Larysa came to the Forpost HELP Mental Health and Trauma Therapy Centre to seek help. The woman is undergoing long-term treatment in one of the hospitals in Dnipro city. She visited a psychotherapist after experiencing humiliation and irresponsibility of medical workers. And it is not even about demanding money. Larysa shared her story, hoping that something could be changed for the better by drawing attention to this problem.

Hospital Ukraine“I got my cancer diagnosis in September 2018. The tumor was very active. It grew significantly in two weeks. Imagine that it turned from a penny into a huge chicken foot. At that moment, I noticed the doctor’s sympathy and desire to help. As it turned out, such surgery operations are rarely performed, so I was a kind of ‘guinea pig.’ The shock came when I got to another place, completely immersed in the world of oncology. In another hospital, I fully felt that we were treated like outcasts or biological waste. How did it manifest? I constantly heard such phrases as ‘Go where you are told, do not ask about anything, do not bother anyone, all that interests you is your problems, look for the necessary information yourself.’ I did not understand my rights, opportunities; we were all actually trained in this way. They behaved this way not only with me, all my ‘companions in misfortune’ spoke about it.

I understand that doctors face professional burnout and build psychological protection around themselves because they see such a large number of patients every day. But, for example, junior nurses show a semi-boorish, arrogant attitude. We started to get nervous, when we saw the nurse who would perform the procedure. People tried to mitigate the situation presenting gifts, giving attention, or paying for services. But her attitude towards us did not improve. The system of using cancer patients in Ukraine has been created for years. And doctors are, as it were, ‘frozen,’ without human emotions. Patients visiting doctors would like to understand what is happening to them because it means a lot for further treatment. Instead, you see the doctor treating you indifferently, and you read so much contradictory information on the Internet. For example, my family doctor claims that vitamins should not be injected into cancer patients, as they cause tumor growth. And my oncologist says that I should do as I see fit. I asked him about this 10 times but did not receive a specific answer. And there are many such questions.

After one episode, I plunged into severe depression, although I was strong and followed all medical prescriptions for more than a year. I had many digestive organs removed. When some inexplicable exacerbations began and the situation deteriorated sharply, I went to see my gastroenterologist. I asked her which diet to choose, what painkillers or enzymes to take. She acted as if I had chronic syphilis and could infect her. She did not advise anything, while demonstrating disgust. It was so frustrating that I almost broke down. In addition, I had problems with blood pressure, sugar, and gag reflexes. I gave up in despair. After that, I had to seek psychological help. I am a strong person and I did not think I could break down like that. I will not visit this doctor again, although she is an excellent specialist. I will visit someone who may not be an expert but is humane.”

Svitlana Doroshenko, a psychotherapist at the Forpost HELP Mental Health and Trauma Therapy Centre, commented on the problem of professional burnout of health workers.

“Patient’s suffering from the treatment process should not be more severe than the disease itself. The profession of a doctor, in addition to knowledge and experience, requires the ability to empathise. You can know everything about the disease and how to treat it, but the effectiveness of treatment will depend on your attitude to a patient. If a doctor is able to sympathise with patients, can provide them with emotional and informational support, then the patients begin to trust, feeling safe and this is very important for healing. We know many stories about doctors who, thanks to their support, help seemingly hopeless patients get over their illness. When a person feels safe, secure, then the neural networks in the brain promote healing. Sometimes it is better not to go to doctors who are gurus in their field but to choose those with whom there is emotional contact and trust. A doctor is still not obliged to perform the functions of a psychologist, except for a main task – to treat. A doctor does not have specific knowledge and skills, so it is unfair to demand this. Therefore, the ideal scenario is when a humane relationship is established between a doctor and a patient.

The flip side of such involvement and dedication of a specialist, combined with a heavy workload, is emotional burnout and professional deformation. If a doctor has to deal with seriously ill patients, see a lot of suffering every day, then a syndrome called compassion fatigue appears. It is even worse than burnout. Emotional burnout can be dealt with by resting and filling your life with various important things besides work. And this syndrome is still little studied. We see what is happening to the volunteers who went through a lot of suffering in 2014-2015 [start of the armed hostilities in eastern Ukraine]. Some of them broke down and even died or became very reserved and detached.

What solution can help? Be sure to take care of yourself in various ways, including self-regulation and self-renewal. Different people find help in different things. For example, it is enough for someone to do some physical exercises. But we must take care not only of our body but also of our mental condition. If to ignore it, a nervous breakdown and professional deformation are possible. It all starts with cynicism and can end in chronic illnesses like depression. Therefore, a health worker can consult a psychologist as well as a cancer patient, Larysa.”

Oksana Konovets, NGO Forpost , Dnipro

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