Reinvention

I remember the rotation I did just before I came here. It was a horrendously busy A&E and I did actually quite enjoy the placement - I've always loved A&E for it's excitement and brutality! But there was this one night - about 3 in the morning. A boy - he didn't look 18 - came in with a gang of friends effing and blinding and saying he'd been stabbed. Of course he was seen that second by the most senior doctors there. It was found, though, that the "massive fucking machete!" had barely broken the skin on his thigh and he was not even bleeding any more. A good examination found nothing else of note all all and there was absolutely nothing else wrong with him. I was going to put a few stitches in - two at the most - when I saw a woman coming in by ambulance saying she couldn't breathe. Not just saying it - she looked it too. She was bought into "resus" - where all the monitoring and equipment is for sick patients. She was attached to a monitor and I saw ST elevation, (the tell tale signs of a heart attack), and she very quickly went into VF (for the non-medics - it means your heart is still moving and making electical activity but is not pumping blood. Basically it means you might be able to shock it back into rythym but if not you are dead). I was there as the bossman doc had asked me before to cannulate (put a drip in her arm for medications) so I saw them attaching the defib (the thing people use when they saw "clear!"). I saw them shock her and shock her. I saw the line on the monitor go flat. I felt her broken ribs crunch beneath my hands as I did CPR. After not all that long they stopped and went to speak to the family. I went out to stitch up a thigh (the job of talking to relatives in these circumstances alone is as yet awaiting me.) He yelled at me - "Why the fuck do they need so many doctors in there? Don't they know I've been stabbed! This is the worst hospital ever! I'm going to so complain about this shithole!" I apologised, and said I was really sorry to keep him waiting, and was really calm and nice to him, but he wasn't listening. He wasn't waiting more than 25 minutes.

The reason I have written about that incident was because it was an example of the kind of stuff that makes me think that teaching is a good career option. But the thing that maybe I like most about this trip is how it is reigniting some feeling of purpose and hope about medicine that I thought I had lost. The staff who work for the organisation here are so inspirational in how they are trying, and succeeding, to improve the health of a neglected and downtrodden, yet so fascinating and kind, people. I was becoming so cynical and downright depressed about medicine, what with horrid arrogant doctors, and an unbelievably frustrating health system, with patients that hated being in hospital (often understandably!) and who gave the staff nothing but abuse. Not to mention MMC / MTAS / UKFPO - whatever it is they are calling it these days - which has got the morale of doctors and medical students at an all time low. But here, I remember the 17 year old who went off smart and funeral-suited and trembling to her medical school interviews - a long time ago now - hoping beyond hope that the as yet unknown interviewers would see how much she wanted to be a part of medicine and how much she thought she would be able to do for people, and allow her to join their hallowed club. I haven't remembered her for a while - but now I'm thinking again how much I enjoy medicine. I hope to remember this to see me through finals - I think I'll need to to avoid going mad!