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Picasso, professionalism and plastic surgery: why privileging the patient’s perspective is a moral imperative
  1. Deborah Kirklin
  1. Correspondence to Dr D Kirklin, Department of Primary Care & Population Sciences, Royal Free & University College Medical School, Archway Campus, 2nd Floor Holborn Union Building, 2-10 Highgate Hill, London N19 5LW, UK; d.kirklin{at}pcps.ucl.ac.uk

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In this issue’s Editors choice, Aoife Moran, Anne Scott and Philip Darbyshire1 (see page 70) argue that the process of living on haemodialysis, while waiting for a kidney transplant, is one in which time is both killed and wasted. Rather like the lives of the protagonists in Beckett’s Waiting for Godot, the lives of people on dialysis are ones characterised by existential boredom. Moreover, their patience will not always be rewarded, because, as dialysis patients know all too well, many of them will die before they receive a kidney.

And yet somehow, in spite of all the physical, emotional, social and economic costs incurred in living these lives of existential boredom and uncertainty, their authors must search, as humans always have, for meaning and purpose within that existence. That search can be lonely and demoralising. It would be less lonely, argue Moran et al, if the healthcare professionals most intimately involved in the care of dialysis patients—nurses—could be helped to remember this. It’s a reminder, a lesson, that everyone whose work takes them into contact with people living with chronic illness would benefit from, and especially, perhaps, those who have been working with patients for a long time.

Because, no matter how much any one individual might have understood about human suffering before he or she became a doctor or a nurse or a porter or a radiologist, it doesn’t take long before the conversations they have with patients are liberally spattered with the word “just”: “You just need a blood test/a colonoscopy/an MRI/a small operation”, “It’ll just be a little uncomfortable/a while until you feel better/a small disruption to your normal routine”, “I just need to ask you some questions/examine you/refer you/tell you something”. Except that for the …

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