Patients Don’t Want Exhausted Doctors

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Before you read what I have to say, you should read Dr Nikki Stamp’s post: How tired is too tired?

One day, I’d like to have a study to prove the post title. But for now, we’ll have to settle for another anecdote:

tired doctor

Late last year, while I was on the surgical service, I had a small chat with a family member of a deceased patient.

During our ward rounds, relatives of patients recently demised would come in, requesting a death certificate to be filled. It’s a long process but it has to be done. Sometimes I would console the distraught relatives. Sometimes I would need to answer questions that had no real answers. Other times, as in this case, the atmosphere would be one of quiet acquiescence: the patient had been old, and suffering; her body had become her torture chamber.

As I was filling the death certificate, the relative noted my scrubs (at our hospital we generally only wear scrubs when we are on call, and many patients have picked up on that).

He said, “Oh, you’re on call today.”

And I smiled, confirming.

He asked, “When do you go home?”

I wasn’t sure if I should say, but I guess it’s not secret. “Tomorrow afternoon by noon, hopefully.”

He was still blissfully ignorant at this point. “So you have to sleep in the doctor’s quarters tonight?”

And I said, “There usually isn’t much sleeping going on while on call.”

The realisation was now starting to dawn on him.

“But you don’t touch patients in the middle of the night, right? I’m sure you have someone fresh to help you.”

And because I was on a roll of truth-telling, I had to deny his assumption.

No. I do touch patients. I do more than touch patients. I compress their chests. I run life-saving fluids into their veins. I call grumpy consultants from obscure sub-specialties to inform them that their expertise is needed.

“Sir,” I said. “If you were in a car accident at 03h00 tomorrow morning, I would be part of the team that saved your life.”

And he wasn’t happy. Because how could a tired doctor (team of tired doctors) have to save his life – or, God forbid, his children’s?

Could he refuse, he asked. Could he demand a more awake doctor; if the hypothetical accident occurred?

Well, I guess he could. Whether his request would be granted, or even possible, was another story.

Suddenly, the plight of exhausted doctors all over the country had become personal to him. He understood.

And, not surprisingly, he was horrified.

Dear Medical Student: Med School Is Not Worth Your Self-Harm

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[TRIGGER WARNING]

A while ago this secret appeared on PostSecret:

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“Medical School made me self harm. It better be worth it.”

 

It made me sad then, as it does now, but I deferred writing about it because… I don’t know why.

An event at my alma mater this past weekend – that I don’t really feel like talking about right now – made me think of it again.

I wish I could say I don’t know what this student was feeling when they wrote their secret. But oh, I do.

I know how unwelcoming the world of medicine can be.

How traumatic.

And how uncaring those who are meant to be your mentors can be.

Medicine is a dog-eat-dog world. We eat our young, and we starve them to such hunger that they start to tear into one another.

Dear Medical Student: medical school is worth a lot of things. I can tell you that because I went from hating medical school to loving being a doctor (well, on most days).

But it’s not worth that.

Medical School is not worthy of your self-destruction.

Nothing will ever be – not art and not science and certainly not the practice of healing.

I’m sorry. I am sorry because that realisation in itself can be earth-shattering.

When you start working as a doctor, you may find that you love it. You may find that the long hours of studying were worth it. That missing parties was worth it. That having shorter holidays was worth it.

But self-harm? Self-harm will not be worth it. Not in this profession, and not in any other.

If medicine – or whatever you are pursuing – is driving you to self-harm, something is wrong. It may be a number of things, but whatever it is, it needs to be addressed. Resolving it is the biggest gift you can give yourself.

Dear Student (ANY student): You are far too valuable for this. 

Self-Care Is Hard

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As my first year as an adult (sort-of maybe I guess?) draws to an end, I find myself reflecting a lot on what has happened. Incoming interns ask for advice and I wanted to write a really cool and inspirational post but I find myself not knowing what to say. Almost as if I haven’t learned enough to offer advice.

facebook-social-promotion-13809-1451332812-16 Continue reading

Sometimes I Don’t Want To Know

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a4c50964f550a70443d53e51fe887a82I didn’t want to know that the man with the compound skull fracture had fallen into a sewer drain while being chased by the police because he was the man that had been scamming poor people out of their grant money for months.

I didn’t want to know that the man with the gangrenous arm had been bitten two weeks ago, by a girl he was trying to rape.

I understand the importance of a good clinical history. But right now, while I’m saving their lives, can I not simply know that he fell in a ditch? Or that he suffered a human bite?

I don’t want to know WHY these things happened to them. Not right now in any case. Tell me later, when they have pulled through the worst. Tell me then, if you must.

Is this wrong? Continue reading

The Passion Deception: It’s Not About The Money, Money, Money

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With a seventeen-year-old in the house (my talented younger brother), the atmosphere alternates between hopeful idealism and gloom and doom for the future. It is hard to be on the cusp of making decisions about your life when you have the greatest desire to do something beautiful for the world, and no real experience with finances.

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The common refrain in our house (and others, I’m sure) has become, “But work isn’t just about money!” I remember saying those same words as I was planning my future; and I recognise them as true. Or at least, partially true.

But you see: work is about money. Continue reading

Recovery, Divided or Together

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The burns’ ward in our hospital is kind of special. It is the only ward that hosts men, women and children together. It is the only ward where everyone has exactly the same problem. It is one of our cleanest wards, and has a high staff-to-patient ratio.

But it’s not a pleasant place. The smells and the pain levels are hard for me to witness, so being a patient there must be so much worse.

I cannot help but notice, whenever I go in there, that the male patients are all sitting around one of the tables, telling stories and having a good time. In the adjoining room, the women all sit by their own beds, doing their own things.

It’s just so… jarring.

As an introvert, I totally understand the need for alone-time. But I NEVER see the women in this ward hanging out.

Support is so important in recovery.

I just wonder why they keep away from one another.

Under Thy Fingers*

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My phone rings while I am taking ward round.

“Doctor, you must come quickly,” says the ER nurse, “We have a stab-heart in Casualty.”

And I run, like they tell you in med school to run for stabbed hearts.

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What do you do for a stabbed heart again? I prompt myself as I run. Continue reading