General Surgery

Well good DAY to you all. Sorry about the length of time I've been away from this blog see it turns out that there just isn't TIME to write frivolous diatribes about ones junior doctorey issues because there are just too many dying patients. The bastards. However, just because I love you all so very much, I've taken it upon myself to give you a lowdown of general surgery, lest you become disenfranchised with life.

THE CAST

Ward 309 Office:

Matt - King among men, bastian of the medical arts, saviour of lives and bringer of joy. You may remember him from such blogs as 'Dr Geoff's Blog'. He has had a somewhat fraught 3 months for reasons that are unmentionable but suffice to say are not his fault. When he'll escape from this is anybody's guess but the fact I haven't found him swinging from the rafters of the office by his own stethoscope is evidence of his plucky determination and good eggy qualities (also evidence that the hospital was built, like, yesterday and so doesn't have any rafters.)

Omar - The whitest brown dude ever to walk the earth. Trained at Oxford university, Omar has the self confidence of a movie star and can often be heard making statements like 'I can't BELIEVE that consultant had a go at me, I mean, I went to OXFORD, so I'm obviously MUCH cleverer than her'. Despite being extremely hard working and an all round saver of my sanity he gets more or less nothing but shit from the consultants because once an F1 said he was a bit lazy. He loves but two things in life 1. Costa and 2. Smoking and trying to cover it up with copious man scent (also his fiancee). An advocate of the 'ditching general surgery because it's shit and running away to orthopaedics' mantra, his goals in life consist of driving to waitrose with his four male children in a landrover and owning several big dogs.

Ben - Jesus reincarnate + on speed. Ben is the most religious person in the known universe and believes heavily in the likelihood that God himself will tell him (literally) how to fix people. This might explain why he gets confused between a Gastrectomy and a Gastroscopy. However he is also extremely nice, takes time to listen to his patients concerns and is loved by every single staff member in the whole trust. Except that Red haired bitch from 313. When we are on shift together (which is rare) our days are spent wandering round the hospital as I wind him up about his faith and whistle the 'Odd Couple' theme.

Preetha Biriani - Half curry, half sized, 100% lovely, Preetha exists mainly to be stressed out and to get fucked over by Bob Smythe. Constantly stressed and generally panicking she is impossible to fault and has somehow survived without burning the hospital to the ground.

Beautiful Emma - Emma has beautiful curly hair that she hates and refuses to listen to anyone (read: me) who likes it. She is highly reliable and puts up with me calling her Beautiful Emma all the time, she also loves lists and owns ridiculous levels of Apple product. She drives an awesome mini, cooks awesome puddings and is generally awesome. Oh and I'm sure she's a great doctor or whatever.

Laura - Can't really remember who this is. Fairly sure she works in the hospital. She refused to help me do a catheter on someone and I'm still not really over it.

Eleanor - MASSIVE breasts, MASSIVE love of Jesus. Eleanor exists in a world separate from our own and once had a go at us for bitching about how bad our days had been. She narrowly avoided Death By Omar at the time and has kept her mouth shut about the topic since. She does not, however, keep her mouth shut enough to prevent her from singing extremely gospelly gospel music overly loudly as I'm trying to convince the Radiology consultant to throw me a frikkin bone. All this being said she is extremely nice and is VERY helpful when it comes to helping with eDischarge summaries. Also did I mention she has massive breasts?

Elsewhere:

Bob Smythe - Forged in the fires our mount doom out of pure incompetence, Bob Smythe is the surgical rota coordinator. Famous for doing ridiculous things, like putting me on my own covering 20 normal patients 40 post take patients and urology on call, and then blaming it all on someone else, Bob will never be fired because that's not how public sector jobs work. We are all fairly convinced we could do a better job than him whilst sitting on the toilet and I would like nothing more than to see him kicked out of the hospital and, preferably, murdered horribly.

OK scratch the murder bit.

The Ward 313 Nurses - Ubiquitously terrible, the Ward 313 nurses love nothing more than to bleep you incessantly for jobs that dont need doing urgently or, in many cases, at all. They have a minimal grip on the English language and, when not trying to have sex with Ben, spend large amounts of time having arguments with Ben. Many of them also smell bad.

Mr Leeder - Grey haired and generally awesome, PCL was once the sexiest surgeon on campus but has now fallen to the status of 'Poor man's John Lund' after he has been repeatedly raped in the ass by the NHS. He has recently been in the papers because one of his patients bled to death after an operation. 'Surgeon told my mother she had a 1 in 2000 chance of dying' read the headline. Given that around 1999 operations of that type had occurred since the last death, I don't really see what people's problem is. Nevertheless he is a great surgeon and a great person.

Mr Iftikhar - My clinical supervisor. Depressingly non-south african and prone to mumbling incoherently, he likes to do ward rounds at the speed of light. This prompted me to create a sticky label system for making writing in the notes easier and faster, which he decided equated more or less to the greatest invention of all time and he now loves me. Despite complaining that he thinks Junior Doctors should work at least 68 hours a week he is actually very nice and he is not beyond putting in cannulas on patients who we've thus far tried repeatedly to kill.

Mr Ahmed - Totally useless in every way, except that he's really very good at doing surgery. All the complicated patients seem to be under him which is a real shame because he's totally unable to deal with complicated patients and generally likes to just ignore them in the hope that they go away.

THE SHIFTS

Day Job - Not Post Take (Around 0.001% of the time):

Sitting around in the mess with minimal things to do, generally one should be able to get home at about 3 in the afternoon but, unfortunately, the registrars like to do ward rounds at 6pm so even when you're not busy you're stuck in the freaking hospital til a million o'clock.

Day Job - Post Take (All of the time, unless you are on Urology, Vascular, Breast or really any job except those people in the 309 office):

A hellish nightmare of stress, bleeps and being yelled at. After a 4 hour ward round of all the new patients, the consultant promptly fucks off to Barbados (or, in some cases, was never there in the first place). This leaves you with around 40 patients who are either a) ill or, much more likely b) total dickheads. Around 1% of on-take patients have any kind of surgical pathology you can tell these patients because they are the people that are reasonable human beings. The other 99% are time wasting douchebags, most of whom bounce in and out of the hospital like a yoyo. One particularly fun patient, Steven Wetden, has been admitted 88 times in the last 10 years with 'abdominal pain'. Most recently, after telling all the nurses to fuck off he then said he was going to the papers to complain that we still hadn't fixed his made-up problem. We wished him good luck because at least the newspaper offices are OUTSIDE THE HOSPITAL.

Post-take shifts generally consist of running around like a mentalist all day trying to do eDischarge summaries that require 0 medical knowledge and having no time to tend to any actually ill patients who actually need someone with an actual medical degree. Sadly the government doesn't monitor hospitals by the number of patients who spend hours dying horribly but instead by pointless figues, hence the importance of us doing eDischarge summaries. The fact that a guy off the street who doesn't even know what 'Paroxysmal Nocturnal Haematuria' even IS would be more than capable of achieving this task has never occurred to the NHS.

Further frustrating matters is the fact that on the ward round the consultant, knowing only how to slice people with a knife, will try and discharge all the patients under his care who he doesn't see will need theatre. The fact that they, what with their crippling heart failure, are totally unable to leave hospital then becomes the F1s problem and the registrar can only help insofar as to say 'Refer to medics'. These guys were all Juniors once and, presumably, know that the medics are just going to tell us to fuck right off but they have conveniently forgotten. Or, more likely, don't really care.

On Call - SAU Emergency

A week and a weekend of 8-8 shifts clerking all the patients who come into the hospital for acute surgical problems (these patients form the post-take crowd mentioned above). My initial fear of this shift was some what impacted on the fact that Mark, the replacement for Dave Nugent in the 'guy all girls fancy' department, had spent the entire meeting with the Deanery rocking silently on his chair saying 'SAU... bad.... so.... bad'.

Actually it's not that bad at all. Yes the nurses are horribly arsey because they're under ridiculous pressure, and the registrar is invariably in theatre just as patients start to get really ill but at least there are lots of people around and everyones in it together.

On Call - SAU Elective

What retard came up with calling this the 'Elective' job I will never know. In reality it's 'Urology' with a bit of ward cover thrown in. The week shift (that I've yet to do) sounds mildly hellish as you cover all your own patients and also clerk the Urology guys who come rolling through the door with their urinary catheters and their swollen testicles. The weekend shift, however, is a godsend of quiet and tranquility (though mine was somewhat scuppered by the Friday when I was basically the only F1 in the hospital and I actually completely went psycho at once point).

The downside really to 'elective' on call is the amount of penis you have to deal with. There is just a massive amount. Invariably the patient won't speak english so will likely be quite shocked that not only have you stuffed a tube into his penis but that you also are about to finger him in the ass to check is prostate. I spent a full 15 minutes squeezing the end of one guy's penis because his foreskin got stuck (I KNOW YOU DON'T WANT TO KNOW THIS BUT IF I HAVE TO REMEMBER IT THEN SO DO YOU).

Nightshifts

Two F1s, one hospital. The good thing about the nightshift is that rather than having a FUCKING BLEEP you instead have a friendly mobile phone (with Snake) to which all your jobs get texted. Furthermore there's a guy taking all the calls from the wards who basically filters only the most important stuff to you. There's also Nurse Practitioners who go and review patients and only call you if they're really ill and Night Support Workers who take all the bloods and do all the cannulas.

In pretty much every conceivable way except the fact that you're working all night this is much better than the day shift. Sure there is noone around to help you if everything goes tits up but, as I've learned from my extensive running around the hospital crying, there is NEVER anyone around to help you when everything goes tits up.

MY LIFE

So yes, General Surgery has more or less ruined my life and, yes, Matt and I rarely EVER get to go on homoerotic trips to review patients together and, yes, I've learned absolutely fuck all medicine and probably forgotten a shit load and, yes, I want Bob Smythe to die but otherwise all is well.

(ALL IS NOT WELL. SURGERY SUCKS).

Love, Geoff
xxx