Issue 48 / 14 December 2015

CHRISTMAS is a time for giving and it’s a good time to reflect. 
What do we give our patients, and what do they give us? And do we, as doctors, still want the same gifts throughout our lives, or do our wishes change?
Many of us started medical practice with the vague notion of “helping people”, though, in reality, we were bright young adults facing an intellectual challenge. That challenge moulded us, together with a multitude of varied encounters with people with all manner of health care needs. 
We might, in our early days, have thought that our main interaction with patients was to diagnose and treat. Time and epxerience might also teach us the role — and value — of being an adviser and counsellor. We learn about empathy, reassurance and support. 
As we live through our own life experiences — parenthood, perhaps illness or injury — we accumulate insight that can help us to help others. The increasing frailty, dependence and death of our own parents can teach us to be better clinicians and advisers to families facing the same issues.
So, in an era of “too much medicine”, the best gifts we can give our patients are understanding, support and good counsel. We can help them navigate the health challenges of the various stages of life — literally from birth to death.
And what do patients give us? 
We are granted an enormous amount of trust. Patients trust us to do our very best for them, to receive and respect their most intimate details, their secrets, their desires. 
By being caring humans, we receive the realisation of the limitations of humanity — the possibility of honest error, the occasional loss of composure. In this sense, there is exchange of trust with our patients.
Perhaps most of all, patients grant us the privilege of entering their lives at the most poignant moments. Whether they are worried, suffering, joyful or even dying, we can take a meaningful place in their life events. 
Compassionate care of the dying is one of the greatest of these privileges.
This Christmas, we might also take the time to think about the gifts we give each other. Whether we work in solo practice, group practice, academia, clinics or hospitals, we all rely on our networks of colleagues. 
Each of us adds value to those networks, both personally and professionally. So, let us remember this year to be kind to each other. To value both learning and teaching. To understand our individual limitations. To empathise rather than blame. To collaborate rather than compete.
I wish all MJA InSight staff, authors and readers the best of times this Christmas. The real gift for me has been to engage in thoughful discussion with all of you. 
I wish you all a better-than-ever year ahead. 
Dr Sue Ieraci is a specialist emergency physician with 30 years’ experience in the public hospital system. Her particular interests include policy development and health system design, and she has held roles in medical regulation and management.

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