It’s all on the file
In 2017 I had a series of eye operations. On the first day a nurse came to talk me. She wanted to take my blood pressure, temperature etc, and go through a few medical and personal details. She turned to her notes and asked me about my previous medical history. I told her that on the whole I was a very healthy active person with no real health issues apart from at that point, my sight.
She gave me a rather sharp look and said she’d like to talk to me about my anxiety and depression. I must have looked pretty shocked and I asked her what anxiety and depression. She shifted uncomfortably in her chair and told me anxiety and depression were recorded on the file in my permanent medical record.
I asked her when these symptoms dated from and she said it dated from the end of 2012 when apparently my GP was concerned about my depression and anxiety issues. It was only a few days later that I realised what this was about, as I had never gone to the doctors to discuss symptoms like that in 2012.
August 2012 was when my world came crashing down. August 2012 is when my son died. There’s quite a lot of 2012 after August which I don’t remember and what bits of it I do remember are really more like random snapshots and soundbites.
In our village is a large GP surgery. It looks after the needs of our village and all the smaller villages for miles around. There’s 5 GPs, several dentists, nurses, midwives, a physio clinic and a pharmacy. In November 2012 I had an appointment to see one of the nurses. It was for a general check-up, which they offer their patients annually and what happened at the check-up is one of those snapshot memories which I recall absolutely and acutely. After we’d done height, weight, blood pressure and the nurse had taken enough blood to fill several test tubes she went to her desk and started writing up her notes. Without looking up she asked me if I would describe myself as is good general health. I hesitated. I said yes. Still writing away she asked me if there was anything that concerned me or was everything alright.
I could hardly breathe. The room seemed to expand in every direction and the pressure inside my head was immense. I said “well it depends what you mean by alright. If you mean, do I breathe and more or less function every day, then yes. If you mean, do I wonder how I’m going to get through today, never mind tomorrow, then probably, no”. She looked up.
“Is there anything in particular which is bothering you at the moment?”
It felt as if my chest was being crushed and I could hardly breathe. The room became a vague and teary haze. All I could manage to gasp out was “My son, my son”. I gasped for breath and for something to hold onto to stop me falling. “My golden boy”. “Oh my god, my son, my son” and I dissolved into that rocking, sobbing mess which at that point had become a daily ritual.
After a few minutes, I started to breathe and fumble in my bag for tissues. I looked at the nurse. She was squirming with embarrassment, unable to meet my eye. In a rather squeaky voice she said, “perhaps you’d like me to arrange for you to see your GP so he could prescribe you some anti-depressants if you feel like this”. It was as if my grief shocked and disgusted her and she had a great need to tidy it away, quickly.
I was shocked. So shocked that I can recall that feeling clearly even now. I looked at her and said “My son died 3 months ago. Isn’t it right that I should feel like this? Isn’t it normal to grieve like this? When did it start being OK to tell people they shouldn’t grieve for their child?”
She looked very annoyed and said “I’m not making you take anything but clearly you’re in bad way and I think it would be better if your GP prescribed something to help you get through this”.
I picked up my bag and stood up. “I’m not ashamed of my son or of my grief. Yes, it’s terrible and I wouldn’t wish it on anyone, but I’d rather grieve and sob for my son and wish every day he was here with me, than drown in pills so other people find me less embarrassing”. As I turned to go, I added “I think this is normal, given the circumstances and I don’t think we shouldn’t be afraid of normal. I don’t think we should be afraid of grief”. It was at that point that the nurse then turned back to her notes and wrote “suffering from anxiety and depression”. Now it’s on my file and it’s become a truth that may follow me around for years.
I ‘ve thought about the nurse’s attitude many times since then and about what it’s like to deal with grief. Grief is messy, dreadful to go through and it can be difficult to know how best to help someone. After 4 years my daughter accepted the offer of anti-depressants from her own GP, which helped her a lot. I’ve never taken them and I’ve wondered in the years since if they might have helped at that point. I think not, but they might have helped later but actually my GP never offered me them.
If on that day I’d met a really switched on, empathic nurse, someone who made time to sit with me, hold my hand, give me tissues, encouraged me to talk and just listened to me, I think it would have made a massive difference, not only to that day but to the days that have come after. That type of response isn’t automatic to everyone and even with specialist training, some clinicians simply don’t have a good response to bereaved families. The over-worked, time-poor GP who often doesn’t even raise their head and make eye contact with their patient, isn’t often the right person to reach out to a traumatically bereaved family member.
I imagine an alternative reality where like the designated “mental health first aider”, each GP’s surgery has someone trained in empathic listening skills, particularly around bereavement trauma and grief counselling. Someone you could just sit and talk to. It’s hard enough for families to access counselling at the best of times and in the early days, often all you need is a compassionate, listening ear. How much more helpful that would be, than a judgemental note on your permanent medical file which reflects so little about what was really happening at that time?