On the other side of the desk

I have sat across from patients and delivered difficult news more times than I can count. I believed I understood what that moment felt like - the weight of it, the fear behind the eyes, the questions that
tumble out or don’t come at all. Then I became the patient, and I realised I understood very little.

In July last year, I was diagnosed with breast cancer. I am a GP. I am the Group Clinical Director for Tend in the Bay of Plenty. I know how this system works. And still, nothing prepared me for what it felt like to be inside it.

"I kept waiting for my clinical brain to take over and make it easier. It didn’t.”

The waiting was the first thing that undid me. As a clinician, I know why waits happen - the system, the volumes, the complexity of coordination. But sitting with a diagnosis and a date that felt impossibly far away, all of that knowledge evaporated. I was just a person who was frightened. I found myself rehearsing conversations I might have with my family, catastrophising at 2am, reading statistics I knew better than to read.

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Then there was the morning a scan result arrived in my inbox, sent directly from the radiology department -no report attached, just raw images sitting there waiting to be opened. Every sensible, human part of me said: don’t look. Wait for the report. Wait for your team. That is what I would tell any patient. But my clinical brain had other ideas. It overrode the lot. I opened them. I sat alone, interpreting images of my own body, doing exactly what no patient should have to do - and exactly what I, as a clinician, should have known better than to do. It was a stark reminder that having medical knowledge does not protect you from being human. Sometimes it just gives you more rope.

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What helped - genuinely helped - was when a member member of my care team said something simple: “This is a lot to take in. You don’t need to process it all today.” Not clinical reassurance. Not
statistics. Permission to not be okay yet. I have thought about those words many times since. And then there was my oncologist. I did not expect to laugh - not really, not during cancer treatment. But she made me laugh, consistently and genuinely, in a way that gave me back a sense of myself that the diagnosis had quietly taken. She treated me like a whole person rather than a clinical problem to be solved. I cannot overstate what that meant. Humour, deployed with care and good judgement, is not a distraction from serious medicine. It is serious medicine.
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I also noticed, acutely, the moments when the system ground me down in ways I had never anticipated. I am fortunate - genuinely fortunate - to have health insurance and income protection, and I do not take that lightly. But even with that safety net in place, obtaining a medical certificate for my insurer every single month is an exercise in exhaustion. Contacting my doctor, waiting for paperwork, chasing it up, doing all of this while fatigued and anxious and simply trying to get through each week. I knew exactly what the form required and why. That did not make it one bit easier. For patients without insurance or income protection, without that knowledge, without the contacts to smooth the way - the burden is so much heavier, and I thought about them often.
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What I want to ask of every person in our network is this: your patients are frightened in ways they may not show you. The one who comes in composed and asks all the right questions is still lying awake at night. The one who seems to be coping may be performing coping for your benefit. Ask the question underneath the question. Give people space to be uncertain. And if you can make them laugh - really laugh - do not hold back.

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I am still in treatment. I am not yet on the other side. But I already know - with more certainty than almost anything I have learned in my career - that I will be a better clinician for having been a patient. I would not wish this experience on anyone. But I am grateful for what it has taught me, and I hope something in these words is useful to you too.
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If this piece makes even one of you pause before the next difficult conversation and ask yourself what does this person actually need from me right now - then it was worth writing.

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