Irregular time off

by Khadija Sesay

Blood tests
Blood tests
Atrial fibrilation
Just not pumping right

How did I do this to myself?
Too many pints
The smell of some fresh lager
Alcohol only affects the liver
Moments at the pub with the boys
But the pills and pints might kill me?
My heart or my happiness?
The smell of some fresh lager

Staring at the walls
The world keeps moving,
But I have come to a stop.
Never going back
The thoughts never stop
Feeling dizzy
Trying to understand

Nights mold into days
Days mold into nights
Continuous thoughts
just want to know why!

My Irregular Heart is still beating
All it needs is some treating
So I will not stop living
The idea is unforgiving
Get on with life, take it as it comes
I will not be controlled by the illness
I will not succumb

If it kills me it kills me.


John was the first patient I saw on a home visit, on the first day of my GP placement. The idea of going to a strangers house frightened and excited me at the same time. The GP had told us John* had a condition called atrial fibrillation, which is characterized by an irregular heartbeat. I was therefore expecting someone who would be feeling unwell and drained by his condition. I instead met a strong man who refused to allow his condition to take over his life.

John explained that upon being diagnosed with atrial fibrillation, he took about two weeks off work to get his head around the diagnosis and the implications it would have on his lifestyle. He recalled sitting by himself in his home and wondering what could have caused his irregular heart beat. He expressed feeling guilty that his condition was his fault, and took measures to be healthier such as drinking lots of fruit juice. He then explained that this did not in fact make him feel better but made him feel worse because the excessive sugar in the fruit juices caused him to gain weight. Hearing this, I felt sympathy for John. It seemed like he was trying so hard to make himself better, but was instead just making himself feel worse. I can only imagine how frustrating it must be to think that your best effort is not enough.

Another important aspect of John's life that made his condition particularly difficult was his social dynamic. A big part of John's life was going to the pub with his friends from work. His work colleagues are his support unit, especially because he lives alone. Unfortunately, John was taking medication to treat his atrial fibrulation, which was not compatible with alcohol. He therefore had to make several adjustments to the way he lived his life and the amount he could drink at the pub. Hearing about this made me try to imagine how I would have felt if I was in John's position and had to change many of the things in my life that were both important to me and brought joy to my life. It almost seemed as though he was being forced to choose between his happiness and his health, which felt unfair. I admired how he handled with dilemma with such bravery.

The aspect of my home visit with John which captured my attention the most were his emotions and thoughts during the time he took off work after his diagnosis. I chose to capture this in a poem using the stream of consciousness technique, which is characterized by lacking coherence, as it tries to mirror someone's train of thought. The title of the poem is Irregular time off, firstly because of John's irregular heart beat and also the fact that although he had time off work, he still had so much to think about, making it quite irregular. Because I wanted to illustrate John's initial confusion when trying to understand his diagnosis, the beginning of poem lacks structure and is quite confusing. I imagine the audience would react to the initial part of the poem as an almost incoherent foreign language, and they might even get frustrated at the lack of sense. This is analogous to how I imagine John felt when he received his diagnosis. The end of the poem flows a lot more than the beginning, and rhymes unlike the beginning. I would expect the audience to feel more relaxed during this part of the poem. This is also analogous to how I imagine how John may have felt after coming to terms with his condition.

During the home visit with John, he shared so much about everything from his personal emotions when dealing with his diagnosis to the way he felt about his relationship with doctors. I realised that while we had just over one hour to talk to John, his consultation with the GP would have been so much shorter, and he may not have been able to express all those emotions inside of him. This made me wonder how I will deal with the fact that as a doctor, I may never have enough time to fully understand the patient, and the short encounter with them would only be a fragment of time in their reality.

Khadija Sesay, GP Attachment, 2013

*The patient has consented to the use of their story as a basis of this creative piece, their name has also been changed to preserve confidentiality.