Killing me softly with this job. Published in BMA News 1 Aug 2014

Strains of Roberta Flack drifted in under the door and through the paper thin walls that separated me and my patients from the waiting room.

“Strumming my desk with my fingers…” I started to hum the tune and play with the words in my mind as the patient sat down. I resist the urge to strum my desk as I know this will be perceived as a sign that I am impatient and want the patient to get on with it.

He launches into a story about how work has been difficult for the last 12 months, how he’s had a disagreement with management at work, how his line manager at work is not taking his grievances properly, how work is making him unhappy. He’s just become a dad and work is affecting his sleep. Work, work, work.

Roberta sings, “Filling my mind with his pain…” my imagination drifts back to the melody again as he starts to repeat himself, as though that will make me understand him even more. I stop writing a song to myself and snap back into doctor mode.

“So, why have you come to see me?” I ask, kindly and as sweetly as I can manage.

He didn’t expect that question, so starts to repeat the story all over again, going into the detail of a disagreement with one particular supervisor that has had it in for him ever since he joined the company and that things got so bad on Thursday he walked out, because he couldn’t stand being in the place any more.

Two can play at repetition, “So why have you come to see me?”

He still doesn’t know.

In the brief silence Roberta sings the next line, “Killing me softly with this job, with this job…”

At that point I needed to make the decision between fully immersing myself into a social problem that I can never solve, medicalising his job situation or drawing the line under my ability to make a difference in some people’s lives. Perhaps the job was killing me softly with every disappointment I felt from patients I couldn’t help or being dragged into situations that broke my heart by their awfulness and the lack of solutions.

“Sounds like the problem is your job and I’m afraid I can’t prescribe you a new job. You may want to call this depression, but you’re clearly not suicidal and anything I do won’t stop your job being awful, will it?”

As he left, a little bewildered, clutching a stress management self-referral leaflet, Roberta finished the chorus, “Wearing my heart out, with this job, with this job.”
Not today Roberta, not today.

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