The night before my first shift in general practice, I frantically messaged one of my doctor-heroes on Twitter (@sindivanzyl). I think I was hoping for a cheat sheet, something about hypertension and diabetes, but the one thing she emphasised was, “Please, please, always examine your patients.”
For medical students that would probably sound absurd. Duh, how can one not examine the patient?
But I learned quickly that, in an environment where there are always more patients to see, it is sometimes easier to make a quick observation from across the desk than to do as we have been taught.
Nary a day goes by that I don’t think back on that advice – “Please, always examine the patient.” Even if I just stand next to the person I’m starting on antidepressants, and take their pulse rate. Feel their thyroid. Check for pallor. Do the good medicine.
Not just because happy patients come back – I don’t care much for “business”.
Not just because I might pick up something occult – more often than not, I won’t.
But because when I promised to heal and not to harm, I promised to be the caring hand. Because when I reach out to percuss a chest, or to palpate a disgruntled abdomen, mine may be the only benevolent touch that a person experiences that day. And I think that sometimes, a soft hand and a thorough examination are worth more than any medication I might dispense.
She was a healthy young woman who came to see me for a “complete check-up” before a holiday overseas. Although I tend to think “complete” check-ups are somewhat overkill, they do present a good opportunity for health promotion and disease prevention. As one does, I asked about sexual history and family planning. She hesitated just a split second before answering, “Well, my only partner is a woman, so I don’t have to worry about pregnancy scares.” And then, we moved on. Continue reading “Doctor. Counsellor. Freedom Fighter.”→
As I enter into my third month of General Practitioner work, I find myself reflecting. I started with private GP locums to fill the gap til I got the job I wanted. But now I’m signing a contract and I’m here to stay – for at least another five months.
One evening, my housemate asked, “So, did anything interesting happen at work today?” When I responded in the negative, we laughed about how my work had become almost mundane compared to working in hospital and coming home with fascinating stories of grotesque injuries and life-saving surgeries practically every day. Continue reading “General Practice is not exciting, but it is fulfilling”→
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? Continue reading “GP Work is Hard”→
Last night I worked my last shift for Community Service. 1 January 2018 will mark three years since I walked into my first day of work. And on that day, more than 1,000 new interns will enter our workforce.
I remember the nerves the night before: being unable to sleep. Feeling like a fraud, like I had been allowed to graduate by accident. Worried that I would be labelled Worst Intern Ever; worried that I’d have awful colleagues. But I survived the first week, and eventually the first year, too.
And so will our new interns. I have some tips for those who need ’em.
In final year, we thought that getting an internship post at our desired hospital was the hardest – and most coveted – thing.
Two years later, we all tried to find a community service posting that would give us a foot into the door to our future specialties.
But we didn’t know that those were the easy parts. Then, we still pretty much had guaranteed employment (most of us, at least).
Then came the end of Community Service, and reality hit us in the face: we were on our own.
* * *
That’s where I am now. The government no longer “owes” me a job, and unless I find one, I’ll be unemployed come January 2018. People used to say, “There’s no such thing as an unemployed doctor.” These days, there are plenty of them, because freezing posts is a done thing. Continue reading “The Threat of Fun-employment”→
Ever since I wrote about how going for therapy was my biggest gift to myself*, I’ve met with a few medical students to talk about the topic of mental health. Many of them were worried about their ability to make it through med school with their illness. Many were worried about the viability of a career in medicine with depression.
When I was a student, there was a rumour that students with mental illness would be excluded from the course. We were informed by our senior students, and they by theirs, and thus the rumour was propagated. Continue reading “Can I Be A Depressed Doctor?”→
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.
If you’ve been paying attention, working hours of doctors (especially junior doctors) have been getting some good airtime over the past few months. The Province of the Western Cape has committed to actively reducing maximum continuous working hours for doctors to twenty-four, the HPCSA has promised to “look into it” (not that we have too much confidence there), and our biggest representative, SAMA (South African Medical Association) has come out in our support.
One of the things to come from all this is the launching of an armband campaign. This has its origins, I believe, from a similar campaign in the UK – although I have not been able to find any source to this link.