I can spend 10 minutes per consultation if people have straight-forward tonsillitis or gastroenteritis.
But what about the parents who are hesitant about vaccinating? I need more than ten minutes to make an impact.
What about the woman whose pregnancy test was unexpectedly positive, and needs to discuss options? She might not have anyone else to discuss options with.
What about the myriad people with psychiatric illness? I need more than ten minutes to figure out if it’s depression, or if there is a history of hypomanic spells. Is it substance induced? Is there another general medical condition? Who can start someone on antidepressants after a ten minute consult?
And what about the worried well? The old people with children abroad, with a bag full of chronic medication, and stories of challenges as numerous as the stars.
My dad has a favourite piece of advice for new graduates. It goes something like this:
Remember that when you come into contact with a patient, you may be the only person that touches them that day. The only person that hears their voice, that looks into their eyes. Make sure your touch is a kind one.
General Practitioners are pushed for time (and push their locums for time) because it’s the only way they can make any kind of profit, really. I understand that. But that is not the family medicine that I was taught, and I’m having trouble finding the balance.
Every few months, the mental health of doctors/medical students makes it to popular media. It seems like these spikes in attention occur, and everyone shouts YOU SHOULD CARE FOR YOUR DOCTORS! and then we write blogs and we tweet and we make youtube videos and eventually we go back to work, and nothing has changed.
I just recently finished a four-month Family Medicine rotation. Our after-hours duties on Family Medicine are as casualty officers at the Accident and Emergency Departments of two different hospitals. Because A&E has high-intensity decision making, our shifts were not allowed to be longer than twelve hours (compare: 24 hour shifts in any other department).
It’s so easy to complain about my daily work. Annoying patients, a system that is falling apart a little more every day, and inconsiderate or lazy doctors and nurses <– you see?
And then there are some of my colleagues who just really make me want to be a better person – and a better doctor.
One of our intern-colleagues is well-loved for being a bundle of fun and kindness. Whatever event our hospital’s social committee organises: he’s there, and he is their biggest promoter. He introduces people to each other, and he encourages them to get out of their shell.
Then there was that one time he walked around casualty on Easter Weekend dressed as the Easter Bunny, handing out goodies to all the interns on-call.
How nice is that?!?!?!
When he has a calm call-duty, he walks around and helps the services that are having a rougher time of it.
Written down, it may seem like he is the biggest gunner or kiss-ass. But he is just so genuine that it does not seem to get on anybody’s nerves (not even my very flammable ones).
I’m by far not a lazy or a mean intern, but when I see people like this guy, I just think: wow. I want to be like that when I grow up.
I heard this song for the first time as I was driving to my New Year’s Day call on Friday. Apparently I’m the only person in the whole world who hasn’t heard it, but WHATEVER okay.
I wept a little.
THIS is what I want to say to people. To the new interns who are hopefully going to realise this year that medicine was the right career for them; but who will certainly meet many challenges this year.
Medicine is hard and you’ll be expected to be super-human, never to have broken wings, never to feel like you can’t go on.
Remember that for every person who expects you to motor on without a wink of sleep, without any debriefing after a difficult resuscitation, there is another who will lend you their wings when it’s hard.
Look for them. Look for us.
Find the people who will support you when your day or week or month is shitty.
And when your wings are working… please help someone who needs them.