Tuesday, 27 February 2007

Do you think I'm sexy?

It’s half past four in the afternoon and I’ve just got out of bed. One of the problems with doing nights is that after a few shifts, you start to feel shattered when you wake up as well as shattered when you go to bed. The entire time you’re awake is against a background of sleeplessness that makes me feel constantly slightly queasy.

I can’t really complain though, the last couple of nights have been FAR more sedate than the first few. When you’re not running around like a blue-arsed fly, hospitals can actually be quite enjoyable places to work. The very nature of the job means that the staff are generally nice, friendly, caring people. When it’s not too busy, like last night, I actually have time to spend chatting to the patients, finding out a little bit about them and having a bit of banter, rather than having to treat them just as walking (or not-walking) illnesses. Work becomes enjoyable.

Last night, I treated this 83 year old lady who was admitted with a worsening of her emphysema. We were chatting a bit and she says:

83 year old lady: You’re very polite, you know
Me: Thank-you, I guess it was the way I was brought up
83 year old lady: And you’re very good-looking. Are you courting, doctor?
Me (thinking back to the previous week): Erm… I suppose I am, yes.
83 year old lady: That’s a shame. I’ll tell you one thing, if I was 60 years younger, I’d be chasing after you!

You’ve got to laugh haven’t you?

Sunday, 25 February 2007

The Storm

I was expecting bad things from this week of night shifts and I was right. I was based on the Medical Admissions Unit, where patients come to be assessed by the onsite physician (me) after being referred in by a GP or A&E doctor.

One of the paradoxes of working in medical admissions is that most of the patients arrive on the unit after 5pm, which is exactly when the staffing levels of doctors and nurses on the unit fall. This means that if you do an evening or night shift Medical Admissions, you can just about guarantee that you’ll have a busy time.

My first night was no exception. I walked in and there were already eight patients waiting to be seen with another five expected from A&E. I warned the FY1 doctor* that with only the two of us working, tonight was going to be manic. He gad a knowing nod.

And so it began, we spoke to, diagnosed and treated the frail, the sick and the infirm into the early hours of the morning. Some patients were critically ill, some just needed a couple of days in bed and there were lots in between. I don’t know if any of you guys have ever stayed up all night (whilst not on drink or drugs) but I find that after I’ve been awake for about 20 hrs my vision goes a bit weird, simple things like making a cup of tea seem to take ages to do and I get really emotional about just about everything. There’s a point in the night, usually about 4 or 5am when you think “The whole world is in bed. Why am I still awake? I don’t want to be here. I just want to sleeeeeep.”

But the patients keep coming in and they all need to be treated.

At times like this, truly, the last thing you want to here is the emergency pager going off, saying “Medical Emergency, Dr Anderson to A&E resus please. Medical Emergency Dr Anderson to A&E resus”


I hot-foot it down to A&E resus and find the A&E staff performing CPR on this old man. I manage to glean some background story. Apparently, this man found he couldn’t breathe and rang 999. The paramedics arrived at his home and found him dead next to the phone. They rushed him into A&E where, by using drugs and oxygen, we managed to upgrade his status from dead to alive. Problem was his heart kept stopping (i.e. he kept dying). Me and the A&E staff kept having to use drugs and CPR to restart it. This went on for about half an hour until we eventually “brought him back” so he had a pulse again. You must note that I’m using a medical definition of “alive” here, this man never regained consciousness. Although he had a pulse, he was not able to speak or move, he couldn’t feel or see anything, hell, he couldn’t even breathe for himself.

After giving him a cocktail of very powerful drugs, we sent him to the intensive care unit where a machine would breathe for him. I don’t know why this man died at home, my best guess was that he had a pulmonary embolism. What I can be more certain of is that he’ll never wake up. He’ll require increasingly higher doses of powerful drugs in the intensive care until eventually they’ll decide to switch the ventilator off and then he’ll die. For good.

As I wander out of the resus room, another A&E doctor asks me to see this woman who is having a heart attack and I’m reminded of the old saying “it never rains it pours.” Heart attacks are extremely serious in their nature and frequently kill, but fortunately, this lady wasn’t having a big one. I treated her, sent her up to the Coronary Care Unit and 06:45, I trudged back upstairs to the Medical Assessment Unit.

I’d been awake for 24 hours and there were still five patients waiting to be seen. One of whom had been on the unit since 01:30. I felt really bad that this poor old chap had been waiting so long to be seen but what can I do? To quote Whoopi Goldberg, “There’s only one me.”

* FY1 or “Foundation Year 1” doctors are in their first year after medical school are the most junior doctors in the NHS

Thursday, 22 February 2007

The calm before the storm

This morning, I woke up at 7am and I know I’m going to regret this. Tonight I’m doing the first of seven night shifts at Town Hospital and past experience has taught me that the only way to get through your first night shift without feeling like death-on-legs is to get as much sleep as possible the day before. So what do I do? I wake up at the crack of dawn and then spend the whole morning worrying about the fact that I’ve not slept enough. I’m such a muppet.

Today, I was planning to do all that “personal admin” stuff that you never seem to get round to doing. You know the boring stuff like, buying a breadbin, ringing up the letting agency, filling out the mountain of forms that I got at the “Town Hospital Induction” a couple of weeks back, but it’s pissing it down with rain outside and quite frankly, I can’t be arsed. I think I might go back to bed after all.

In the beginning...

I like writing and have just got a brand-spanking new broadband connection so I’m starting a blog. I reckon there’s no better way to kick things off than by letting you know a few things about myself.

I grew up in the 1980s, but am fortunate enough to have been too young to care about the politics or fashions of Margeret Thatcher's britain
I’m a junior doctor working in a hospital in a Town in the UK. (For those in the profession, I’m a Senior House Officer or SHO).
I live in a city which is a commutable drive from where I work.
I enjoy my job (except for the times when I hate it).
Given half a chance, I’d lounge around listening to music all day.
I’m a bit of a geek at heart, but disguise it well.
I despair at politics – it constantly surprises me that these so-called intelligent people can make such obviously WRONG decisions time-after-time
I reckon I’m pretty intelligent, but have more than the occasional “blond moment”
I’m a bit of a sex fiend and this keeps getting me into trouble
I love running but am not a gym-addict
I used to be a bit of a piss-head but have calmed down in the last few months – don’t get me wrong I love a pint as much as the next man but these days I don’t want to taste it twice, if you know what I mean.
I’m always impressed by people with talent and passion
Sunset is my favourite time of day.
I hate having to get up in the morning before my body is ready. I need my sleep!
I would love it if it were summer all year round because I hate cold weather
My all time favourite book is Michael Crichton’s Jurassic Park
My all time favourite film is Laputa – Castle in the Sky
My all time favourite album is The Bends by Radiohead
My ideal woman is someone smart, sexual, funny, attractive, and passionate I think twice I’ve found someone who I could possibly be with and twice I’ve let her slip away…