Stress Points

Stress Points

From Chicken Soup for the Soul: Say Goodbye to Stress


Stress Points

“Doctor, Doctor, come quickly — a confused patient has just driven away in our ambulance!” I rushed out to see the ambulance disappearing south on the road towards the dangerous pass. Quickly we dispatched a second vehicle, with two regular hospital drivers in it, to chase after the precious ambulance. “That’s worth five stars,” I ticked off in my mind. I had already collected three stars that day from arguments between key members of my hospital staff. It was going to be a top day for a crisis score.

There seem to be an inexhaustible supply and an infinite variety of crises that reach the superintendent’s desk in an African mission hospital. As that superintendent, I quickly found that I had to devise a way to withdraw a little from these frequent problems, or the stress could cause burnout. I could not afford to get emotionally involved whenever the smooth running of the hospital was threatened. For this reason I developed a scoring system by which each new problem could be graded from one (mild) to five (catastrophic), taking into account the nature and implications of each occurrence. I could then keep a running tally and see whether the day would break any record as the score rose. While this didn’t make me relish new challenges, at least it provided a harmless game that kept my feet firmly on the ground.

By analyzing problems in this way I could keep cool when threats appeared and view the issues from outside my own emotions. This helped me to plan solutions dispassionately.

Unfortunately staff shortages are the norm in mission hospitals. This meant that I had to take my full share of clinical duties as well as administrative tasks. Rounds in the children’s ward were an emotionally draining experience. Malnutrition leaves the kids vulnerable to every infection and their resistance is poor, meaning the mortality rate is high.

Every few nights there would be call duties, which meant a full round of the hospital to check on critical patients, and then often being called to new patients in casualty or a patient who had deteriorated suddenly.

I found that the only way I could control the stress generated by the workload and the constant calls to help desperately ill patients was to free my mind completely of all the current problems when I returned home to my wife and family. I would turn to other interests the moment I got back and forget the problem patients whom I had been assessing. I found that I was able to do this so well that when a nurse called to say something like: “Doctor, that ill patient in the female ward has got worse,” I would not know it was the seriously ill typhoid case until the nurse reminded me of the details. Then it would be clear and I could rush to the ward and prescribe the necessary treatment. My home thus became a fortress against the daily stress.

And the missing ambulance? An hour after the vehicles had roared out of the hospital, they both returned safely with the hospital drivers in control and the confused patient seated quietly in a passenger seat. The report I received was that the patient had stopped the ambulance neatly at a viewpoint in the pass, and was found standing and admiring the fine view. He quietly returned to join the driver for his return trip to the hospital. I firmly believe it was worth the five stars I gave it!

~ John McCutcheon ~

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