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10Network She I Autumn/Winter 2012Vocation, Vocation, VocationI recently found myself sitting on a train next to two young doctors who were obviously on their way to London to take their membership exams for the Royal College of Medicine. Throughout the journey, they sat engrossed in the finer points of the possible cause of double vision related to damage to the central nervous system. As I listened, I found myself impressed by their technical knowledge (most of which, I knew, I had forgotten) but I couldn't help wondering if they knew anything at all about human nature. Never once in three hours did they talk about the patients who suffered these conditions as people. They were diseases on legs. But these were doctors bent on a hospital career, and for those of us in general practice, at least, priorities have changed. We are actively encouraged to talk about how consultations with patients make us feel, and the effect they have on how we treat the next patient. We talk openly about the limits of 'conventional' science, and the profound effect of intangible skills such as looking at problems from the patient's perspective. GPs in training today spend months examining the way they communicate with patients, how well they listen and how much they take the patient's concerns into account. As well as their hospital training, they spend at least a year shadowing a single GP trainer before they are let loose on their own. Here, they encounter patients when they're well - as people with families, dreams and fears. Here, they visit dying patients in their own homes, working in teams with the astonishingly dedicated individuals who know I toyed with the idea of being a ballet dancer, too. And perhaps my medical training was not quite as heartless as I remember it, with learning by ritual humiliation in front of your fellow students the method of choice. I'm sure there were consultants who cared more about how much we learnt than about bolstering their egos. But I do know that the medical students were never, ever invited to join the private discussions with very sick patients' relatives, where a far more pragmatic - possibly even human side came out. Medical training has changed a lot over the years but even today's newly qualified doctors have been encouraged to believe that failure is not an option. The only exception is in specialist palliative care, which has blossomed in the last few decades to provide hope for thousands of patients and their families every year. Here, for the first time, medical students learn that it is possible for people to have an active choice in how, if not when, they die. The trouble is that during training, the average student spends five years in the 'go-for-it' atmosphere of the hospital, and only a couple of weeks in a hospice. attempts at surgery when he developed straw-rot from the injections, and sits on a high shelf in my study to remind me of my roots. My single minded determination to be a doctor from such an early age was a source of interest, and sometimes mild amusement, to my parents' friends. I would be wheeled out at parties to explain my passion - and my rallying cry was simply 'I want to make people better'. It would be twenty years before I even conceived of my equally crucial twin role - that of helping people to die well. I may be remembering selectively. Perhaps my childhood ambition was not quite so single minded. Like most girls, I Even today's newly qualified doctors have been encouraged to believe that failure is not an optionDr Sarah JarvisJohn HumphrysYou can meet Dr Sarah Jarvis at the Network She Business Awards in November where she is our guest speaker along with former gold medal Olympics winner Diane Modahl. For award night details go to Current doctor on BBC One Show and Radio 2. Spent 10 years as ITN lunchtime news doctor. Writes articles for Good Housekeeping, My Weekly and medical journals. Trained at Cambridge and Oxford Universities. Is a GP in inner city London. Women's health spokesperson Royal College of General Practitioners. Chair cholesterol charity HEART UK. Other books include Diabetas for Dummies, Children's Health for Dummies and A Younger Woman's Diagnose- It-Yourself Guide to HealthFACTFILEFor your chance to win a copy of The Welcome Visitor go to

www.networkshe.com11Vocation, Vocation, VocationUnder certain, strictly regulated circumstances doctors should be allowed to help their patient die. By 'help', I mean more than just withholding treatment - that has always happened and the law allows it - but by taking more active steps. Sarah was dubious. It flew in the face of everything she had been trained to do as a doctor and, more importantly, what she personally believed was ethically and morally acceptable. In the years following my father's death we agreed that we had been arguing about the wrong thing. This is not about a cold, clinical procedure in which a doctor stands at the bedside of a sick person and calmly administers the injection that will stop the heart beating. This is about recognising that there is such a thing as a life force or, if you prefer, the will to live, and what should happen when that disappears. There should be a recognition that, just as we expect to have control over our own lives, so we should have control over our own deaths. of this book alongside my own. She has the knowledge that only a doctor who has practised as a GP for many years can have. Good doctors not only help keep people alive; they help them die. More specifically, they help them have a good death. But Sarah make up the hospice community teams.In hospital, they have learnt that we are 'conquering' the diseases that used to kill you quickly - heart attack, heart failure, cancer. In general practice, they learn about the flip side - that some people just spend much longer dying.John's introductionIt's a risky business, writing about something you've never experienced. The problem with death is that there's no other way to do it - on the basis that once you've actually experienced it, that's it. We don't get a practise run. We can't come back and talk about it. We don't get a second crack at it if it went badly. It's not like giving birth: you can't change your views the second time around with the benefit of hindsight. On the other hand, there are plenty of people with tons of second-hand experience - doctors, nurses, hospice staff - who see it happening all the time. That's why the name of Dr. Sarah Jarvis is on the cover This is about recognising that there is such a thing as a life force or, if you prefer, the will to live, and what should happen when that disappearsJohn Humphrysand I had a few differences to sort out before we could put pen to paper. I have come to believe over the past few years - mostly because of the circumstances surrounding the death of my own father in 2003 - that there is a powerful case for some form of assisted suicide. CENTRAL PROMENADE, LLANDUDNO LL30 1BA (Next to Venue Cymru, Private Car Park)t: 01492 878101 e: mid-week breaks from £54.50 pppn DBB Winter mid-week breaks from £49.50 pppn DBBTerms & conditions. Supplements apply for deluxe and superior rooms, single supplement applies, subject to availability, not available in conjunction with any other offer.MID-WEEK BREAKS,THEATRE BREAKS AND PRE-THEATRE MEALSLARGE PRIVATE CAR PARK AND NEXT TO VENUE CYMRU AND SHOPPING CENTRESTheatre Breaks from £80.00 pp DBB13342_185x107 ad_Layout 1 10/08/2012 09:43 Page 1