledgeable raises our fears
The physicians explained that while their knowledge brings succour to patients, the same knowledge becomes a burden when a doctor becomes the patient.
“You may have an understanding (of your ailment), and that understanding can be both positive and negative. You know the implications of treatment and all of that.
“In this implication, in the sense that we understand that there is always, in every management, a side of complication. Because of this, you are much more careful, and being more careful brings fear.
“You also appreciate the fact that you get well and that you don’t have complications from the management. So the depth of knowledge is what makes us different from ordinary people, and all of that sometimes makes treatment more challenging. It is actually one of the very difficult things when doctors become patients,” Adedeji said.
Backing Adedeji, Akinola said, “The challenges doctors face when they become patients are many, but the first thing is vulnerability. Doctors are used to being in control and making decisions, so when you become a patient, you feel vulnerable and powerless.
“You may struggle to trust other healthcare workers—maybe your resident doctor or house officer is now the one setting the IV line and giving orders. You might find yourself questioning, ‘What are you doing?’
“The emotional and psychological impact is another challenge. Knowing more about medical conditions can lead to increased stress and anxiety about your own health.”
On his part, Ogirima said, “If you’re asked to do some screening tests for cancers, you will be scared and there would be a lot of apprehension—wondering what the results might be. Of course, the result can be either negative or positive. But the fact that you know what the implications might be if the result comes otherwise will get you afraid.”
Also speaking with PUNC Healthwise, an Epidemiologist, Dr. Japhet Olugbogi, said discomfort on his leg made him uncomfortable and he was already dreadful of battling arthritis.
Dr Japhet Olugbogi
“One time, I started feeling discomfort and thought, ‘I’m too young to have arthritis. I’m not on the big side, I don’t talk much, so why am I having this discomfort?’
“I called a friend who is a physician, and he laughed, reassuring me that I didn’t have arthritis. He asked me a lot of questions to determine if it was something sinister, but thankfully, it wasn’t.”
On her part, Owa said, “Having too much knowledge has its own implications. We know that no drug is totally safe. Most of these drugs, if not properly used, can act as poisons in the system.
Doctors have all this knowledge about so many things and because we know the implications of things—like surgery—it becomes even scarier. We’ve seen patients sleep and don’t wake up—they just sleep after successful surgery and wake up in the great beyond. When you know too much about something, fear sets in.”
Struggles and survival
Along the fears and struggles come their saving grace. Our correspondent learnt that going by the dictates of the Hippocratic oath had been their secret ingredient that had made doctors appear as immortals.
Despite being physicians and knowledgeable about illnesses, the doctors said whenever they have unusual feelings or discomfort relating to help issues, they immediately subject themselves to other health experts for medical examination.
“It is unethical to self-diagnose. It is also unethical to prescribe drugs for yourself. In medical practice, a doctor must subject himself or herself to another physician at all points and I regularly do that.
“For me, I have physicians I consult because of the level I have reached in the practice. So, I know who to see for what ailment, and I’ve never been disappointed,” Ogirima told our correspondent.
On her part, Adedeji said, “Obviously, you can’t do those things by yourself. Even for some of us who are specialised, and so deep into our specialty, we don’t self-diagnose. We subject ourselves to other physicians for treatment.
“The same way we advise our patients, we also follow that advice. We don’t manage our ailments ourselves, because you need to bring yourself to the position of a patient to get full management.
“Though as a patient, you are not going to be an ordinary patient because you understand the extent to which your colleagues are treating you, but still someone else has to do it for you.”
Akinola added, “One day, or another, we will all become patients. The only hope we have is the Hippocratic value, the succor we can depend on—the oath our colleagues have sworn to uphold.”
Doctors’ demand
To ensure the healers are healthy enough to cater for several patients battling different ailments, the Nigeria Medical Association and Nigerian Association of Resident Doctors have called on the government to provide a viable health insurance policy for health workers.
Dr Emeka Orji
A former NARD President, Dr Emeka Orji, urged the government to reward doctors’ dedication with improved welfare, including proper health insurance.
“Hardly a week or two passes without a request for financial contributions for a doctor in need. For instance, we have had doctors who required kidney transplants but couldn’t afford them, relying on contributions from colleagues and associations. We have also seen cases of doctors collapsing at work, only to discover they had heart conditions requiring urgent, costly interventions. Some of these cases necessitate seeking medical care abroad, further highlighting the inadequacy of our health system.
“The fact that doctors working for the government do not have a viable health insurance system that adequately caters to their needs raises serious concerns. If doctors are struggling with healthcare access, what happens to the average Nigerian citizen? It is alarming that doctors, who dedicate their lives to caring for others, do not have functional health insurance beyond basic medications like paracetamol. Once a doctor requires any advanced medical intervention, they are left to fend for themselves, often resorting to seeking public financial assistance,” Orji said.
Dr Babajide Saheed, Lagos NMA Chairman
Also, the Lagos State NMA Chairman, Dr Babajide Saheed, bemoaned how governments across the country take doctors’ welfare with levity, adding that doctors are also paying out-of-pocket to access healthcare.
“Generally, doctors’ welfare is not being taken care of. A doctor paying for surgery, treatment and drugs in the same place he or she is working is wrong. Even that is still fair; how many doctors can afford to access healthcare abroad? Or some of the specialist hospitals in the country. The financial capability to pay for better healthcare is very low among doctors. The little amount of money we have, we use it in settling domestic stuff.
“The government should invest in the welfare of doctors in the sense that there should be proper insurance policies for doctors catered for by the government and not doctors. And if there is any emergency, the doctors would be at peace to seek healthcare because he or she knows insurance is there and not that the next thing a sick doctor would think of is how to crowdfund for his or her treatment,” the NMA boss said.
