Perspective. It’s a fascinating concept, any way you look at it.

job_interviewThe story sounded familiar, uncannily familiar. It had been a long day of interviewing applicants for GP training and the answers being given were having an increasingly ‘I’ve-heard-this-all-before’ flavour, but I’d definitely heard this particular example earlier in the day.

Both applicants described a specific hospital-based incident in which a lack of teamwork almost resulted in patient harm. The details were identical, until it came to the story’s climax.

Each applicant clearly and convincingly described how he unilaterally saved the day, despite being hampered by his colleague’s incompetence. I have no idea whose version of events was accurate. Maybe one (or perhaps both) was deliberately trying to mislead, but I got the impression each genuinely believed what he was saying.

Perspective. It’s a fascinating concept, any way you look at it.

I’m sure we’ve all had the experience of hearing two somewhat conflicting sides of a patient’s story, usually from different family members. They’re generally not too difficult to reconcile and/or the differences are inconsequential, but occasionally they throw up a real challenge.

I had an elderly patient with advanced dementia, who was cared for full-time by her daughter. Everything seemed to be rolling along happily enough until the other daughter visited from interstate. There were the usual familial disagreements about what should happen to Mum, but in this case the second daughter came to me with some pretty serious allegations of elder abuse.

The son, with a third version of events, got involved, as did a neighbour, whose story conflicted with everyone else’s. The relevant authority dipped its toe in and then hastily withdrew it, claiming there was “no clear case”. It was right — the case was anything but clear.

As it happened, in the midst of the bickering, claims and counter-claims, the matriarch at the centre of the drama conveniently brought the matter to a close by getting pneumonia and slipping away quietly and quickly in hospital.

Blessedly, she was without any significant assets for her offspring to contest, and they were civilised enough to not involve any lawyers in the division of her crocheted tea-cosy collection.

In my own family, differences in perspective are fodder for amusement rather than Grand Canyon-scale rifts. My 92-year-old paternal grandmother has always been a stoic, capable woman with a make-the-best-of-a-bad-situation attitude.

Over the years, the rose-coloured tint in her recollections has intensified to more resemble a bright scarlet, and her remembered role in past events has her firmly ensconced in the driver’s seat. Now in her twilight years, she happily sits with her increasingly positive memories and regales her fellow aged-care residents with her achievements (over and over again!), feeling progressively surer that she has lived the best and most heroic life possible. That some of her stories bear little relation to the facts as remembered by other family members is of no consequence.

Mind you, these ‘facts’ are all a bit wobbly anyway. My father is always right (according to him), my mother remembers the emotions attached with great clarity (but not always the event specifics), and my brother claims to have forgotten almost everything that happened to him before the age of 18.

And me? Born with the Pollyanna gene, I’m probably more like my grandmother than I care to admit. I’m certainly not at the believing-black-is-white stage yet, but I would quite like to be by the time I reach my 90s.

It strikes me as quite a pleasant way to see out my days: a legend in my own lunchbox, utterly convinced that my life has been near-perfect.

First Published in Australian Doctor on 30th August, 2013 On Perspective

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