There's a reason I'm not a poet

Posts tagged ‘physician heal thy self’

Coming soon to a hospital near you

Happy New Year folks! And next weekend, gōngxǐfācái!

Since coming back home I’ve been trying to earn some money to pay off the lovely debts that China has left me with, and so I’ve been doing a bunch of locum shifts in a few different locations. Around Christmas, I was back in haematology (where I was about a year ago), and I’m doing a few shifts in my FY1 hospital as well as a semi-regular job in one of the hospices. I’ve been describing a “locum doctor” as the medical equivalent of a substitute teacher, only thankfully without the abuse that a bunch of them seem to get from their students. ..For the most part.

I’ve actually enjoyed being back in some of my old wards, and I’ve been touched that people recognise me and are happy to see me. I’ve also been touched by one nurse in particular who felt that a hug wasn’t a good enough hello and decided that stroking my face repeatedly was more appropriate.

But it has been nice. Moving around a lot in your jobs can make you seem like you’re just another number, but it’s a good feeling when people not only remember your face but your name, and are pleased to see you. And it’s rewarding to know that my efforts going into being “a good team member” didn’t all go to waste.

I’m currently applying for more long term posts though. The ultimate goal is to become a consultant (ideally in some form of oncology) but the next step on that path is to get out of locum work and back onto a training programme, new posts for which are filled every August. So next Wednesday I’ve got an interview for Core Medical Training, where I’ll be asked by a couple of consultants what exactly I was doing in China and how ingesting a large number of carbs makes me a better doctor. Still working on my answer to that one.

Until then I’m looking for a more regular locum job so that I don’t have to worry about where I’m working next month, and so I can plan things slash work through my millions of lists of gigs and photography classes and NI Science Festival events that I want to sign up for. So we’ll see what turns up.

A slightly more bloody fricking exciting and awesome development in my life is the expectant arrival of a new niece and/or nephew! My sister tells me it’s not twins if Friends has taught me anything it’s that you never know. I’m really looking forward to greeting the new arrival, and my sister will be the first in this generation to have a child, so we’re probably all going to descend on little Norbert/Brenda/Quentin/Alexis with our various sailor suits, sheep skulls, sk8rboi shoes and other things we thought were good ideas when we were kids.

God help them.

M

The early bird catches the dole

My first two years of work are now finished- I’ve completed foundation training! I managed to get past my general incompetence, various hoop-jumping assessments and dramatic shit-storms in the middle of the night. I feel like I’ve progressed a fair amount as a doctor in this time, as is to be expected. I’ve tried to focus on my learning and tried to keep good principles in the back of my mind as I practise, and obviously I’m still an inexperienced junior doctor making mistakes but I’m happy with where I am clinically at this point in my career.

Thinking about the future, I’m leaning much more towards oncology as a future speciality. I’d thought about it during medical school although only had a fortnight of experience in the field. So,  I chose my foundation year rotation with the A&E/Oncology combo that I got during F2. And it proved to be something I really enjoyed, and something I seemed to be reasonably good at. The four months have given me good opportunities to not only increase my clinical experience in the area, but also to get a few whistles and/or bells to add to my CV. Nothing overly fantastic, but something to promote myself with in an interview.

As for the more immediate future, I’ve decided to take a move that doesn’t advance my career objectives: I’ve now joined the glorious ranks of the unemployed! The plan to go to China has been something running through my head for a couple of years now, and never quite come to fruition. So last Autumn when the decision of whether or not to apply for a job never year arrived, I decided to not even look at the Core Medicine application system. That way I wouldn’t panic-apply and end up not doing what I’ve been wanting to do. So until I head off in nine days time I’m enjoying being a lazy gobshite and doing sweet eff all!

Holidays don’t come easily in medicine, and with my last job (due to severe staff shortages) any time off came with a nagging feeling of guilt over leaving the rest of my colleagues to deal with the added stress that one-less-person-in-work resulted in. So now I’m taking this opportunity to relax, be happy, and enjoy the fact that for this brief period of my life I have much fewer things to worry about.

Instead, my focus is on What Happened To Barb and where in Belfast are the best locations to catch Pokémon. Jeremy Kyle and Jeremy Hunt can both kiss my ass- this is great.

M

Business Talk

Bit of a catch-up post here, as I sit in my on-call room during my night shift. This new haematology job is clearly very stressful.

That’s right, I’ve finished my rotation in A&E. Seen about 600-700 patients, witnessing gunshot wounds, major incident trauma teams, things I thought I’d only ever read about in textbooks, and assessing plenty of drunk/crazy/unlucky/heartbreaking (delete as appropriate) people throughout the four months.

While it’s not something I want to do as a career, it really was a great fun rotation. It was exciting, always interesting and once I got past (some of) the blinding fear of people threatening to drop dead on you, it was good fun. The nurses and doctors worked as more of a team than I’ve seen before, and the sense of camaraderie was brilliant. I ended up going on two staff nights out, and seeing consultants break dancing and nurses winning dance competitions is something I won’t soon forget.

But all things must pass. And thankfully that includes the 2 out of 3 weekends rota. That’s right ladies and gentlemen- I have a life again. I’ve moved to the regional centre for haematology (lymphoma, leukaemia and haemophilia are the patients) and I think it will be a good job. At the start it was obviously daunting, what with not knowing what the acronyms mean/where the wards with your 22 patients are/what your consultant said their name was again. But I think I’ll get there.

The main downside of the job is that unlike as a consultant in clinic, the majority of people I see aren’t the success stories of Disease-Free for ten years, it’s the heartbreaking ones who just want to get better enough to be home in time for Christmas. But in many cases that’s not feasible. So there will be a few less-than-cheery times ahead. One of the paths I’m thinking of is cancer care, so these few months will be quite useful in seeing if it’s something I’m interested in/able to deal with.

Right, I’m off to either do some work or catch some sleep. My nights so far have been surprisingly calm, so I figure make the most of any sleep opportunities while I can!

M

What is your emergency?

So I’ve moved on from my FY1 year and have been working in A&E for the past month now, and I think my experience so far can roughly be imagined by the fact that I’ve had three whole days off in that month. That includes weekends by the way.

In a word? Relentless.

Part of me is a little sad that I was off last weekend, because the whole “I’ve had one day off so far” was such a badge of pride at week three. But the majority of me is quite happy with the fact that I actually got some me-time.

The thing is though, that while I’m working essentially every day, the shifts aren’t that long: say like a 8-4:30, or 11-7, or 4-12. So you often get either the whole morning off or else the evening, and so I’ve actually been able to make a fair amount of plans over the past while, which has been nice. In my previous jobs I had days that were much longer, and so committing to things was harder in a different way.

I have been enjoying A&E, and I think over the four months I will have certainly learnt a lot. The place I’m working in just opened up a new A&E department, and man is it shiny. So it’s a nice place to work in. On a good day, you’re enthused by the variety of things you’re presented with, by the enthusiasm and hard graft of the people you’re working alongside, and by the hilarious people that come through the door (intentionally or otherwise).

On a bad day, you’re overrun by swarms of people coming through the door, you’re filled with blind fear and your mind is thinking “oh pants I have no idea what’s going on with this person and I’m too young for this crap and I can’t decide if they’re going to drop dead if I let them walk out the door or if they’re just a bit drunk/weird/insane” (delete as appropriate).

But I’m getting there. Getting a bit more confident with dealing with diagnostic uncertainty, with judging levels of safety, and assessing what the person actually wants you to do for them today. And there’s time for improvement. So obviously by the end of the four months I’ll be an absolute boss at everything. Obviously.

In other news I’ve moved out of my house and am currently back at home while we look for a new place to rent. Turns out it’s pretty difficult in Belfast to find somewhere suitable, but we’re making some progress with a place now and it should hopefully work out. I’ll also be starting up Chinese lessons again later this month- custard bun 4lyf

M

And on the ninth day..

I’ve just finished an eight day stretch playing the role of the “surgeon of the week”- which basically means going round all the patients that have been admitted under the ’emergency’ team, ie all the people who have come through the doors and haven’t been labelled to be under a specific team like urology, ENT or vascular surgery.

And it was a very busy week. I think the take was busier than it normally is, because the wards were all pretty full and the ward rounds were going on a good hour-and-a-half longer than they normally would. Which meant at times it was pretty stressful, and I was having to work pretty hard the whole time. There were also a few patients that got pretty sick in quite dramatic ways.

That all being said, I actually really enjoyed it. I felt like I was properly doing the job I signed up to do, and I think I was doing a good job at it too. I tried my best to be organised, walking around with my clipboard and lists of patients and rapidly burning through the ink in my pen. At times your efforts are in vain, but that’s life, and that’s the NHS. The sick patients got better, and part of that was down to me being the one working out correctly what was wrong with them- which was a pretty good feeling.

Sadly there were a few days that were just incredibly busy, staying several hours later than I would have liked, being late for social events and missing my Chinese lesson, but again that comes with the territory so I’ve gotta just man up and get on with my life.

Man was I ready for this weekend though. Getting up shortly after six and not getting to sleep until 11 or 12 for over a week really takes it out of you. My plan had been to get stuff done today but I’ve spent most of my time stuffing my face and watching Game of Thrones. AND IT’S BEEN GLORIOUS

I’ll have another post coming up soon I think. Til then: tatty-bye

M

On how life is

So it’s been a long while since I’ve posted on here. Sorry, to my many thousands of adoring fans. Maaaaaay be a bit of a mammoth post.

I don’t think I’ve actually blogged since starting work, so I guess that’s one major thing to talk about! It’s been a long time coming obviously, and despite all the years of thinking ahead to how it was going to, there are ways in which it’s not what I expected it to be. I was fully aware of the fact that as an FY1 you’re not often the person who gets to make all the decisions, and that essentially for a lot of the time you’re a secretary with a medical degree. And that view has kinda panned out to be true: a fair amount of my time is spent doing paperwork. Which is fine, but one thing I didn’t expect that in the hospital I’m in it isn’t really the norm for the medical FY1s to go on the ward rounds and see the patients. Which kinda meant that for the first while my only patient interaction was when taking blood; I wasn’t seeing any kind of clinical decision making, never mind doing any for myself. And this annoyed me if I’m honest as it massively limits your scope for actually learning anything.

Thankfully, they changed the system of how things work in the hospital shortly after I started, and I spoke to a few of the other doctors on my ward about me getting a bit more involved in the ward rounds. As a result of this I’ve managed to get on the ward rounds virtually every day and so am learning a lot more than beforehand which is good!

The ward I’m based on is filled with some really friendly people, which makes a massive difference to the old happiness levels. People in NI anyway are a bit warmer to strangers than in England, but I think on top of that the atmosphere in the hospital/ward is quite an encouraging and welcoming one, so I’ve been quite content.

The bit that’s not being going so well so far is the flipping practical skills. I knew as a medical student that when I started work the thing I would struggle with is putting needles in. It’s something I’ve never been overly happy with how good I am, and despite practice I seemed to improve but never quite be where I wanted to be. Sadly I’m still not there yet. It’s a little bit frustrating because it means that if there’s a list of things to get through, I’m slowed down massively by something that other people could do in five minutes or so, and so it hampers my ability to get other stuff done.

Oh well.

On a different note I’m really enjoying generally being back in Northern Ireland, and I think it was the right thing to do. I’ve been able to see my family much more often than I have previously, and the amount of effort to do it is a million times less! Having a group of friends that are ready-made has also been a god-send, because making plans is so much easier. You can come back from work and go to the cinema/pub/dinner/Matilda night or else have something fun lined up for the weekend with minimal effort, and the medicine chat stays where it belongs: in the hospital! For example, yesterday we went on a Game of Thrones location bus tour, travelling to some of the places where scenes from the TV show have been filmed (I wouldn’t know as I’ve only really read the books)- apart from being accosted by a French TV crew it was great fun.

Oh and before I forget- the last Reason To Be Happy: MY INCOME. While it’s not astronomical it certainly feels like it as it’s more than enough to do me! I still have an awful lot of debts to pay back but it’s just great to not have to worry quite so much about every pound that you spend and being able to eat what you want rather than what’s cheapest. So yeah, smiles all round!

M

I ain’t sayin I’m a gold digger

As the saying goes, money makes the world go round. As a student then, my world tends to find spinning really difficult. In my last few years of medical school, the student loan people decided what would be really fun would be to decrease my income by a third. Thankfully my parents have been amazing and have helped me through any difficult times I’ve had, as they’ve done so the whole way through my degree.

What also helps is the fact that I’m phenomenally cheap. I’m a big fan of Sainsbury’s basics pasta, and firmly believe that pasta and sauce from a jar forms a great basis of a well-balanced diet. Who needs meat or vegetables anyway. This has meant I’ve managed to reach final year without actually touching my student overdraft- a feat I’m pretty proud of, considering some people max it out in about a month of starting university.

But inevitably, fun things happen and you want to go to them, or friends want to celebrate being born, or a new Chinese restaurant opens up and is serving dumplings and it’s the best place in the whole world and the food tastes like heaven (if heaven were made out of soy sauce that is). So over the past few years I’ve come up with a good solution to help find more money: selling my body to science. A university is a great place for research to be taking place, and so all you have to do is know the places to look for researchers searching for “Healthy non-smoking males aged 18-25”

The studies I’ve done have ranged from the tedious (questionnaires on impulsivity), the cushy (having my brainwaves measured while I fall asleep in a soundproof room) to the downright bizarre (having my reaction time measured when I see photos of people holding up poo-stained underwear). Yes, that last one was real. There have also been a few great ones where people are running training courses for doctors and are looking for volunteers to act as patients or models of ‘healthy anatomy’.

Over the years then I’ve just about every investigation under the sun, whether it’s 24 hour ECGs, a DEXA scan, ultrasound scans of my abdomen/heart/lungs/arms/legs/neck, an EEG, blood tests for just about everything and 24 hour urine collection (that last one was fun). It’s a hypochondriac’s dream really. The only one I have left to tick off is an MRI of my brain- being left-handed, I’m often excluded from these studies as my brain might be “the wrong way round”. But I’m comforted by the knowledge that everything else in my body looks completely healthy, and also by the cheques and bank transfers that semi-regularly make their way to my bank account.

The whole thing has thankfully meant that as I approach the end of my student days, I don’t need to worry about having debt of £1000, and can instead enjoy myself until I reach The Real World and start getting a salary.

… At which point I’ll instead get to worry about my debts of  £30,000- now that’ll be fun. I wonder what I’ll have to do to pay that off.

M