Personal View: Hard Times

At the end of 1997 I wound up in hospital with a rather serious illness and lost four weeks of teaching time. Then, in late November I was discharged only to be greeted with the news that my mother had developed end stage liver cancer.

I guess I had been kind of expectantly waiting for the moment when her condition would become terminal-my mother had developed breast cancer with complications some five years earlier, and even with more than two years' medical training, the diagnosis of end stage cancer still knocked me sideways. While I reeled from the double blow I had suffered I prepared for my return to academic work at college and, when the time came, I duly ploughed in with junior firms.

Over the following months my mother's health got worse and I was having to return home a lot to be with my family. By the beginning of March she was gravely ill and she was admitted to Hammersmith Hospital in London. I started travelling regularly across London, from Mile End in the east to White City in the west, to visit her and meet with my brother and my father. This was not easy and the journeys tired me out.

My attendance was suffering greatly, my grades were poor, my enthusiasm had waned, and I was unable to concentrate. I felt terrible, tired, and guilty. My mind was full of thoughts but I couldn't catch a single one. I was so exhausted one day that I woke up late and couldn't get to the hospital to see my mother until 5 pm. The feeling of inadequacy was overpowering and I even got my friend Liz to accompany me that day for moral support. From the moment that I sat with my mother, in her terrible pain and humiliating state, I felt pathetic and terrible at not having the decency to keep my promises and duties to those who trusted me.

Around me I built an emotional wall, a defence from the outside world, and it protected me to a point. That flawed yet superficially intact facade told my family that everything was all right at college and that I was doing well. Most of my friends knew little or nothing of what I was going through and how long the whole charade lasted.

I remember visiting my mum the last time in hospital. I remember hugging her and telling her I loved her. I didn't see her alive again. She died at home on 6 April 1998. I just felt numb and not much else. Guilt consumed me about not having been there for her. What could I have done? Did I respond correctly when she asked me to "help her"?

Throughout this five month ordeal I needed help and I sought it from my teachers and tutors at the medical school. In many ways my senior tutor at the college was helpful. Between us we arranged for extra. curricular pathology tutorials to catch up on the time I had lost when I had been ill. He made reports for my file and provided me with contacts for support, such as the counsellor I started seeing.

But my consultants were uncaring. I informed them of my problems and of the extracurricular work that I was doing to catch up. The college registry provided back up but this was still not enough for the men who hold your career in their hands. I was failed in three different rotations, for various reasons including poor attendance (though I had college approved absences) and lack of enthusiasm. It seemed (and still seems) that they picked their own criteria for choosing to fail me, using no universal standards, and the frustration was intense, so much so that I ended up having a rather voluble argument with one of these dinosaurs outside theatres.

Never had I felt so let down by the people I had needed most to support and help me. I was under incredible pressure, felt terrible, and had all my self confidence shattered. I needed positive guidance and instead this was what I got. My senior tutor was now forced into the position of "advising" me to take an additional six months to complete my medical training, and I had no option but to accept reluctantly. I had to find the time somewhere to resit everything.

Now I am back on track with my studies and settled with the extension to my course. However, I am still disappointed with the medical school. For all the good things my senior tutor did, he did not try to help secure consideration of my situation in my rotation assessments and exams. He has also made me do extra ward work to "fill out" my "spare time" in my extra six months.

Late 1997 and most of 1998 were terribly hard times for me, and they would have been much worse if it weren't for my family and friends, especially dear Liz, who listened to me and cared for me. But I feel that my college turned its back on me, one of its many fresh young talents that need nurturing and support, and gave me little help when I most needed it.

Navin Chohan, final year medical student, Queen Mary and Westfield Hospital, London

In memory of Iran Chohan, born 14 January 1954, died 6 April 1998


studentBMJ 2000;08:217-258 July ISSN 0966-6494