This pain inside where no one can see is slowly killing me
This torture inside, hidden is ripping me apart
These thoughts inside are haunting me
So dark it hurts so badly
No one understands what it’s like
Waking up every morning wishing you didn’t
I want this to be over. I want the pain to end
What I would give, just to sleep and never wake up.
Unknown
THE BROKEN ONE
This poem is a mere representation of one of my encounters in a clinical block. The first day of my clinical block I was given a 21 year old male patient with RDV(+) and TB. When I first talked to him, I introduced myself as a physiotherapy student and he seemed quite keen on receiving treatment. That day I only assessed him and told him that we would start with the exercises the next day. When I went to see him the next day he was not keen at all, I tried all I could to convince him and tell him about the benefits of physiotherapy but that did not make a difference. For three consecutive days I would go beg him to allow me to treat him but I always failed to convince him. At this point I was really getting annoyed and irritated with him because I felt as if I was wasting my time. One afternoon I heard him talking to a psychologist and that is when I actually realized that he did was not giving me attitude but rather he was devastated after finding out about his status and that affected him psychologically.
In this poem the person talks about a pain he feels inside that no one else can see, the pain is slowly killing him inside day by day and no one notices. When the patient was talking to a psychologist he told her that he felt that no one understood him even at home, his family would fuss about him having to eat and not stay in bed all day. When he was in hospital nurses fed him pills and food, doctors would listen to his chest and draw blood from him and physiotherapists want him to get out of bed and walk. As I stood there listening I felt that he was trying to say that no one really asks him how he feels inside, everyone was just concerned with his physical well being. After all he is only 21 years old and he has TB and RVD, to him that only means one thing: his life is completely over.
Even though I was empathetic towards him but I still had to treat him because that would help him get stronger and better. At this point my clinician had already advised me to explain to him the benefits of treatment and the consequences of not receiving physiotherapy treatment to him once again for the last time and if he still refuses I would then have to discharge him from physiotherapy and he would have to sign that he understands everything that I had told him but is still refusing. Now I was battling with my thoughts. Should I make him sign and discharge him from physiotherapy or do I continue seeing him and trying to convince him to allow me to treat him as this would be beneficial for him and his well being?
Empathy is defined as, “the ability to understand and share the feelings of another.” It is the capacity to put one’s self in another’s shoes and feel what that person is going through and share their emotions and feelings. It is the recognition and validation of a patient’s fear, anxiety, pain, and worry. It is the ability to understand patients’ feelings and facilitate a more accurate diagnoses andh more caring treatment. (Mendez et al,2016) As health professionals when we see a patient we always ask how they are doing, with that question we expect them to tell us whether they are feeling pain and discomfort or not. We are not really concerned about their psychological state. Often times when we deal with our patients we use the detached concern approach, where we are concerned about our patients but we do not want to get emotionally involved. At times this may seem like the best approach as it is crucial in diagnosing and treating patients, and also as being too much emotionally involved can disrupt our thinking and affect the way we treat the patients furthermore it may lead to compassion fatigue. Dr. Charles Figley (2017), defined compassion fatigue as an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper
But using a different approach, one which gives empathy a significant role can be very helpful. Expressing empathy is highly effective and powerful this helps in building patient trust, calms anxiety, and improves health outcomes. Therefore it is of great importance that to a degree, health professionals welcome feeling the suffering of their patients (Austin, 2019). Being emotionally impacted by them, by their fear or helplessness, can be helpful. For example, it can generate trust in the patient. If a patient sees that I care for him/her they are more likely to trust me. And a patient that trusts his therapist is more likely to follow her advice and plans for treatment. when we suffer along with the patient, the patient is much less likely to feel abandoned and alone. Although it is paramount for health professionals to show empathy towards their patients that should not cloud their judgement, patients are often very manipulative and they sometimes use pain as an excuse not to receive treatment, therefore in showing empathy we should not lose sight of the fact that treatment is of great importance as it ensures that the person gets their independence back or at least gets them close to their baseline.

REFERENCES
o Dr Charles Figley, (2017). Compassion Fatigue awareness programme, Where Healing Begins. New Orleans, LA. Tulane University
o Austin. M. (2019). Empathy in Health Care, Why empathy in the doctor-patient relationship is better for everyone?. Psychology Today
o Menendez M, et al. (2016). Paper #195. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla. Retrieved from https://www.healio.com/orthopedics/business-of-orthopedics/news/online/%7B64ba2499-bd0c-496d-9fad-c213f998a226%7D/study-finds-physician-empathy-strongest-driver-of-patient-satisfaction