Medical Students

I've heard this already - many times. All the older doctors complaining that we young'uns aren't half the doctors they were when they were out age. And I've always thought that was just a load of BS. But, lately I've been thinking they may be onto something. I was only a medical student last year so I don't think that my view of what it used to be like has changed all that much. There is one observation I've made in the last couple of days though - the medical students who are just about sit their gen med/surg exams aren't as boned up on their practical skills as we were only 2 years ago. I remember cannulating on my first day in clinicals and being quite up to scratch by the time exams came around. But on Friday I was speaking with a couple of medical students who happened to mention that they had yet to get their 5 supervised cannulas signed off - and with only 6 or so weeks to go before the exam. A little more probing revealed that neither had really done ANY practical procedures on patients - only getting to use the simulators at the clinical school once or twice. Now I don't know if this is the trend now for medical students, or it is this year in particular, but I hope they catch up a bit before they hit internship, otherwise I can foresee all the calls I'll be getting to slip in difficult cannulas for them on their cover shifts.

Disclaimer - if any of you are reading this, don't take it personally. I assume that you've covered what you need to for your exams and that's fine - I'm just commenting from personal experience and I promise to be nice if you end up calling me at 8pm with a difficult cannula =)

Take Days

Take days are my most dreaded day of the week. Take days are when its my unit's turn to admit all the surgical cases which come through emergency. So one day a week, and one in every four Fridays and weekends, each of the surgical units has this pensive experience. Now by chance or design, my surgical unit's regular take day is a Monday. For some reason, Mondays tend to be THE day of the week when all and sundry decide to troop into the hospital's ED with anything from bellyache to ruptured appendicies. We get hammered every Monday. The game is then to fix and discharge as many patients as we can by Friday, in anticipation for the following weeks take. Its a never ending cycle - a game, if you please - a big merry-go-round that is modern medicine. Don't get me wrong, I know I'm sounding bitter, I do love the job I'm in - I just wish that there were less patients on my list. It'd make such a difference if I could sit down in the Cafeteria for lunch a couple of days a week. I know what you're thinking, 'Shut up and suck it in; eat a teaspoon of concrete and harden up' - but so bad was our last take day, that the night surgical registrar had mercy on us and decided to slow up the last two admissions by a couple of hours so they would come under the next surg unit. No joke. So, if you're out there reading this, please avoid coming in on a Monday - any other day of the week would be fine ;-)

Public Holidays

Okay, so I know its been awhile since I've made a post, and yes, its because I've been busy; and all I want to do when I come home is to crash in bed and wait till I have to go to work again. I'm not bitter, I promise. I've had two whole weeks now as a surgical intern and my experiences so far can be summarised in two words: Utter Chaos! Its been fun, but a lot of the time it feels like you're flying solo without proper backup. I can understand why. The registrar's job is to be in theatre learning their trade, while its our job to keep things running smoothly. That's fine, but it seems like sometimes (well, a lot of the time), I end up in situations where I'm dealing with things that I probably shouldn't be. I won't give any specific examples, it's not fair and all the non medical people reading this will freak when they realise that when they go into have surgery, the majority of their medical needs are met by people with as little experience as myself. Let's just say I do the best possible job I can with the time and resources that are available to me. Feeling nice and safe are we?

But to come to the real crux of the post - Public Holidays. Whatever you do, if you can in anyway avoid it - try not to get sick on a public holiday. For 14.5 hours, I was the sole doctor responsible for all 3 surgical wards, or about 100 patients. 'Busy' just doesn't quite cut it when describing my day. The pager was singing all day long, and in the end I still had three pages of jobs that I didn't quite get to before it was handover time. So please, please, please don't come to my hospital on a public hospital when I'm on cover. It's best for both of us - my sanity and your health.

Morality or something like it

Okay, so something happened today when I was having lunch with a friend. Its one of those hypothetical 'what ifs' that we cover during an ethics lecture, but this time it happened for real. After lunch, as we were walking back towards the hospital, we spotted an ambulance in the middle of the road with a small crowd around it. Apparently, a pedestrian had just been hit and the ambulance had only just arrived. At the scene there was a young women sprawled on the road with two first aiders in attendance. Now, you might think me a bad person for this, but my first thought was, 'F@#K! What am I supposed to do? F@#K!' I mean, what exactly AM I going to do? The ambulance is there, the paramedics were starting to get things organised, all I'd be doing is walking up saying I'm a doctor and then that's about it! Without all the blood tests, splints, x-rays and nursing staff, what exactly can I provide to this person lying in the road, other than a few empty words of encouragement? Without all the back up you have in the ED, there is pretty much sweet f@#k all I can do in the street. Needless to say, and to my shame, I continued to walk on by. Only after we had passed by did my friend dare to ask, 'Shouldn't you have done something back there?' Right.

Days off

Another one of the things I love about the emergency department is that we are contracted to work a 38 hour week, and the consultants and other doctors try very hard to ensure that we get to knock off on time. I've heard some horror stories of 70 hour weeks from some of the other interns on the wards and I'm not looking forward to moving to my new posting in 3 weeks time. These 38 hour weeks are split up into two 10 hour and two 9 hour shifts - giving us in effect, a 3 day weekend. There is only one downside to this - occasionally this 3 day weekend falls during the week and there's no one to go out with; so you end up sitting at home and pissing away your free time dreaming of all the cool things you could be doing if it was actually the weekend. But I digress... I love my days off, so far I've caught up with a friend for lunch, done a little bit of shopping and then I'm going out with some other interns tonight to tell a few 'warries' (read general chance to bitch about work conditions, other doctors, nursing staff, the system in general). I love it.

My job as an Intern

For those of you reading this, an intern is the most junior form of doctor to be found in a hospital.
In general, without sounding too cynical, their job is more likened to that of a glorified secretary - albeit, one with an amazing ability to multi-task - but a secretary none the less. On the wards, our job is to trot behind the boss (read consultant - senior doctor in charge of the unit), listening in as he extols his opinions on the management of the patients with the senior registrar (read senior doctor in training), trying to catch his every word so that we can transcribe it into the patients' notes and have a PLAN. Now, this PLAN which we have written ever so carefully in the patients' notes doubles also as a list of jobs for us to follow up on once the higher ups have disappeared to wherever they go after ward rounds (a mystery I have yet to discover). Do I sound patronising? I apologise, but it is the truth.

Now, personally, I have yet to experience a ward job other than as a student. I am sure that when the time comes, I will have a lot more to say on the subject - and hopefully by this time, will have ceased to be cynical about it. So, if not on the wards, what exactly have I been doing for the last two months you ask? I have had the pleasure of spending two glorious months in A&E - Accident and Emergency, otherwise known as Casualty or the Emergency Department. Now, why have I enjoyed my time so much here? I actually get to practice medicine. I see patients of my own, develop a management plan of my own, and implement it. Of course, I have to check what I'm doing with one of the senior doctors, but all the same, they are my patients, I am caring for them, and I love it.

Welcome

Hi and welcome to my blog. I've started this in the hope that I can share with you all the roller-coaster that is my first year as a medical doctor. In a way, this is a bit of catharsis, a way of venting my feelings on patients, the public health system, my own ineptitude on occasions and just my thoughts in general. I don't think that too many people will come across this blog, so I am not too worried that my own personal thoughts will cause anyone any harm. In any case, I'll try to depersonalise or protect the privacy of others where possible. I do apologise in advance if someone reads something, makes a connection, and is offended. With that sorted out, thank you for taking the time to read this, and once again, welcome.