Day 1:
First day back after holidays, having (quite cleverly) tuned my body into getting up at 11 and going to bed at 2am I have in fact had a ridiculously poor nights sleep during which I kept having dreams about trying to get to the airport on time but realising I'd left my passport, legs and ability to see at home. These dreams seem to strike me a lot and presumably indicate that I am still getting over my parents' divorce or, more likely, am totally mental.
06:30 Things are going from bad to worse, I pour milk onto my cereal to discover that it has, upsettingly, transmogrified into curds and/or whey. I set off early to work in the knowledge that there is some cereal in the Mess.
07:00 Driving to work, it's raining and so the roads are inexplicably busy, furthermore it's the 1st day that the schools are back so the roads are busier still. I've been undertaken at least 5 times while going at 50 in a 40 zone and it's really starting to piss me off.
07:05 Someone tries to undertake again, I swerve into the left lane causing him to lose control and go crashing into a ditch with a resulting (very satisfying) fireball and screams of "if I only I were less of a dick maybe I'd still be alive now"
07:15 There is a huge queue on the A52 that, despite rhyming beautifully, is not what I expect at this time in the morning. It turns out to be a result of someone having crashed their car and left it horizontally crossing both lanes of traffic. Presumably, given the fact that all drivers this morning are MENTALISTS, this person was either being undertaken or was an undertaker (and was late to the funeral).
07:30 I arrive, breathless, in the mess not because I am running late but because there are so many FUCKING STAIRS. There is nothing but Harvest Moon generic 'Wheat Biscuits'. I shake my fists. "Brodie!!! You've MESSed it up again (see what I did there). I only accept Asda brand 'Wheat Bisks', Sainsbury's 'Wholewheat Biscuits' or better!! What do you think I am, an animal!?"
08:00 Ward Round: Various things have been going on during my absence, most notably someone STABBING THEMSELVES IN THE NECK. Also having a fun time were Mr Complex and Mr Sutton-In-Ashfield who, during their long stay on our ward had decided it would be prudent to go FUCKING MENTAL and spend all night long shouting and telling the nurses to go stick their life saving medications where the sun don't shine (Scotland).
One of our other patients, Mr Slim, has also been causing problems. He has developed the FANTASTIC habit of agreeing to investigations/procedures when the Registrars are around and then flatly refusing them when they actually come to happen. My patience with him is growing increasingly thin, not least because he also smokes in his room and is generally disagreeable, but I still spend an hour organising the peripheral access team to come and put a line in his arm.
10:00 Brodie is, for the 7th time at least, regaling people about how he was chatting with the nurses and they all thought I was gay. He finds this extremely hilarious, presumably because despite his pink shirt and bleached hair, he secretly fancies boys.
14:00 I've got a med student, Val, (who will remain nameless) trying to get some tips on ABCDE situations. I am disheartened by quite how much she seems to already know about these things and that my usually impressive knowledge of Asthma medication dosage is like Kindergarten to her. (Insofar as it stars Arnie and THERE IS NO BATHROOM).
14:30 Knowing that it will fuck her up I get her to do someone's cannula. Given that I am getting progressively worse at cannulas and NO students are any good at them I'm confident that the resulting bloodbath will cheer me up.
14:31 She gets the cannula in first time. Not even first time with a little poking around, perfectly first time.
14:35 I murder her and hide her in the drugs trolley.
15:00 The nurses come to install Mr Slim's line, he tells them literally to "go fuck themselves". We call one of the registrars who, totally failing to understand the situation, instructs us to "just reorganise it".
Being a Junior Doctor is not so much about saving lives as it is actioning ridiculous demands from your seniors who seem to have forgotten, or chose not to remember, how much of a pain in the ass these things are. In this case we at least knew how to contact the nurses, but quite often you're asked to speak to some nebulous department like "Medicine" and "just ask them if they could see Mr X, we think there's something going on with him". Invariably the person you talk to firstly shouts at you for not having a decent reason to ring them and then demands you speak with your consultant. The consultant tells you to tell them that they should just come down straight away. They tell you to tell your consultant that there's no reason for them to come down. Your consultant tells you to tell them that...
It's like two (young) siblings who have fallen out refusing to pass the each other condiments at the dinner table unless the message is passed through a third party. If the consultants spoke to EACH OTHER this whole thing would take literally seconds to sort out, but that isn't how hospitals work. For some reason.
16:00 I'm on the phone with the Registrar, again. It seems whenever I have to ring the Reg it's always the same guy due to some fluke of timings. I'm becoming fairly convinced that this Reg is beginning to think I'm a little bit Spesh and is probably Fitness To Practicing my ass as we speak. I try to add in sentences like "That's what I thought needed doing but I wanted to check before I did anything" to make it sound like I'm not a retard but a sinking feeling in my heart doesn't think it's working.
17:30 I should have left half an hour ago. Despite there being as much action on the ward this afternoon as there is in my pants, ever, all manner of shit seems to be going down at the end of the day. The On-Call SHO is stuck in theatre, patients are piling up at the treatment room and I need to organise umpteen things for the patients on the ward.
18:00 Just as I'm about to leave it's announced that a guy needs his ear sewing up and I'm keen to learn how to do this so I wait around 10 minutes for the Reg to show up.
18:30 He shows up and we are sent on a merry chase around the hospital trying to find the various pieces of kit we need to do the job. On returning to the ward we find that they are all readily available in our treatment room in the cupboard we didn't bother to look in.
21:00 I eventually get home to discover that the chicken, destined for cooking in my Nando's sauce and being swiftly eaten, has gone off. WAY OFF. In fact it's reeking out the entire fridge and seems, when seen from the corner of ones eye, to be moving.
21:30 I return from Asda with Pizza. This is bad given the amount of terrible I have eaten at Hywel's over the last 2 days but tough shit, pancreas, what did you ever do for me anyway?
Day 2:
08:15 Ward round has split and I'm off seeing the Paeds cases with Sri. Presumably as revenge for the fact that, due to his Indian origins, no-one can quite work out what his name actually is, he has taken to calling me Steve this morning.
08:30 "Steve", he asks, "Did we get the results back on that swab"
"I have no idea, Mr Kumar", I reply, despite this not being his name "I'll look it up on iCM when we get back to the ward"
We decide that at least this way if we've accidentally killed any patients some poor sods called Steve & Dr Kumar are going to get fired and we'll get away scot free.
11:00 We're desperately trying to get the neck stabbing man off our ward because, despite being a lovely guy, he requires constant surveillance to ensure he doesn't attempt to kill himself by fashioning a noose out of some oxygen tubing or something equally ironic (the hospital isn't covered for ironic death in it's insurance policy). This requires talking to Psychiatry which is a hellish nightmare that, in of itself, can precipitate mental illness in even the sanest of people. I'd spoken to them the previous day and they'd promised they'd take him off our hands
"Where did they say he'd go?", the matron asks
"I think it was ward 53", I reply with uncertainty
"Oh well I'll just ring them up and get a bed sorted, you're sure it was that ward?"
"Not entirely" I say because, frankly, who remembers random numbers from 24 hours ago
Another nurse, who I didn't even know was listening storms off and slams the office door muttering "I just don't know where we get these Doctors from??!? It's like a frikking madhouse in here!!"
I am slightly perturbed by this emotional outburst, I mean I am occasionally a little bit quirky but this was by far one of the least quirky things I've ever said. I decide she's probably ON HER PERIOD or broody or something equally chauvinistic that shifts the blame away from myself (whilst dying a little inside).
16:00 It's football fever, Mr Sutton-In-Ashfield is wandering the corridors in an attempt to find a room with a TV. He, with some considerable mental effort, writes "Football" on a piece of paper and thrusts it in my face. Given that I FUCKING HATE football, and would rather die than spend 90 (though in reality MUCH MORE THAN 90) minutes listening to the insufferable droning of the crowd and watching grown men drop to the floor at the slightest bump to roll around crying in 'agony', I don't know what channel the football is on. I instruct the gentlemen to go and sit in the TV room and see if it's on in there hoping that the hospital have, for some reason, subscribed to Sky Sports for every single ward and for good measure supply him with a St George's flag, some Stella Artois and a wife to beat.
16:30 Brodie is bantering with the nursing staff who all suggest he goes and buys them coffee. He refuses (as you would) but I offer instead because I have nothing better to do with my money. Unfortunately this backfires and somehow Brodie is forced to buy everyone coffee at some non-trivial cost. To make matters worse he doesn't even DRINK coffee.
19:00 I get home late, again, after sorting out various THINGS for people.
Day 3:
14:00 I'm teaching students again, one of them is from the Pirates Of The Caribbean and the other one has an amazing surname that I can neither remember nor tell you on here anyway. These guys are also horribly knowledgable and are also judging me on the fact that there are so few patients on the ward that there are none to actually examine.
In actually, it's not that there aren't enough patients to examine, it's just that half of them would literally tear your FACE/OFF if you went near them.
16:00 Mr Complex has his family in, they ask me questions I don't know the answer to about when he might be getting home. Mr Complex, feeling lucid at the moment, asks me why I don't always talk to him.
"|I'll tell you why, matey, it's because 50% of the time you're a lovely old dude with a heart of gold and the other half the time you're urinating in the nurses handbags, screaming 'Fuck you, C*nts' and tearing out lovingly placed arterial lines"
Anyway he also adds that when he met me & Matt (or "those two brothers" as he calls us) it was the loveliest day of his life. Potential overstatement? I THINK NOT.
Day 4:
07:45 I'm busy preparing the M&M presentation for this morning. I'm struggling to decide on peanut or crispy so I decide to go with both. Some of the slides have pitiful levels of detail because we inherited them from the previous F1s and, as I found out about the meeting yesterday, I didn't have time to get the notes in.
07:55 Mid way through moaning about the fact I'm likely going to get bollocked for the poor quality of the presentation just because I was the only one to do it, I realise that Mr Spikey, one of our scarier consultants, has been sitting in the office for an unknown period of time. I run around trying to organise everything for the ward round so as to look super efficient but, bizzarly, he soothingly tells me to relax as we have plenty of time.
08:05 Pondering at what point Mr Spikey is going to turn nasty and kill us all we do the ward round. Everyone is on their absolute best behaviour, making sure that the notes for the next 3 patients are in hand and that we have pockets stuffed with tongue depressors.
08:10 ANOTHER consultant turns up to help with the round. At this stage there are more consultants than there are F1s.
08:45 The ward round is over and none of us have been killed. Though the sheer stress of it has shaved at least 10 years off my already crippled-by-doughnuts lifespan.
09:00 The F2s and I are hurrying towards the meeting room, fully aware of the diminishing levels of free breakfast that will be available as each minute passes.
"I'm taking full English or nothing else" says one "If they try any of that 'continental' bullshit I'm going to go mental."
09:10 The F2s and I choke down our croissants and pan au chocolat
09:30 The meeting starts. I am, almost immediately, bollocked for the poor quality of the presentation.
11:00 Yet more medical student teaching. These guys are pretty on it but they tell me how in awe of my slickness and knowledge level they are so they can live, for now.
12:30 We have free lunch courtesy of an evil, 3rd world famining, child molesting, animal testing pharmaceutical company. Frankly I don't care, as I'm hungry. The rep, a cross between Roger Moore and Marty McFly senior (2015 edition), seems to be past his best and keeps meandering off on side notes including the fact he was sure he met one of the F2s when he was in Australia. He does, however, believe wholeheartedly that his product is the best damn nasal steroid this side of fluticasone propionate and really REALLY wants us to love it too, even if we never prescribe it to anyone. Fortunately the ST2 takes it himself so the old man is happy and we feel as though we've earned our sandwiches.
14:00 The guy that Val cannulated needs a new one. Given her immense skill the first time it is MANDITORY that I succeed.
I do not. The guy looks at me wearily before letting me try again and eventually I get one in.
15:00 I'm asked to cannulate a patient by the ST2. The guy has cerebral palsy and a trachestomy but that doesn't stop him from smack talking me.
"Are you a trainee?" he screeches as I enter
"Nope I'm a real doctor"
"And just out of interest, how many of these have you done"
"Probably about 50"
"Alright, very well then"
Foolishly I make some comments about how excellent his veins are.
15:05 I'm trying to figure out how, despite being able to feel the vein and being able to feel the cannula tip above the vein I am totally unable to get the cannula IN the fucking vein. I give up and go for another try.
"What do you mean you couldn't get it, what's wrong with you", the patient adds helpfully
I get flashback from the next vein but am totally unable to thread the cannula into it.
"Third time lucky" says his lovely carer "You must just have difficult veins"
The third cannula goes in, but then the vein spontaneously explodes.
"Are you related to [insert what later turned out the be the name of some terrible darts player here]? He could never get anything right either"
I give up as I am seconds away from retorting with comments so ridiculously harsh and non-PC that I daren't write them here.
17:00 I'm trying to cannulate a particularly nice patient who had already kindly allowed my students to poke her with sticks already today. There are some beautiful straight veins on her hand so I go for one. It promptly explodes leaving an expanding haematoma in it's wake. I decide today is not my day and get Brodie to do it.
Brodie also manages to explode a vein, which makes me feel slightly better.
17:30 I cannulate my OWN HAND to prove that I still can. Midway through flushing it with saline the nurse walks in and assumes I'm doing heroin.
18:00 I'm midway through filling in a complaint form about MYSELF for being so shit at cannulas when the ST2 asks me if I can write up some fluids for the cerebral palsy guy. I go into the room to get his notes and he makes a crucifix out of his two index fingers and hisses at me.
I punch him in the face and tip his wheelchair out the window.
In my mind.
18:30 Turns out I've entered a world of pain by agreeing to do this job as I also have fill out the patient's drug card which has about 40 medications of it, none of which have the doses worked out.
"He also needs some ibuprofen by the way" says the ST2
"Yea well you can shove the ibuprofen up your ass" I reply
"Well, that is how they give it in France" he helpfully retorts.
Day 5:
09:30 In an attempt to get my consultant to actually sign me off I've decided to go to clinic to help him with his audit. I've even fashioned a receptacle out of a Clarks' shoebox. Unfortunately before I can start one of the consultants, who loves giving me stupid tasks to do, demands that I go back to the ward and get one of his patients down here immediately. I'm too fat and lazy for such things so I bleep the SHO on call but, unbeknownst to me, the phone system routes his reply to a phone in some other room (and why not, that makes perfect sense) causing great upset with the nurses in the other room and wasting his time significantly. Fortunately he figures out what's going on and manages to sort the problem out.
10:00 All 6 of the pens I brought with me have been pocketed by patients. Clearly they felt they needed repayment for the time it took to do the questionnaire. Fortunately one of the nursing staff lets me know about some clipboards with attached pens that the patients can use that would be far too cumbersome to pocket. Suck on THAT you thieving bastards.
12:00 I bleep the SHO on call about another important matter. We need someone to save us some pizza from the mess as we wont be there by 12:30. Unfortunately he is busy and the F2 he sent in his absence is unobtainable. I have to go to the mess myself and save some pizza for Sri or he might not marry me when I propose to him next week.
12:45 We're all beginning to lose faith in the Mess committee. Firstly they can't figure out how to access the 4k in the mess bank accounts, then they fuck my cereal up and now the pizza is 15 minutes late. I'm perilously close to texting Brodie to tell him he sucks, potentially waking him up due to the fact he's on nights over the weekend, when the pizza finally arrives. I grab a box of Chicken pizza for Sri and spent the next 40 minutes guarding it savagely.
12:30 Sri discovers the pizza is chicken and bacon midway through a bite. He doesn't eat bacon due to some probably religious but generally important reason and is forced to spit it out.
No marriage for me.
13:45 I've been chatting with the Reg for far too long about going out on the lash in the evening (it's been a while since I've had a good night out and I could do with a drink after this week) and it's time to do some work. On returning to the ward I discover that one of the nicest patients we have has just been told he's got an inoperable recurrence of his cancer. Mr Spikey is visibly upset by it and tells me that he just doesn't get paid enough for this kind of work.
The F2s, having noticed that I do some of the lesser known tasks during the week, very kindly let me go home early. On leaving I see the newly diagnosed patient crying in the corridor while the nurses try to comfort him. It is horrible.
15:00 I get home and realise I've developed a rotten cold in the last 5 minutes.
I spend the remainder of the afternoon sobbing from a combination of a rubbish week, the distress about the patient and the fact that Lucy Knight gets stabbed to death in ER and she was so lovely.
22:05 I'm awoken by a phonecall. Far too groggy to be using my voice I track down the caller on Facebook who's letting me know that everyone's out in Vodka Revs. I'm far too ill/emotionally distraught for such things and go back to sleep.
On the plus side, we got Virgin installed over the weekend and it is fricking amazing. Or as amazing as a combined internet/TV service can be...
Tune in next week for more Trust Me, Maybe I'll Have Fewer 'Emotions' By Then
Geoff, we do oh so love reading your blog. Feel very in touch with you! Sounds like you're doing an amazing job. Sorry to hear about your patient, that sucks. Loads of love - joe and Nikki x
ReplyDelete