A shadow

I am shadowing the doctor I will be taking over from in 2 weeks. She's from Eastern Europe and says she is shocked every day at the dirt of the hospital.

Best quotes: My new consultant - "What's the most important thing for this patient? Placement. Ever read "The House of God"?"

The F2: "The most important thing you will learn is what to do with the dying."

Wondering what to do with a patient with strange symptoms - F1 - "Get House on the phone." Registrar - "Oh, he'll just say it's lupus." F1: "It could always be lupus."

Also, I found out I am on call on my first day, next Wednesday, which means that I will be clerking patients in from A&E, and carrying the cardiac arrest bleep. Dear God! I am nowhere near old enough for this! I just don't know how to prepare for it.

Too posh to push

I was so interested to read the G2 today about how many obstetricians would actually opt for a caesarean. This follows a report last week about how midwives are trying to decrease epidurals even more, by trying to make people pay for them.

I was lucky enough to deliver babies during my Obs and Gynae rotation. I saw a lot of births, natural and caesarean. I would go for a caesarean in a heartbeat.

From the other side of the clipboard

I've been reading an old edition of the Student BMJ about how it can be a really positive experience to be an inpatient for a while. It made me remember how a matter of a burst appendix when I was applying to medical school was something that actually taught me a lot.

Firstly, how it's absolutely astonishing how little I felt I saw any medical person. I met the surgeon once, after the operation, for about 30 seconds. That's it! His juniors came round occasionally, not even once a day, and never asked me how I was. I felt rather abandoned! And when my cannula tissued, my hand was growing steadily bigger for a day filling with antibiotics and looked white and horribly unhealthy, and it took about 24 hours for anyone to come. I would have taken it out myself if I was an inpatient now, but then I was still scared of doctors. I hope that when I start I will try to remember that patients are scared of their disease, scared of their pain, scared of my needles, scared of my drugs, maybe even scared of me and my colleagues!

Nice little earner

The NHS has a surplus of more than £1.6 billion this year yet hospitals in the UK stand to make £3.5m in total from charging their first year junior doctors. The charge is equivalent to a 20 per cent pay cut, it has been calculated by the
BMA.

- Daily Telegraph, 8th July 2008

I sit in my newly furbished living room as I type. The house still smells of its new paint and new carpets. (Light cream - I wonder how long they will stay that way!) and I am thrilled to be here. It's 5 minutes from the hospital and it's half the price I paid for half the space in London. I love it. But if you'd told me until 3 months ago that I would not be living at the hospital I would be working at, I would be very suprised. But I've gone to the private sector.

I would have been expected to pay £485 a month for one small room in a block if I had gone for the hospital accomodation- that's more than I paid for my room in Marylebone! People in my position last year didn't have to pay a thing.

I don't think junior doctors are special. I don't think they deserve a free ride. But with people already being put off applying to medical school because it is too expensive, salaries for the first year should not be cut into to such an extent for such ridiculous charges.

And still, just across the Severn:

The Welsh Assembly Government has announced that free accommodation will continue in Wales, yet hospitals in the rest of the country will begin charging first year doctors for their rooms when they start next month.

- Daily Telegraph, 8th July 2008

Little Miss Doctor!

Well who would have thought it? I actually made it through medical school. Am feeling quite fragile from the Finalist Ball and lots of champagne etc since. I remember a few months ago, I was talking to one of the junior doctors on the firm I was attached to. I said I wasn't sure whether to go to the ball - it was bloody expensive and there was another party going on. She said I should definately go. She said "It's the only time in your life you're going to feel like a somebody. This summer will be the best time of your life, cos you'll start work and realise a doctor's life is shit and you'll be treated like a nobody!" Yeah, good pick me up! Also not making me feel that much better is that I know the girl who is doing the job I'll be taking over from, and she hates the hospital and the job and the NHS so much she is going abroad to continue her training, joining the ranks of British junior doctors who are swelling the ranks of the antipodean medical profession. Ho hum.

But seriously, I have job lined up. A house with the boy. Things are looking good!

In the midst of exam hell

I try to tell myself I'm still alive and a real person despite the fact I have been doing nothing for months except attempting to turn myself into someone I'm not - ie a confident future doctor. I wake early early in the mornings, with my head full of dreams full of patients that I have seen over the past few years, ones that are probably still alive, ones that are dead. In all the dreams I am disappointing people. And they are more real to me than the exams are.

"You take a really sleepy man, Esme, and he always stands a chance of again becoming a man with all his fac-with all his f-a-c-u-1-t-i-e-s intact."

-JD Salinger

Patients who have made my day, #2

Doing Obstetrics last year. One of my favourite rotations in medical school. Pretty girl, first baby. So excited. Boyfriend and Mum, so excited. Suddenly, baby's not doing so well. People come in and out the room, surround the bed. Told that she would need an emergency caesarian. Right now. Paediatricians woken up. Theatre prepared. Obstetric Registar awaits with scrubbed hands, crossed in front of him (the way they do to avoid touching anything). Crying from pretty girl and boyfriend, Mum being soothing. She's bought into theatre. Midwife says to Dad "scrubs in there if you want to come in." Points, leaves. He changes, comes out pulling the top over his head. Comes into theatre. Mum sits outside the door, staring in front of her. Pretty girl is quiet now but her mouth is shaking. Then suddenly, so so quickly, there's a wet little baby crying. He's completely fine. Given to the paediatricians, deemed hunkydory. Given to pretty girl. Midwife looks over her shoulder at me - "Go tell Mum if you want." I go outside. She's there, she stands and I will never forget the look on her face. I knew then, looking at her, that despite her calm before, she was expecting the worst and thought I was going to say her daughter/grandchild was dead. I made my face break out in a smile and said that her daughter and grandson were doing really well and everything had gone fine. Her face crumpled. She sat down again very quickly. I put my arm around her, feeling her woolly jumper and sweat on her neck. I told her she could see him in a minute. She cried and cried.