I’ve taken the garden room into my heart.
The back room, unofficially titled the garden room. It is unwanted and unloved by the other doctors here. Situated unsociably away from the main consultation area, it began life as a hastily constructed after-thought. In an annexe off the far end of the patient waiting room, the room is disregarded as small and stifling, with its low ceiling, un-feng-shuied furniture arrangement, and the doctor’s chair abutting a door that doesn’t completely shut. Even when it did used to shut, the formica and plywood layers allowed confidential conversations to carry clearly through from the room to the unwitting public waiting outside, despite numerous attempts at DIY sound-proofing by the practice manager.
You learn to speak clearly but quietly in a room like this.
Being the newest, youngest, and above all temporary member of the medical team, it was an unspoken given that the senior doctors would get the “real” consultation rooms. Having already been warned of the temperature fluctuations, the strange layout and wide berth given to the room by all, the receptionists tried to soften the blow by ensuring my nameplate was ostensibly emblazoned on the formica door whenever I was at the practice. Perhaps they pitied me for the inevitability of my punishment. In the beginning, if by some crazy turn of luck one of the main consultation rooms was not to be inhabited by one of the seniors, they would break the news with rapturous smiles and expectations of the joy I would surely exhibit at the realisation that I did not have to spend the afternoon in the back room.
What they and the seniors, and I myself, didn’t expect was that I would come to love this little room. It’s not as if I don’t see its shortcomings. When TK, a GP trainee, entered to sit and eat lunch as we waited for a meeting with the practice manager, his evident distaste of the surroundings led to a list of unforgivable faults he had found with the room, on the one occasion he had found himself booked here (being only one rung up the food chain from myself). I could not deny the facts pointed out: the cramped space and extremely low ceiling leading to the air of claustrophobia, the shape of the room allowing only one way of arranging furniture. An occupied doctor’s chair means the room entry is blocked, and there is no chance of spinning on the high-backed leather chair- denying a fundamental, hard-earned privilege of a GP. There is, literally, extremely little room for manoeuvre when patients enter or leave, only marginally improved by the doctor getting out of the chair each time and trying to jam it in as much as possible under the large desk. The saturated lemon yellow walls and harsh fluorescent tube lighting close down the room even further, whilst the room heat conservation dynamics mean that if the portable electric heater is not turned on, patients sit with their teeth chattering, and if it is turned on, within minutes the room is so warm that entrants are greeted with a blast of hot, dry air and have even complained of being faint and dizzy as consultations progress.
In the eyes of the practice, this room is the pariah of the building. But we fit. Both newcomers to the establishment, I identify with its awkwardness. I recognise its quiet beauty on the hazy winter afternoons when the late sunlight unabashedly floods the room past the blinds and gives life through rich, golden verticals to the yellow walls. I’ve found peace in the afternoon silence, and the hypnotic sound of soft rain against the semi-opaque window, giving hint of green garden beyond. The cramped conditions, nevertheless has given me enough space to spread out an impromptu prayer mat consisting of a cut from the disposable tissue covering the rickety examination bed, and in turn allowing me to give thanks for the peace in that moment of isolation.
Its dimensions have even had an impact on my professional practice. Whilst other doctors call through patients over the mechanical tannoy, for me a necessity has become a habit, where I step out of the garden room, call patients from the door and watch as they get up and make their way towards me. In doing so, not only am I able to greet them with a smile and an invitation to the consultation, but it also allows me to make observations on non-verbal cues that might not necessarily be possible when the “actual consultation” begins- the way they stand up, the way they walk through, facial expressions and eye contact- a whole host of information can be gleamed before they even enter the garden room and the “patient mask” slips down into place.
Patients frequently initiate a quick exchange about the garden room quirkiness. My apology-tinged humourous replies often sets patient defences at least a notch lower than their initial level, allowing rapport to form and a consultation to begin with that person sensing an equality in our interactions as a doctor and patient. Whilst this can be a problem in certain consultations where a more paternalistic approach is required, in the overwhelming majority I find this approach to be beneficial both for myself and for patients, and my preferred method of consultation.
In this room I’ve been witness to so much joy, fear, hope, shame, elation, desolation- the extent of the human condition, and its inherent fragility has been the background for my intellectual and emotional turmoil and development. It has been the first time since I graduated, that I’ve felt the layers of detached cynicisim regarding people and medicine slide off me, instead of accumulating. I’m closer to practicing the core values and principles of this vocation than I ever could be whilst navigating the politics and crass bureaucracy of hospital medicine. It has been, and continues to be, an absolute privilege for me.
So, after all that, how could the garden room not occupy a special place in my heart?
