Is anybody actually in charge?

I’m employed by a company to do a job and I do it well. Unfortunately, the people who run my company have decided to sack all the people doing the job I am and make us re-apply again for the jobs we are already doing.

They said I can only apply for four positions in four different areas of the country. I’m not happy about it, but I dutifully go through the processes and, because I do my job well, I get shortlisted and interviewed for all four positions I’ve applied for.

I spend a lot of time, effort and mental energy preparing for the series of interviews to try and perform to the best of my ability, after all these interviews are important and I don’t want to be unemployed come the summertime. These interviews are also very stressful but I try my hardest at each of them.

On Friday night my employers email me to let me know that they’ve changed their minds (again) and ask me to guess which interview I’ve done best in (they’re not going to actually tell me which I’ve done best in). Then they say that I can only apply the job in which I believe the interview went well and the rest of the interviews will count for nothing.

My contract is being terminated in the summer and I only have one opportunity to apply for one job to replace it.

Currently, in my company, there are 32,300 people doing my job. These people are competing for about 21,000 positions and come summertime, a third of us will be out of a job.

If anyone told me about a situation like this, I’d advise them to change companies to one that actually valued the hard work of its employees and didn’t treat them in such a slipshod, slapdash, disdainful manner.

Trouble is, my company is the NHS and my job is a junior doctor.

I don’t want to leave the NHS but I’m asking myself, with increasing regularity, “Is it worth it?”

Life Choices

In this life, we must take responsibility for the choices we make.
Tonight I had the choice of

1. Preparing my presentation for my interview for a training position in London tomorrow

2. Messing around on the internet for four hours.

Which do you think I chose?


Looks like I'll have to make up the presentation on the spot

I am such a retard

The St. Patrick's Day March

As a profession, we doctors tend to have the attitude that says "just get on with it" whenever bad things happen. We don't complain (at least not en masse), we don't strike, we just take the endless shit that's heaped on us. Things are changing.

A group of docs called RemedyUK are getting us to take a stand over MTAS and they organised two marches yesterday - one in London and one in Glasgow.

Beforehand, I don't think I grasped the importance of the occassion but this march turned out to be the biggest protest in the history of our profession. It was great to see so many of us speaking out (some very loudly) and uniting against a system that is shafting so many people. It was good to meet up with old friends too. There were great speeches by RemedyUK, by the West Midland surgeons, but I couldn't believe it when David Cameron took to the stage.

I can't stick the Tories or what they stand for and I was fuming that he basically tried hijack the march and turn it into some sort of Tory-party rally. Grrrrr.....

My mood was not improved when the BBC showed their news review and made the march sound like a pro-Conservative demo. In fact, I've got to stop typing now because my blood is about to boil.

I hate fucking politicians.

-----------------------------------------------------------------------------------

I've calmed down now. All in all I have to say that it was great to see so many people taking a stand and this is another step towards forcing the powers that be to sort out this mess they've created. I feel proud.

The joy of spring and the MTAS fiasco

I’m feeling very happy at the moment. I don’t really know why, maybe it’s because spring has its foot firmly in the door. Maybe it’s because England beat France on Saturday. Maybe it’s because I’ve just had a free weekend (a very rare thing for me at the moment) and the sun shone and I spent it drinking beer with friends. Maybe it’s because I spent a lot of time this weekend having sex with a beautiful woman. Whatever the reason, I think that, in general, life is going pretty well at the moment and not even the ongoing MTAS fiasco is dampening my mood.

You may or may not know about the way the government has tried to fuck up junior doctor’s training but in a nutshell, here’s what’s happening.

The government is sacking every junior doctor in the country on 31st July this year.

They are making us re-apply for the jobs we are already doing through the Medical Training Application Scheme (MTAS).

If you do not secure a job starting 1st August via MTAS, the system PREVENTS you from re-applying EVER again.

Due to a number of wholly predictable cock-ups, including lost documents, computer crashes and leaked marking schemes, MTAS has not worked. There are thousands of doctors who are not even being interviewed for the jobs they are already doing and doing well. This means they are staring down the barrel of unemployment and will either have to change careers (after between 7 and 10 years of medical training) or leave the NHS to practice medicine abroad.

It’s crazy.

Aphra Behn has put a more detailed guide to this debacle on her blog.

Unsurprisingly, this is causing a huge amount of stress, panic and misery among my colleagues; you can read about just how upset and angry some doctors are here, here, here, and here.

Fortunatley for me, I’ve managed to secure an interview for every position for which I’ve applied and the second of my interviews is tomorrow.

I have to say, I’m feeling very relaxed about it, which is sort of strange given the potential importance of tomorrow’s interview but, to be honest, I have no faith in this system and honestly do not believe that whether or not I get offered a job will have anything to do with how good a doctor I am.

It’s with these thoughts in mind that I’ll walk towards the interview panel tomorrow… and smile.

Wish me luck!

The reason why doctors work late...

Friday, 4pm and a patients arrives on the ward from the Medical Assessment Unit. This man is as sick as a dog. Jaundice has turned his eyes and skin bright yellow and we look at his blood test results and his bilirubin level is about 500. This is very bad news indeed. He’s a homeless man and you didn't need to be a doctor to tell that he was seriously unwell. He was all skin and bones and he had the haunted look about him of someone who knew his time was at hand. He wasn’t fighting it.



This man wasn’t well enough to even speak to us anymore. For us to know why he was so jaundiced and unwell, we needed to scan his liver by ultrasound.

In hospitals, half past four on a Friday is the worst time to try and organise things. Departments are shutting up for the weekend and the staff are trying to finish up their workload so they can get to home/to the pub.
Luckily for us, our consultant (effectively our boss), was on site and he came straight to the ward and, after speaking to four different radiologists, found someone who was willing and able to scan this poor man’s liver. The radiologist pages me 16:40 and says “I’m in the ultrasound department, I need to leave at 5pm. If you can get the patient here in the next five minutes, we can do the scan for you.”

So I grab one of the nursing assistants and we wheel this patient on his bed, through the corridors of the hospital to the Ultrasound Department.
I have to say, this was all very dramatic and one of the few times I actually felt as though I was in an episode of E.R. or House or Holby City or any of those medical dramas where people are always running through corridors yelling “Emergency! Emergency!”

The radiologist is there waiting for us and the scan shows that this man’s liver is chock-full of cancer. This is why he was so jaundiced and this is why he was so unwell and this is why he was going to die. As doctors, there is nothing we can do to save this man’s life, but, because we managed to get a scan done, we’ve spared him from having further blood test, needles, catheters and all the other unpleasant things that we do to our patients in order to diagnose and treat their condition. What we can do for him is make sure his last hours are peaceful and painless, and from that we can take solace.

I’m typing this on Sunday evening and I will be very surptised indeed if he’s alive when I get to work tomorrow morning.

The ward night out

Last night, I went out on a night out in the Town with the nurses from the ward. I must confess that I was a bit wary about going out drinking because, in my experience, I’ve found that when nurses get drunk together they get totally wasted and crazy stuff happens.

I got the train from The City (where I live) to The Town (where I work and where we were going out) and got in just before 10. A couple of phone calls later and I manage to track them down. It turns out that they’d been drinking since 4 o’clock and were totally off their faces. It was pretty obvious that there was going to be very little in the way of meaningful conversation going on, so I had little choice but to get pissed. It actually ended up being a really fun night withoads of banter with random bods and lots of laughing and dancing.

At about midnight, James, one of the other doctors from the ward, pulls me to one side and tells me that Anna, one of the nurses, was coming on to him. Problem was that she was in a long-term relationship and he asked me what I thought he should do.

I know the whole “doctors and nurses” thing is such a cliché, but seriously, it’s so true. Just about every male doctor I know has shagged at least one nurse, you could call it a perk of the job. For me personally, it’s been two – one as a house officer and one as a medical student. It would have been more but for my views about sleeping with people you work with, I’ll explain my opinion in a later entry.

Anna’s pretty cute and I definitely would, so after giving James that caveat that I’m a bit of a badboy I said:

“Look, she obviously really likes you and from what I hear, she’s liked you for a while. I don’t think the fact that she has a boyfriend is really relevant here, she’s a grown woman and she’s capable of making her own decisions. Personally, I think it takes a lot of guts to say what she just said to you, and personally I don’t think that I’d EVER say that to someone, no matter how much I liked them. I think what’s important is that you decide what YOU want to do. I think if you’re honest with yourself about whether or not you want to go out with her, or shag her or kiss her, then you can be honest with her about it. And I think she deserves that honesty whatever happens”

Surprise, surprise, half an hour later, James and Anna are swapping spit on the couch in the corner of the club. I think things would have gone further if Anna’s boyfriend hadn’t arrived to pick her up about an hour later. I wonder what she’ll say about the whole thing on Monday. Stuff like this makes work so much more interesting!

All in all, I had a surprisingly fun, if a tad cheesy night out, and I’ll definitely go along to the next one – and next time, I’ll start at 4 o’clock!

Mind on the job!

I took Tina out to dinner last night to celebrate both the fact that I’d been paid and that I’d finished my nights and am now officially back in the land of the living. Tina is a girl I’m seeing at the moment. I met her in a club a few weeks ago and since then, we’ve become sex-buddies. She’s very pretty, very tall, brunette with big blue eyes, big breasts and a sense of fun – just the type I go for, in fact. She’s a total party girl and her antics make me laugh loads. Maybe part of the reason I like her is that she provides a flip-side to my job which is often really depressing.

For example, one night, me and the registrar saw this 59 year old woman in A&E with breathing difficulties. We saw her at 23:30 and she looked awful. She was a long-term smoker and this had destroyed her lungs, leaving her with COPD. In addition to that, her heart was failing, meaning fluid was building up in her lungs, slowly drowning her and making it even harder. On top of that, she also had pneumonia, so there were three very good reasons why she was sick and couldn’t breathe properly. When we saw her in A&E, it wasn’t so much a question of IF she was going to die, but WHEN. I was determined that it was not going to be on my shift and we gave her all the appropriate treatment but, as we expected, she continued deteriorate and ended up dying about noon the next day.

I was lying in bed thinking about this woman this morning when my internal “voice of reason” kicked in and said:

Voice of Reason: What are you doing?
Me: Nothing much, just thinking about that patient
Voice of Reason: Why on earth are you thinking about that NOW?!?! You are an idiot. You are lying in bed on the first day off you’ve had in ages, you’ve got a dead sexy woman lying next to you, she’s stroking your stomach and rubbing her breasts against your side and you are thinking about that woman gasping in hospital. Come on son, mind on the job!

And I guess this the age-old problem of not being able to leave work at work. In the time since I qualified as a doctor, I’ve got better at not dwelling on things, but sometimes, still, work gets to me…

Steady hands

Try this: http://members.iinet.net.au/~pontipak/redsquare.html
I got 26.113 secs on my fifth go! Maybe I should become a brain surgeon.

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?

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”

Bugger.

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

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…