Late Night Blogging

It's a night (do doo do) shift (do doo do)...

It's day 10 of the never ending (but actually ending today) stint with no sleep and what a week it's been. Before we get into the whole medical blogging thing I think we should all observe a 5 minute silence at the loss of Steve Jobs from Apple. It is clear that,. in reality, he probably died years ago and has been replaced by a cyborg that has (characteristically for Apple) died just out of warranty. Either way let us hope that the company continues to make amazing and magical products and that I don't wake up in a years time using Internet Explorer and spending all my free time removing malware from my computer.

Day 0

A continuation on from the blog I wrote last week. I only really wanted to moan slightly about the fact that at 7am on a Sunday morning when I'm driving into work the last thing I want from Radio 2 (usually such a premiere station) is "Jeeeeesus, jessus loves you (unless you're Geoff), oooo let's praise Jesus". Now, I realise it's a Sunday and that, in England we are all theoretically Christian but, frankly, anyone who's up at 7am is probably on their way to work and if they're on their way to work on a Sunday they're clearly not Christian enough to need a reminder of the wonders of Jesus.

In fact why does ANYONE need a reminder of the wonders of Jesus. Christians are already pretty clued up on the matter and non-christians really don't care so what are they trying to achieve?!?

Sigh

Day 1

Monday Monday (ba daaa, ba daa da da) so generally unpleasant particularly after 3 12 hour days (ba daa, ba daa da da).

For some reason the rota coordinator decided that 3 weeks in would be a good week to give ALL THE SENIOR STAFF ANNUAL LEAVE. It's all fine though, probably.

11:00 My FOOT students arrive for some high quality teaching. Matt is playing the patient. Brodie is butting in for no apparent reason. I get them to examine a patients chest in 6 minutes.
11:13 Still attempting the examination, the students aren't even looking at the guys chest yet.
11:20 They give up, they have at least been extremely thorough. The patient gives helpful advice such as "remember to always ask the patient what's wrong", which is unfortunately totally disallowed in the exam. Nice idea though.
11:30 I mock them, painfully aware of how terrible I was at their stage but pretending I was always awesome.
12:00 It turns out that the Star Trek Villain we had allegedly sent home on Friday was STILL HERE ALL WEEKEND and we'd been totally ignoring him. The consultant arbitrarily decides to keep him in yet longer, with no real explanation.
12:05-17:00 Other stuff happens but I've forgotten it because it was F*CKING AGES AGO

Day 2

The Day. From. Hell.

09:00 I'm on call, various people have various problems with their various ears. I don't really mind as all we have to do is get to our hyper-mandatory unmissable training at 13:00
11:00 One of the patients is describing central crushing chest pain (a cardinal heart attack sign) but is otherwise totally well. Matt decides that, to be on the safe side, he should just call the Med Reg to be sure.
11:30 The Med Reg appears, angry. "Oh yes, we know it isn't a heart attack", I tell her "but we thought we call you just so that we could.."
"Waste my time?" she snaps
11:35 The Med Reg leaves, grumpily.
12:30 A patient arrives to have a bit of cotton wool stuck in his ear. Being a super pro amazing ear suctioner I accept the task with fervour.
12:31 I can't even find his ear hole, I call the Reg (that's pronounced redge for all you non-medical types)
12:32 "OK, now all you need to do is take this speculum in your hand" The Reg says, silently judging me, "and place it carefully in this ear hole like so". The ear hole magically appears, mocking me "Are you sure you're OK to be doing this? Just use the crocodile forecepts and take it out". "Oh yes no problem I know what I'm doing" I reply, "Now Mr. Patient, I'm just going to suction out this bad-boy and we'll be on our way"

The reg reappears round the door "Er, you'd better use the forcepts".
Ah yes.

12:45: The cotton bud has turned into some kind of candy floss esque mush and can only be removed picogram by picogram. The clock on the wall ticks loudly as the time till unmissable teaching shortens.
12:56 I finally remove a huge chunk of mush from the guys ear and practically kick him out of the door. "andifyouhaveanymoreproblemsjustcall er someonebye", I call after him.
12:58 The F2 who is supposed to be relieving me of the on-call bleep fails to show. I ring him. No answer.
12:59 I find Brodie looking stressed in the Office. He's had a patient with all sorts of bad shit going down. I decide the only right thing to do is to leave him to miss teaching and get kicked out of medicine. I give him the bleep too, just for fun.


14:00 I find Matt who is pretty distraught after a former patient, widely thought to hate us all, had returned for a quick check-up replete with chocolates and love only to discover that he actually had to stay in for a week. The week happens to coincide with the only week he can ever see his children again before they're sent off into space to find a new planet for us to inhabit. Or something.

14:30 A patient I saw at the weekend returns still complaining of difficulty swallowing. She needs to go to theatre and have a CT scan and have a cannula and solve Fermat's last theorum.
14:45 There are no radiologists in CT, there is noone answering in theatre and there are NO VEINS IN THE PATIENT'S ARM...
15:00 We're (and by we're I mean me, but I bring Matt along so we can make sweet love in the corridor) called to A&E to see a boy who's stuck something in his nose. The boy is cute, his fear of 'stuff-in-nose-removal devices' is not.
15:30 I call the Reg
Reg: "What now?"
Me: "Kid. Thing. Nose. Can't remove. Help"
Reg: "Book him for theatre and admit him and for GODS SAKE STOP RINGING ME"
(Note, the Reg is actually lovely, I just fear he hates me)

16:45 Me and Matt are trying to get hold of some kind of anaesthetist to put this kid to sleep. Matt rings the theatre and is given the name of someone to call:
Automated Switchboard: Kall Kate, What Name Please?
Me: "Dr Bloogar"
Kate: "Calling Jane Bloomer unless you say cancel"
Me: "Cancel, Dr Bloogar"
Kate: "Calling Drake Puma unless you say cancel"
Me: "Cancel, Dr Bloogar"
Kate: "Who shall I say is calling"
Me: "I er.. it's.. I er"
I slam the phone down, in hysterics over the fact I have apparently forgotten my own name.
We call the actual human switchboard who suggests that Dr Bloogar doesn't exist and maybe we mean Dr Moogar. We laugh at her foolishness

17:30 Turns out it WAS Dr Moogar
17:45 Dr Moogar denies all knowledge of even BEING an anesthetist but helpfully points us in the right direction.
18:00 Apparently the Reg got the thing out of the kids nose ages ago and we all suck.

Home.


Day 3

Quite a relaxing day. All is well except that more and more of our patients are starting to hate us. It's not OUR fault we need to relentlessly stick them with needles.

OK so it is a LITTLE our fault but we're only doing it because we LOVE them. and we get paid for it.

Day 4

08:00 Matt isn't in today, I cry a tear of loneliness as Brodie continues jumping up and down on the office chair to see at what point it will break. Still, at least he's stopped throwing his own poo around the room.
10:30 One of the nurses comes to say a patient has been waiting around for half an hour and is getting really angry. I decide to defuse the situation, using the skills I learned from my computer shop days/having divorced parents.
10:35 The patient has an ear the size of a grapefruit and is clearly in some serious pain. I can see why she might be annoyed. I soothe her with apology and call the Reg who recommends I take her downstairs immediately. All is sorted. Suck on THAT private healthcare.
11:40 "Now mate", questions the F2 "are you sure that everything's OK, do you need any help at all with anything? Are you sure? So you're going to be OK?"
"Yes", I reply "all is well, thanks, but could you do me a massive favour and save me some free pizza from the mess"
"Sure", he replies
12:30 I go up to mess. There is no pizza for me. I am saddened.

16:00 There's an emergency in clinic, a patient has a fragile airway. Hungrily I go and find her and bring her to the ward. I fail to cannulate her repeatedly. My will to live decreases significantly
16:05 "It's OK", lies the ST3 anaesthetist, "She had terrible veins, the fact I got it in first time was really just luck"
16:10 My bleep has gone off several times but this patient really is quite ill so I don't answer.
16:30 I eventually go down to A&E to deal with the bleep. There are two patients, neither of whom sound remotely ENT related but it's quicker to go and see them than to argue.

My first patient has a cut on her nose. Now obviously you can't spell Otorhinolaryngology without "Nose" so you could see why they rang me. But really, it's A&E for gods sake, they fix cuts on people for breakfast. I go see the patient, she has the worlds worst attempt at some butterfly stitches and blood is oozing out. I ask where some glue might be (that's right we glue people in the FACE here) and get told that actually the nurses can do the gluing. They glue her up and her nose looks great, well not great but she was 92. Why this hadn't been done 4 hours ago I can't really work out.

Another nurse asks me what the plan is. "Well she needs to come down to the fractured nose clinic in 5 days after the swelling has gone down".
Nurse: "What clinic?"
Me: "I don't really know. I just know there is one and you A&E types sort it out"
Nurse: "I've never heard of it, you're the doctor you should know"
Me: "I've been here a week and I don't work in A&E, sorry"
Nurse: "Fine, what else do we need to do"
Me: "We could do a coagulation screen as she has been bleeding for several days and that seems a bit odd"
Nurse: "Naaaah"
Me: "OK, well if you don't fancy doing it then...."
Nurse: "It's not that I don't FANCY it, it's just that I don't do everything because i'm TOLD to, I QUESTION decisions"
Me: "Fine well she has been bleeding for 3 days..."
Nurse: "Naaah"

"LOOK, Nurse, I'm a DOCTOR, do what I f*cking tell you to do" I say, slapping her on the ass "And get me a coffee". Is what DIDN'T happen because this isn't the 50s.

What did impress me was just how the argument kept escalating despite the fact (perhaps not well represented here) that I was actually being very smiley and attempting to back down the whole time. What did she WANT?!

The other patient had a problem with his eyes. Now because the Ophthalmologists work from home (despite earning £100k a year) and never EVER want to come into hospital the A&E people couldn't get hold of them. VERY OCCASIONALLY eye problems are caused by an ENT problem (in children) so there was a tenuous link however after examining him it was very clearly not ENT and very clearly Ophthalmology.

I wrote this in the notes, explaining that they really needed to get him seen by Ophthalmology. I learned later on they took this to mean "send him home" and the ophthalmologist got very angry. YOU SUCK, Ophthalmology, TRY EARNING A LIVING LIKE THE REST OF US.

*cough*

Days 5,6,7 will be in the next blog as this one is far too long already and I'm on holiday next week so wouldn't otherwise have anything  to write.

Join me next time for another Trust Me, I'll Have Forgotten Everything That Happened This Weekend So Will Largely Be Discussing How Much I Like Cake.

G