Day 1:
06:00 buzz, buzz buzz, BUZZ BUZZ *GUITAR SHRED* "SAM's LEAVING, SO GIVE HIM ROCK BAAAND, GIVE HIM YOUR HEART, THERE WILL BE NO NEGLECTION" Screams my own singing as it does every morning at horrible o'clock. I really should change this alarm at some point, not just because I hate the sound of my singing but also because it causes me to hum the associated shredding guitar solo over and over again whilst in the shower.
06:15 I emerge from the shower to find that it's dark still, horribly dark. Dark like the SUN (in 12 billion years). It is difficult to find my clothes.
07:00 Dressed in odd socks with my shirt hanging out of my fly and the wrong shoes on I begin my drive in to work. It being a Monday everyone is trying to kill me, as ever.
07:45 I am pleased to note that my "Tonsilitis" "Patient" is still there, adding justification to my decision to admit him the previous week. Faith in myself is restored, all is well with the universe.
08:00 Apparently one of our patients needs some platelets before theatre, though no-one really understands why. Brodie and Kat have one of their many arguments where he forgets that she is about 4 years more senior than him and, in all likelyhood, knows what she is talking about. As they bicker I ring up blood bank to find out if the platelets have actually been ordered.
"Oh yes indeed, they're here." Blood bank replies encouragingly.
As soon as I put the phone down someone points out that I should have asked if we can actually HAVE the platelets.
08:01 "Oh hi, I spoke to you a minute ago about some platelets"
"No that wasn't me" replies Blood Bank "that was Christina, I'll just go and get her"
*Long Pause signifying that Christina was likely in the middle of some important and potentially life-saving job and has to be dragged away to come back to the phone*
"Hello, Christina"
"Urm, yes sorry, these platelets I just spoke to you about"
"Yes?"
"Well can we have them"
"Well yes of COURSE you can have them?! Just come and pick them up"
69 seconds into the day, nae into the WEEK and I've already made myself look like an idiot. Sweet.
08:15 "So I read somewhere that he has asymmetrical tonsils" says Sri when we go to see Tonsil-Boy "but I don't see any evidence of that."
"Well it was only because Geoff wrote it in the clerking" someone adds
"Oh well if it was GEOFF who wrote it.." Sri begins to say. At first I take this to mean "I trust Geoff, so this lends credibility to the asymmetrical theory" but subsequent indrawing of breath and remarks of "Wow Sri, Harsh" from the other guys on the round added a somewhat "Geoff?? Fuckin GEOFF? Geoff the worthless F1? What the fuck does HE know?" air to the whole situation.
Maybe I need to stop caring what Sri thinks about me, because every interaction with him ends up chipping away at his impression of me and it hurts like a thousand daggers in my soul. I have a similar problem with Tash's parents and, realistically, it would be better to stop caring about what ANYONE thinks about me, that way I might sleep at night.
08:45 I'm sad to note that one of my favourite patients is back on the ward. I like him not just because he was very nice about me stabbing him a hundred times with spiky needles but also because he commented that I was "a great doctor" to one of the registrars in clinic. The fact he's back on the ward is likely to mean some kind of depressing recurrence of his cancer, which is frankly no good at all.
10:00 Dermatology come at last to review our patient. For some reason, this particular speciality have a reputation for being dossing lazy types who merely find a long latin name for someone's rash and then prescribe steroid creams. The fact it is 4 days since we referred them this particular patient on an urgent basis isn't helping their case. Matt & Ravi, who are Derm fanboyz are keen to find out the diagnosis but before we can talk to them the team leave having written something in the notes that they have subsequently hidden somewhere on the ward.
13:00 Matt rings microbiology to discuss the discharge of one of the patients, who came in last week (and I can't really remember if I wrote about it or not) with a nasal abscess) and turned out to be growing the "hospital superbug" MRSA in his pus. There was some discussion as to whether it was worth ringing microbiology, who are theoretically very scary (though generally very nice) as they had previously told us to just stick him on oral clindamycin when he goes home. However Kat, who is infallible (and who I really need to find a criticism for at some point, lest it look like I'm in love with her and cause her to end her life as a result) had written in the notes that we should just check to be sure.
It turns out that it was a very GOOD idea to ring as he has actually been found to have not MRSA but VISA. Not knowing what this was we looked it up and discovered it to be "a type of credit card that is in competition with MasterCard", my job is more like Sam's than I'd realised....
Ahhaha. Aren't I funny. But seriously, of COURSE we knew what it was this is TEAM AWESOME I'm talking about. Between us we know EVERYTHING (ish. vaguely). So VISA is Vancomycin Intermediate Resistant Staphylococcus Aureus AKA "Hospital Super Bug Pro Extreme II: Ibiza Mix". Essentially it occurs when MRSA mutates so that the D-Ala-D-Ala terminal groups of the peptide wall become D-Ala-D-Lac. I'm sure you can all see that this will have a profound effect on the ability of vancomycin to kill the bacteria and thus we all need to RUN FOR OUR LIVES AAAAGHHHH.
Instead of nuking his room from orbit (the only way to be sure) we instead put him on IV Teicoplanin (that has increased hydrogen bonding and so dimerisation is.. oh you don't care do you) AND clindamycin in the hope of curing his ass. We remark that, had we ignored Kat's note and sent him home he would likely lose his nose. Sad though that might have been it would have been a brilliant prequel idea for Phantom Of The Opera.
Just picture it it: Jazz Keyboard Player is living the dream *various scenes of him laughing and joking with his beautiful girlfriend +/- cute child*, gets a nose infection *"Ha ha, don't worry sweetheart it's only a spot"*, loses his nose *unwrapping of bandages with gratuitous "NOOOOO"*. Poignant scene where, with a background of lightning and dramatic music, he finds a discarded party mask on the floor and, cackling, uses it to cover his noseless face. As he looks up at the bathroom mirror the descending D minor Phantom theme plays.
Coming 2012.
A Team Awesome Film.
15:00 We find the Dermatology guy's notes:
Derm Review October 2011
Impression: Vasculitis ?Cause.
Plan: Prescribe Steroid Cream
Mr. Lay Z
Dermatology SpR
Ha!
Day 2:
09:00 "Hi it's Mr Week here" says the person who's bleeped us "You didn't see my patient on ward round this morning. I really think you should go and see her straight away".
Damn right we should. This women, it turns out, had had the majority of her HEAD removed the previous day and was on the intensive (but not so intensive as all that) care unit. Unfortunately by this time everyone senior has buggered off somewhere so Matt and I go skipping off arm in arm to review her.
Fortunately for her and for us the I(BNSIAAT)CU staff are pretty on it and have reviewed her themselves. I also note from her "chart" that she has had a LOBECTOMY. This excites me no end because it reminds me of something like Shutter Island until I remember that the brain surgery thing is actually a lobeOTOMY. Rats.
Anyway though, Daily Mail readers, she was fine. In fact she was fit to return to our ward that very same day.
09:10 It also transpires that we forgot to see any of the post surgical patients on the children's ward. We go skipping off there too and talk to the nurse in charge.
"Usually we just send them home but there was nothing written in the notes to say we could discharge them without a review".
Fair enough. We wander round and have a look and, as everything seems fine, we send them home. This pleases the anxious parents and the children giggle in that heart warming fashion. Aren't we lovely.
09:45 Panic starts to set in that maybe there is some kind of unbreakable rule that F1s can't send post-surgical patients home regardless of how minor their surgery was and how well they are afterwards.
09:46 We ring the registrar for some kind of confirmation to make ourselves feel better but there is no reply.
10:30 Assuming that the registrar is too busy reporting us to the GMC to return our calls we begin searching for jobs online. There are none. Damn economy.
11:00 One of the guys who had surgery yesterday hasn't weed yet and his bladder has 750mL of urine in it. He isn't enjoying this very much.
He enjoys even less the fact that I'm going to have to stick a tube down his penis. I'm not enjoying this either because I've never done it on anyone awake and, despite what Brodie tells you, I'm not such a fan of the penis.
11:05 I bleep a friend of mine, Dave, who's on the Urology film. Partly because he's much better at this than me (as he deals with penis all day every day), partly because he's generally an excellent guy but mainly because he's one of the few F1s you can contact through the automated telephone system and I enjoy that fact enormously.
11:15 Being amazing Dave suggests he just comes to my ward and helps me. This turns out to be extremely fortuitous because I find I've forgotten more about catheters than I ever knew; to the point that I don't really remember what equipment I need.
11:30 I'm all dressed up in my gear and have the guys penis lying in front of me. Dave talks me through the joyous process of injecting it with goo, massaging it down the shaft (I'm not even joking) and then making idle chit chat with the patient about the weather while it takes action.
11:35 After the most painful 5 minutes of my existence I
Note To Self: Give Dave a hug when not covered in penis.
13:45 Teaching on ABCDE. This ABCDE isn't just the alphabet but is in fact how to manage acutely unwell patients. It has, however, been taught to us just as many times as the alphabet and yet more lectures on it seem rather excessive. Furthermore I am absolutely BUZZING on caffeine and desperate for the toilet. I've been desperate for the toilet since the beginning but had overestimated my ability to cope. Worryingly we're only on B at the moment and, as you can tell, there are several more letters to go.
14:10 He's STILL yacking on about something. Something I no longer care about.
14:20 "Now, I've finished talking about the scheduled content of the lecture but I just wanted to say a little something about "Patient Centred Care"
Up comes one of those diagrams of a jigsaw puzzle where they've tried to squeeze text onto each on of the pieces but have done a terrible job because THEY SUCK.
"Now the importance of patient centred care is." OH MY GOD SHUT UP YOU STUPID, STUUPIDD MAN.
I'm becoming ever envious of Brodie who went running out about 10 minutes in. At first I thought he might be dying or something but now I've come to realise he's just smart.
14:30 The lecture finally ends and I run to the loo, fearful that my bladder is about to explode horribly.
14:31 The toilet is out of order.
"Been waiting 90 minutes and the fucking toilet is out of order" I mumble at someone I've never even met in the corridor before hurtling up the several flights of steps to the second nearest facility. This toilet thankfully works and severe bladder blowout is averted.
15:30 Matt is bleeped (notice that so little has happened today that all the stories are actually about Matt) by some other F1. This F1 checked with the switchboard whether she would be getting an F1 ENT or a real bona fide SHO ENT. She was told that all the ENT bleep holders are SHOs.
They lied.
In order to make up for this we go up together because 2xF1 = F2 (it's simple maths, really) and find, upon nasendoscopying that some dude has horrible cancer.
I'm also worried by how much this (the Healthcare of the Older Person, previously Healthcare Of The Elderly, previously Geriatrics, previously Old Fogies Place To Die) ward smells of urine and faeces in comparison to our shiny ENT ward and how little I'm looking forward to my placement in that specialty in the near future.
Note To Self: Buy medieval doctor's outfit with beak full of pot pouri
17:00 Sri ascertains that there is no horrible cancer and the guy has, in fact, got a cold.
F1s for the win!
16:30 I leave early in order to get to my Summer Holiday rehearsal on time. I am keen to get there before it starts not only because there are only 2 rehearsals left and they really need some practise but also because the people in charge are really mean and yell at me if I'm late despite the fact that I'm busy SAVING CHILDREN'S LIVES (by sending them home after operations).
17:30 FU
17:40 CK
17:50 ING
18:00 TR
18:10 AF
18:20 FI
18:30 C!!!!!
Day 3:
11:00 I'm writing he discharge summary for a 92 year old lady who's had a HUGE operation. Despite this she is extremely well and is verily bouncing around the ward. On top of this she is also incredibly nice. Maybe Health Care Of The Slightly Less Young Person Than You Might Find Say On Paediatrics might not be so bad after all.
15:30 Not alot has happened all day, in fact it would fair enough to say that NOTHING has happened all day. Suddenly, however, Matt is called down to A&E to save someone's life and Brodie is called to clerk in a patient who can't breathe or something else trivial. This is all fine though because there are lots of us.
15:45 A lady arrives whose CT scan has just shown that her head is completely brimming with pus. So much pus, in fact, that it has eaten through the bones enclosing the sinuses where the pus is brewing have eroded exposing her very brain to the infection. I fear that she will be in a bad way but when I go to see her she is fine, positively chirpy actually.
It is clear, though, that she needs urgent attention so I set to work cannulating her and pumping her full of IV antibiotics. The nurses are busy with all the other shize that's going down so I go off to prepare the antibiotics themselves.
16:25 Anyone who says that nurses have an easy job (which I'd like to think is nobody) is an idiot. Getting all these various tubes connected to the various fluids and then connecting them to the antibiotics is horribly tricksy. In the process I've managed to squirt most of the juice over the floors in the clean room and the antibiotics are likely at homeopathic concentrations. Nevertheless I eventually get them connected and arrange for her to be put on the emergency theatre list.
17:00 I feel like I'm forgetting something...
17:45 Something important...
18:30 But what?
21:00 OH SHIT! I was supposed to be meeting with my Educational Supervisor at 16:00 and I completely forgot. I didn't even ring him to say I was busy I just completely forgot I was supposed to go. Seeing as this guy has met me only once so probably doesn't know that such idiocy is unlike me and that he signs off my whole ePortfolio which is, itself, the basis by which people judge me during my future job applications this was a pretty big error.
Bollocks.
I send a grovelling e-mail but will, during my day off the next day realise that my laptop failed to send it making me seem even ruder. Looks like i'll stay as an F1 for ever. Great.
Day 4:
07:45 Today's the day we send off our 360 degree appraisal forms (/the Teddybears Have Their Picnic)
360 Degree appraisal is theoretically the time when being a generally pleasant and competent doctor becomes all worth while. We send off requests to various people so that they can write little reports on us that are then anonymised so that we don't go and murder those people who aren't nice to us. There are, predictably though, some problems with this.
Firstly you get to pick who to send the appraisals to so if you've managed to piss most people off but, despite it all, there are a few that don't hate you then you can just send it to them and look great. People can't demand to write about you so some twats never get any comeuppance.
Worse, though, is that you MUST get your clinical supervisor to write about you. My clinical superviser spends a lot of time trying to get Solomon Vandy's family back and helping national Rugby teams win the world cup so as to bring unity to their countries but spends ZERO time on the ward and only sees me in clinic when I can make it down there. This is frustrating as he probably thinks I'm an idiot as a result of this and will write mean things about me, or just refuse to do the thing at all meaning that I fail the entire year. Grr.
09:00 It's M&M Meeting Time. I have brought cake that my next door neighbour made and hoping that, as a result of this, my supervisor might just sign my 360 thing anyway. On entering the conference room I find about 50 medical students huddled in the corner looking scared. As they are unable to sign my 360 appraisal there will be 0 cake for them.
09:30 No consultants have arrived yet but a registrar has decided to start off with "Journal Club" where we all squint our eyes at a projection of an academic paper written in the smallest possible font. About 15 minutes into this I realise I haven't actually been reading it all, despite my new glasses and fear the discussion we'll be having afterwards. Fear
09:35 BLEEP BLEEP
Thank you Steve, I say to the heavens as I'm literally saved by the bell.
09:45 I return to the ward to find the Reg, Mr Saharaparathyroidectomydoberryloperawhatsit sitting in the Office. He needs help with various tasks that I am more than glad to do to get out of journal club.
10:30 I head off to get my 'flu Jab to prevent myself from getting the AIDS again this year and am devestated to hear that all my cake has been eaten. My consultant has eaten some of it so hopefully the Geoff Love Serum I baked into it will sort all my problems out. Apparently he even made a joke about having a Cake Based (rather than Case Based) Discussion with me when he signs me off.
Hehehe.
12:00 Brodie is getting twichy and rightly so, given that he ordered an iPhone 4S and the only thing that's getting between him and a date with Siri is the pesky dying patients. Only there are no dying patients, there are barely any patients at all. I feel his pain but am unable to justify giving him half the day off especially as there's noone else in.
13:00 My catheter man is back in to have a TWOC (Trial Without Catheter) so I take him into the treatment room and hoick it out. Just as he gets dressed the nurses appear at the door dresses to the nines in safety equipment and carrying a billion trays with stuff in.
"Did you already take it out" They ask
"Errr yes"
"Whaat? But we were going to do it! I've even got the student nurse in here to show her how it's done"
I notice the student nurse lurking in a way I can remember oh too well and feel terrible, even though I was only being efficient. It also strikes me how much ridiculous faff they have to go to, likely because of hospital regulation, just to pull a tube out of a man's willy. No wonder they're always so busy.
13:05 The guy, so pleased to have his penis back to himself, wonders if he can bring some flowers in to a patient on the ward who he met on Monday. I am keen for this but go to check with the nurses who inform me that, luckily, ours is the only ward in the WHOLE HOSPITAL that allows flowers.
Flowers are apparently banned in the NHS because they're covered in BAD THINGS that KILL YOU. Quite how any people who spend any time outdoors survive beyond 25 is, therefore, beyond me and as for GARDENERS, well, I dread to think.
15:00 I send Brodie to get his iPhone. His presence on the ward is clearly ridiculous as we've been sitting around for hours with nothing to do.
17:00 On call again, nothing happening.
17:45 The phone rings, it's someone with some ludicrously complicated problem that I have no hope of knowing how to solve. Fortunately for me there are 2 registrars in the room and one of them offers to take over the case, despite the fact he's due to finish work in 5 minutes. How nice.
18:40 We're still dealing with this really complicated case and it's not helping that the patient is one of those (depressingly commonly occurring) people who when asked something like "when did this first happen" reply with something like:
"Well, it was on a Monday, or was it a Tuesday? No it was a Monday because I'd just been shopping at the... the... the... you know... the Shopping Centre. So Yes I was shopping and I though 'I must buy myself some onions' but, of course I'd left my onion buying purse at home so I didn't know what to do. So what I did was I rang my son. He's working as a builder you know, just started, he's very good. He never really wanted to be a builder but he never did so well at school and because his dad used to be good with his hands it encouraged him to try. He works for Smith's, is it Smiths? Maybe it's Reynolds? No no Smiths. No Reynolds...."
Eventually she shuts the hell up and we can leave but I'm bleeped down to Paeds to look in a kids ear. The kid has photophobia, a rash, neck stiffness, a temperature. "MENINGITIS" written all over him in lettering and a blood culture came back showing that he has meningitis. For some reason, though, I'm called to look in his ear just in case this is all a result of some surgery (and by surgery I mean we looked in his ear under anaesthetic) the previous week.
18:30 The ear is fine, I advise them to get some Penicillin in his ass right quick like.
N.B. PAEDS A&E ARE ACTUALLY EXCELLENT AND WOULD NEVER LET SOMEONE WITH MENINGITIS GO UNTREATED FOR ANY LENGTH OF TIME
19:45 Kat comes to take over for the night and lets me go early. This is good because I'm supposed to be going out for drinks with the Registrar. Given that I have work for the next 9 straight days I should really say no but as I have NO SOCIAL LIFE I could do with getting out the house.
23:30 Home. It's way past my bed time.
Day 5:
03:00 All my dreams are being narrated in the registrar's voice. This is disturbing on so many levels.
07:00 So. Tired. But Must. Relieve. Kat. Early. Because. She's. Been. On. Nights.
07:45 I relieve Kat early, because she's been on nights.
11:00 Nothing has happened so far, at all, I take a wick out of a guys ear. It take 2 minutes.
19:00 Someone famous has been admitted onto the ward. Let's call him B. Pitt, no that's too obvious, Brad. P. People are making quite a fuss, despite how Z list this guy is (Z list is actually pushing it, he's not even ON a list) and there are security everywhere.
I get very annoyed because, whilst trying to help a poor 15 year old who's been trying to find his friend in the hospital for 20 minutes I get shouted at by security. I then get shouted at by hospital management for not listening to security.
19:20 Security are bleeped to some kind of shooting/bombing/arson in A&E but assure us they'll be back ASAP.
"Oh gooood" mocks the nurse "How could we possible survive without you"
20:00 Kat arrives after the most uneventful day ever. I am literally bored out of my mind. Fortunately it's time to go to Matt's.
20:15 I know you don't care about my social life (what little of it exists) but I must write how exciting the whole visit to Matt's was. Firstly it involved not sitting on my own crying like my usual Saturday Nights, secondly the whole invite leads me to believe that maybe Matt doesn't hate me after all and that his usual "Sorry I can't do anything this weekend because I'm errr.... busy... er... yea" excuses might not actually be thinly vailed lies to fob me off. Thirdly the whole thing was generally great fun and he made delicious curry and I had beer and woooooo.
Day 6
07:15 My alarm goes off. Note how much LATER it is. This is because Matt lives next door to the hospital so there is no ridiculous commute. Wooooo.
10:00 I actually have a patient to see. He has tonsillitis which is always fun because it's so easily fixed and, given my horrific experiences of the illness in the past, I make sure to load patients up to the very brim with pain killers. The guy seems to appreciate this.
13:00 The registrar rings to find out whether I'm OK. I am, not least because I'm a pro but also because there is NOTHING TO DO.
14:00 Star Trek Villian (yup he's still in hospital) starts bleeding. I'm taking no shit today so I soak packs in a variety of drugs and shove them in his face. This stops the bleeding and lets me continue my dull as hell day.
14:30 A kid in Paeds has rammed some stuff in his ear, for some reason. On arrival I'm told by the (male) nurse that I've filled out a bit (boo) which has given me a great arse (woo) and that before hand I was "mincey skinny" (errrr).
I try to remove the ...stuff... in the kids ear with a... thing... and he screams. Kids do enjoy screaming in these situations so I just tell the mother to come back another day when someone who cares less about people screaming is around to jab things in the childs ear.
16:00 Nothing else has happened all day, I'm generally gossiping with the nurses. It's all good fun really. There are 6 patients on the ward, only 3 of whom are mine and only 1 of those actually needs any kind of attention.
18:00 Bored now. Want to go home.
19:00 So. Bored.
20:00 AT LAST Kat is here so I can leave. Yeeeey. My elation at the weekend being over is somewhat dampened by the knowledge that I have another 7 days left (including 3 nights) but at least I can eat some delicious lasagne that I left in the fridge.
20:45 Our microwave is broken and, by virtue of the unrotating turntable, can only cook 2cm x 2cm sections of any food in it. I cook my lasagne piece by piece, rotating every 5 seconds or so. The outcome really isn't very good but the task has been about the most interesting thing I've had to do all day.
TUNE IN NEXT WEEK FOR Trust Me, I've No Idea When I'll Have Time To Write This As Hywel Will Be Here (Did I Mention This Already? Well GOOD).
Byeeeeeeeee.
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