Dissecting the Day: What I Almost Carried That Was Never Mine
Not everything you feel belongs to you…
There are days in clinic that are not clinically difficult,
but leave a residue.
Not because of the patients.
But because of what surrounds them.
Recently, I encountered a series of cases that, on the surface, were straightforward.
Viral conjunctivitis being escalated into admission.
A corneal abrasion framed as a potential threat to vision.
A patient appropriately referred for eczema herpeticum, yet with an expectation that something needed to be prescribed.
None of these required aggressive intervention.
All of them required clarity.
And yet, what surrounded them was something else entirely:
urgency without stratification,
intervention without indication,
fear without proportion.
The Subtle Pressure to Escalate
There is a quiet pressure in medicine that is rarely named.
It sounds like:
“What if it gets worse?”
“Better to be safe than sorry.”
“If you don’t do this, don’t blame me.”
On the surface, it looks like care.
But sometimes it reflects discomfort with uncertainty,
a need to act,
and an inability to sit with proportion.
When this pressure builds, escalation becomes the default.
Admission. Medication. Urgency.
Even when not clinically required.
When Intervention Exceeds Indication
Patients may not understand the clinical details of their condition.
But they understand something deeper.
When the level of concern exceeds the level of disease,
they feel it.
It comes out as questions:
“Is it serious?”
“Do I really need this?”
“I feel something is off.”
This is not always about mistrust.
It is often about incongruence.
The Other Side of Practice
My approach has always been simple.
Treat based on indication.
Match intervention to risk.
Do not amplify fear to drive compliance.
Viral conjunctivitis is managed outpatient.
A corneal abrasion heals.
Not every red eye is an emergency.
And sometimes, the most appropriate prescription is
reassurance,
time,
and clear explanation.
The Moment That Changed the Day
After all of this, I noticed something in myself.
Not just frustration.
Something heavier.
I realised that I felt embarrassed to be associated with this.
When I paused with that feeling, something became clear.
It was not just frustration.
It was shame.
Naming What Was Never Mine
Not shame from wrongdoing.
But shame from association.
A quiet internal response that said:
“I don’t want to be part of this.”
And the moment it was named, it shifted.
Because I could see clearly:
I am not the system.
I am not those choices.
I am not that way of practicing.
Returning to Clarity
Nothing changed externally.
The system remained what it is.
But internally, something settled.
There was no need to correct or to resist.
Only a quiet return to a simple truth:
I do not need to carry what I do not practice.
The Sovereign Eye
To see clearly is not just about the eye.
It is about seeing through urgency into indication.
Seeing through fear into proportion.
Seeing through reaction into truth.
And sometimes, it is about seeing within
what we have been carrying
that was never ours to hold.
On that day, the clinical decisions were straightforward.
The real work was this:
letting go of shame,
and returning to clarity.
