'The patient may appear well' - Amy's Story
by Madeline Dann

Tags: multimedia - film - under_the_skin - various - general practice/psychiatry - psychiatry and ethics - Self-harm -

To suffer so greatly in so many different ways, and to not know the root cause, but to still carry on takes a certain type of person. Through my film I hope to communicate aptly the story of Amy* and the invaluable lessons I have learnt from her.

My title The patient may appear well is a direct quote from Amy herself, she spoke to me about how important that phrase was to her upon her diagnosis of fibromyalgia, which explained some, but not all of her pain. It was her tool for explaining to her friends and family and rebuilding the bridges between them.

The first scene shows a bloodied razor, I used this to show the problems Amy had with self-harm after the suicide of a close relative. Following this the razor is seen to drown in water, this depicts the turbulent experiences that Amy had, but also her moving on from self-harm as the blood is seen to be washed from the razor. I learnt from this that self-harm is something that can be overcome with the right help.

After being discharged three years ago from hospital due to a lung condition Amy has suffered from a recurrent, undiagnosed pain in her chest and many of her friends and family do not believe that her symptoms are real. I used a bandage to cover my models face (who acts as Amys friend) as this relates to how it has blinded Amys friends to her real suffering as they cannot put a label on it. I also painted the words BELIEVE ME on to precede the above scene, and further emphasise Amys need to be believed.

My final scene shows a question mark painted on skin, I used this image to portray the confusion of having no diagnosis, the chains wrapping around my model show the effect of the debilitating physical symptoms she puts up with, which are trapping her inside her own body. The drawing of the chains becomes more and more erratic to show how the longer Amy goes without a diagnosis the worse and worse her confusion and inevitably her quality of life becomes.

I have two artistic themes running throughout. The first being that all pictures were taken with the background of a bathroom, as it portrays a cold, clinical and unwelcoming place, something I believe Amys life once was. The second theme is the few out of focus photos, which portrays her struggles with the stigma surrounding her lack of diagnosis, which blurs her perceptions of real life. This also represents the trouble she has with communication between health professionals.

I have learnt from Amy, amongst other lessons, that communication is vital in healthcare, as it shows respect and attentiveness for the patient through their illness. Good communication is vital to ensure that the care given to the patient is the best care possible. After all, in the future as a practicing Doctor, this is what I will now strive to do.

*The patients name has been changed to preserve confidentiality and she has consented to the use of her story as a basis to this creative piece after reading the explanatory letter.

Madeline Dann, GP Attachment, 2013


Niharika Singh

28 October 2017 - 20:12:01
"This is a very informative piece of work and the film was very concise but effective and also quite emotional. For Amy to not have a diagnosis and not be believed about her pain must have been terrible for her and I think that was captured well with the bandage saying 'Believe me'. Overall a very hard hitting and well executed film and message."

May de la Rue

28 October 2017 - 23:57:29
"This film is a great reminder that just because a patient does not have a diagnosis does not mean that they are not suffering. Amy's feelings are very cleverly portrayed in this thought-provoking film. "

Liam Carty-Howe

29 October 2017 - 22:53:28
"Madeline has taken two complex topics, self harm and lack of diagnosis, and expressed the effects they can have on a patient in a unique and imaginative fashion. The shocking opening scene of a bloody razor juxtaposed with a clean clinical background immediately informs the audience of not only Amy's suffering from the suicide attempt of a family member but also of the suffering her condition and the lack of a diagnosis had upon her. Madeline later uses a bandage and chains in an innovative way to represent how Amy's friends were blinded to the extent and reality of her pain as well as the trapping and isolating effect this had on Amy herself. Amy's choice of media (short film produced from a burst of still shots) perhaps represents how we as an audience of friends and clinicians of patients can only ever see small amounts of peoples suffering, snapshots of their pain, but that does not make it any less real. "