by Brendan Stern

I felt that the biggest hurdle to this patient’s well being and health was her depression. She had a long list of serious medical problems, however sitting in on the consultation, it was her depression that seemed to be the overriding concern. It is difficult to say whether these medical problems caused her depression, but of course there are many people out there with the same conditions who cope and live fulfilling lives. For this reason, my creative piece is a reflection of the patients feeling of loneliness, worthlessness and sadness. Her inability to grasp simple dialogue between the GP and her husband was made obvious several times as she repeatedly said “you’re confusing me”.

As the consultation went on, she progressively deteriorated and eventually broke into tears. Watching the consultation was also very difficult on a personal level as it was distressing to see someone with so little self-belief. It reminded me of the intrinsic importance of the relationship[ between mind and body and how the two are so often related. It provided evidence for me that having a negative, defeatist perception of life can often lead to other problems which manifest themselves physically.

Initially my creative piece started out as a charcoal drawing from a life drawing class. I felt that this was a good starting-point as the position of the model was very closed and vulnerable. The model is almost hugging herself – and although the patient had a loving, protective husband, it still seemed from listening to the patient that she felt very lonely and so I felt that this imagery was well suited. The fact that the model is naked, with her head dropped low and clenched limbs represents her vulnerability, lack of self esteem and depression. I felt that the initial charcoal drawing worked well but needed some more depth to highlight other various features in the consultation. Therefore to allow me to work further on the piece, I photocopied the drawing, stuck it onto thick paper which I then was able to overlay with watercolour and oil pastels. I decided to keep using only black, white and grey tones as this reflected the loss of hope depression usually holds over individuals. The black background surrounding the woman centred in the middle of the page represents feelings of emptiness and isolation which the patient seemed to show at various stages during the consultation – sometimes looking vacantly at the wall for minutes on end. Finally, the chair which she sits on has been left bright white, highlighting how the people around her, such as the GP and her husband were acting together to try and help her. This contrast between the bright white of the chair and the dark grey and black tones of the woman and her surroundings is intended to reflect the patient’s lack of awareness of the level of support she has around her.

Brendan Stern, GP Attachment, 2011