Source: Creative Writing
It felt good to not have to wake to the alarm and rush to the train station, joining the commute to work. I can’t believe how tired I am but I think most of that is post-adrenalin come down.
I’m looking at the rota planning ahead. I’ve got my first set of long days next week which means that after 5pm I will carry the bleep for the other acute medical wards. I will have five of them in a row. It’s my week and I’m going to have to just crack on. I suppose the bonus is, I will learn fast!
My leave has been decided for me – I don’t get to choose it. None of us do. I suppose if something urgent came up, I could ask for a swap but that looks like it could prove to be a bit of a pain. We are all assigned ‘lines’ in the rota and trying to mix up the said lines results in all sorts of rota clashes.
It’s just so nice to be out in the summer in the fresh air. The summertime buzz helps makes me forget for awhile the strange position I am in. I have a much anticipated, sought after job and yet I am anxious, on edge and nervous. It’s good to be amongst people looking so well and healthy.
I never realised weekends went so fast. It’s Saturday night now and then tomorrow this time, I’ll be trying to sleep for the early rise to get to my hospital again. And back onto the ward. It will be day one of the late on-calls. I won’t be home before 11 pm for the whole week and then early up the next day. So a 8am start and a 10pm finish. Going to be slightly slaughtered I think.
It’s Friday and I feel a sense of relief. I can’t help it. If I’m going to keep this journal I need to be honest and keep it real.
I don’t know if it’s just this hospital or if it’s like this everywhere but there is a degree of humiliation one must endure. I appreciate it depends on who you encounter and how you hold your own but nonetheless I am experiencing it. It might just be first week initiation.
Take for example the daily post ward round pilgrimage to radiology carrying the carefully written imaging requests as asked for by the consultant on the ward round. Our hospital has two worlds – the old and the new and they are connected by a rather long corridor. The radiology department lives in the new world. It takes about 13 min to walk there at a brisk pace.
On the ward round, it makes sense that one of the patients needs an urgent CT abdomen – I won’t go into details. I carry the form with the patients details, the questions that we are asking of the scan and why the patient requires it.
Standing in the radiology queue comes with it’s own legendary reputation. All FY1s from every corner of the hospital gather here at a certain time of day – post ward round time – with their requests tightly in their hands. The ease with which you will get the stamp of approval depends on who is on that day – both in terms of secretaries and radiologists.
You watch as each one steps forward to justify the request. It’s in full view of everyone and as one after another is interrogated about the reasons for scanning we quickly add more and more justifications to our forms with their small boxes, over-filled with reasons.
It’s important to not over-scan unnecessarily and to not also waste important resources and slots. So this screening process is important. But the process of filtering is painful. Especially when your own consultant has explained quite clearly the reasoning behind the request. You carry this with you, feeling confident.
I am called forward. It’s passed from the secretary to the radiologist. He steps up to the counter and I smile confidently. He looks at the form and declares that it’s not warranted based on the information. I try to verbally portray the indication as identified by my consultant. I am told I am not a courier carrying paper requests.
I turn away to head back to the ward feeling a failure. I have not managed to secure a CT today and it’s a weekend so the patient won’t get it until next week. I walk back to the ward and try to contact my consultant who is in clinic. When I do get a call back to explain, I hear a sigh down the phone. Half an hour later I get another call, as I am busily trying to catch up with the jobs that have piled up since my trip to radiology.
The CT abdomen has been cleared and would I please take the form back to radiology. Nothing is changed on the request form.
I make the second trip down the very long corridor, leaving more jobs behind me. I hand over the form to the secretary and it’s given the required stamp.
I feel every inch like a courier.
It happened and I survived. More importantly the patients survived too. It was a strange day – not anything like how I thought it would be. Everything is such a rush. I feel I know nothing. What have I spent the last five years doing? I feel so out of my depth and not prepared. But I passed all the exams, the written papers, the practical exams. I wore the gown and got my certificate so they think I am ready but I don’t feel ready at all.
I’m working in a male gastro ward and it’s unofficially called the Yellow Brick Road because of the number of jaundiced people inside. The majority of them are patients with alcohol liver disease. I have never seen such yellow people and the men look pregnant with really big bellies from the ascites. I’m sorry to say but it’s the shade of yellow of the Simpson’s cast.I have never seen anything like it in real life.
And the more yellow they are and the bigger the bellies – the sicker they are. These men are not well at all. But the team are working hard to save as much of their livers as possible. The sad thing is that many arrive acutely unwell, undergo care and processes that will take off the fluid, and they recover but then they go back out to drink and the start the cycle again.
I will be seeing most of these patients for the rest of the four months I am in Gastro I am told. It’s a revolving door for many until they kill themselves from drink. There is a sign on the door warning that if any relatives bring in alcohol onto the ward for the patients, they will be escorted off the hospital site, never able to return.
I was on a day shift today. I have a horrendous commute in because my partner refuses to relocate to the city where the hospital is. I don’t think people who are not doctors understand what this job is like. I am only on day one and know that this arrangement is not going to work.
The swollen oedematous patients are quite hard to get cannulas into. I am already having a hard time getting them in. A nurse has helped me today. They are not going out of their way to make me feel welcome but instead I feel like I’m being sussed out. I think it’s going to take a bit of time to build some bridges here – they see us come and go every four months. But at the end of the day, a patient needs iv access and I’m struggling. So the nurse has done it but something tells me I’ve got to learn and learn fast.
The ward round in the morning produced a list of jobs that I split with the SHO on the ward. She still wears a white coat and is a bit of a character. I’ve not seen anyone wear a white coat since I did my anatomy dissection class. But true they are great for pockets to put all the essential little books in them. She has worked through the list, helping me to organise the jobs in a logical manner.
I finished an hour late today – leaving at 6pm. I’m exhausted from the anxiety of it all. I look forward to the day when I am not terrified about coming into work.
I’m too tired for Star Wars analogies today.
Once upon a time there was a baby docling who was filled with all the excitement and anticipation that comes with the start of every adventure.
‘Twas the night before the first day on the ward. A bit like the first day at school meets Luke going off on his first mission with the rebel alliance.
The padawan doctor stepped outside from the family celebrations held in his honour to mark the coming of medical age. No longer a student but still feeling very much in the dark.
He looked at this stethoscope and his trusty little pen torch – his weapons of war, ready for battle. Fighting against disease and death along with all the other brave padawans who he had stood recently with, shoulder to shoulder pledging their allegiance to the cause during the grand ceremony marking their right of passage into the mighty halls of those that practise the art of healing.
He didn’t feel brave neither did he feel afraid. He felt ready but unsure of what was to come.
He did however wonder how long he could keep the Star Wars analogies going – foundation training takes 24 months and he was running out already of ideas.
Induction was done in a flurry of powerpoint presentations and a ton of paperwork. I signed paperwork, filled in forms and tried to understand the complexities of the rota, legalities of what we can work and what we can’t and of course pay. I don’t understand most of it I must admit.
The knots in the pit of my stomach are increasing. It’s crazy because this is not the first job I’ve ever had but it’s certainly building itself up to be in a class of it’s own.
Graduation Day was good. A finale of one stage of my life. But frankly right now I’m already missing the cosiness of Hogwarts with Drugs otherwise known as medical school.
Getting to this point has already cost me in grey hairs and even some hair loss, debt and years lost when I could have been hitchhiking around the world or even trying out as a Costa Barrista for a summer. I find myself enviously viewing the coffee makers and think how blissful it must be to not have to think of anything more stressful than whether they need chocolate with that froth. What will the pay back be? Will there be any? I’ve heard it described as both the best job in the world and the worst. I’m talking about medicine now – not making coffee.
I’m reading the headlines daily about NHS cuts, lack of recruitment into higher speciality training and the looming privatisation of the NHS at the hands of the Tories. Why did they public vote them back in? I don’t get it. It’s such an uncertain future but right now I’m thinking about what’s around the corner.
The first week in Aug on the calendar marks the change over period and the arrival of the foundation doctors. An army of Padawans entering hospitals and stepping onto wards for the first time. What will the seniors be like? I saw a post on Facebook that said some might want to be Obi-Wan Kenobi but can’t help channeling their Darth Vader.
The Jedis sat grandly in the great hall in their robes, cloaks and mortar board hats to watch their Padawans graduate.
The Oath was taken for the first time by the Padawans and also reaffirmed by their teachers.
The forces of privatisation and the looming attacks against their dominion – the NHS -were alluded to within the final speech.
Would the new medical warriors have learnt enough to now not only fight against disease and injury but also against other evil forces at play that would directly or indirectly harm their patients?
Only time will tell – but the wise ones knew their prodigies were stepping into an uncertain future and an unclear path. One that many may fall from before the journey is done. And there is no shame in that, indeed their bravery for embarking on this mission will be revered. But amongst the harvest, there just may be the one promised in whom the Force is strong that will survive the battle against the dark plans of Darth Hunt and his Empress and win in the noble quest to safeguard healthcare free at the point of delivery for all.