‘I felt pain… I couldn’t speak… I felt so scared… but I was still there… I was still me…’ The moving story recounted by Kate Allatt of her frightening experience with locked-in syndrome brought back vivid memories of my work as a doctor. I remembered the countless times I had seen patients unable to fully express their stories – for pain, for fear of embarrassment or being a burden, because they didn’t know, or couldn’t say, because there wasn’t enough time. But I also remember the tremendous difference it made when we took time to elicit this information – and how essential it was in providing safe and effective care.
When I was working as a Fellow in Trauma and Orthopaedic Surgery in London, I recall an elderly patient who was refusing emergency surgery for her hip fracture, insisting instead on being discharged home despite her agonising pain and inability to walk. It was only by taking the time to find out her whole story (beyond our medical questions) that we learnt she had caring responsibilities for her frail husband and felt unable to leave him unattended to accept treatment for herself. Knowing this enabled us to arrange care for this lady and her husband, achieving a positive outcome for both. But without knowing her whole story, we could not have truly cared in this way.