Aequanimitas

I am sitting in the Library waiting for my class to begin.

At 2pm I take the students at the Hospital wards.... a mass of humanity with sick lungs, or brains or hearts, perhaps it is easier to list what's left that's healthy. Huge wards overflowing with the sick and almost all seriously ill. I trudge week in and out among them and I am constantly reminded of the decay, death and impermanence of life. A few weeks ago, a student showed me a patient with cirrhosis, liver failure, but she did not realise how close to death the patient was. When I explained to the students the gravity of the situation, she cried for she had not expected this despite speaking to and examining the patient. The student is young and inexperienced, and death is not something she is familiar with, at least not yet in this life.

Yesterday 2 students spoke to me about a young patient who is similarly desperately ill with cancer. To them it was confounding as to why such a young person can have an illness usually associated with more elderly people. They had clerked the patient and I can see had become attached emotionally. Nature favours NO one, its all causes and effects.

The great Physician Sir William Osler said that the most important quality a doctor must develop is EQUANIMITY. He used the term Aequanimitas, a mental state all who practise medicine should develop. In a famous valedictory address, "Aequanimitas," he described his view of how a physician should carry him- or herself. He talked of the caring and sense of detachment and objectivity that one must have with patients.

It is because of this emotional mist that makes the treatment of relatives and loved ones a NO NO in medicine. We fail to see objectively when we become emotionally attached to the patient. That is also why it is unethical for any doctor to fall in love with a patient, once a patient never a lover be.

To see any situation objectively, the lessons are clear; the mind must first be calm, and the emotions reined in. There must be equanimity no matter how trivial or grave the situation is... otherwise we bring in or see factors not there but imagined. This state of dissociation from our emotions is not something an untrained mind can do, and I can see that many of my students have not developed that skill yet.

Dr Wong