I will write about my exam and my first few weeks in a new hospital… five minutes!

I am currently having a Buffy break.

I seem to be having a lot of those lately Be it, break from reviewing some literature, break from revising for my second attempt at MRCP Part 1 or as right now, break from the Big Clean

Big Clean.  Urgh.  I haven’t lived in the same place for more than a year since 2003 and the yearly move and house clean is really starting to wear thin.  Granted if we’d kept the apartment cleaner in the first place it wouldn’t be so time consuming, and if we didn’t have so much crap it wouldn’t have taken so long to move (but I love my Buffy comics, My Little Ponies and various hoodies from uni societies – why get rid of them?!)

I received my rota via email last week.  I don’t quite understand it… it’s weekly and very confusin but we haven’t been assigned yet, that’s for Wednesday.  It also looks like we have to cross cover Neurosurgery overnight… which creates a huge collective yargh from all my neurons.  Granted it’ll be the Reg taking all the referrals and doing the complicated stuff (like angios and coiling) but I’ve only ever referred to Neurosurgery before (which, I might point out, takes FOREVER) I haven’t ever looked after the post op patients or anything like that.

Nimlodipine and dexamethasone… that’s about my knowledge of Neurosurg, still steep learning curves are the way ahead in medicine… aren’t they??? Please say they are…

When I worked in A&E I referred a patient to the local Neurosurgical centre and it was one of my favourite A&E experiences.   When you see a patient in A&E, there’s a sheet of paper for you to clerk on that has all their details already and what the reception staff has ‘booked them in’ as – it could be chest pain, ankle injury, fit… etc.  This patient’s was ‘head injury’ – the A&E staple.  Though following a history and exam I thought otherwise… no signs of head injury and no memory of the events, coupled with focal neurological signs and a Glasgow Coma Scale of 14 – not good.

CT scan and primary intracerebral bleed later I was on the phone to the Neurosurgical SpR who seemed to like to discuss things with their Consultant quite a lot!  They then phoned back again for more information at which point my response was ‘Well we’re just taking him into resus as his GCS is dropping… he’ll probably end up tubed’

(That was me trying to sound really cool and like I was on ER… hell, I was really cool and in Emergency… just with much fewer patients and gunshot wounds and interstaff relationships)

The patient made it to Neurosurgery and had the bleed evacuated and is having rehabilitation.  It was a good story, sometimes you forget about all the things that happen in medicine that are amazing. Personally I can think of so many situations where “I should’ve done that” or “Maybe that wasn’t right” or “That definitely wasn’t right” or even crying for hours cause someone died (and I was too emotionally involved) and you forget when things go right.

That’s an important lesson.  I think.  Maybe I should learn it myself sometime…

I’ve decided in that kind of whacky new year’s resolution thingy to start writing again (I do remind myself that I said this earlier in the year but I feel more inspired tody!)

Reasons being

I’m currently in the middle of a move

With medical training the way it is at the moment in the UK up until a few months ago I didn’t know if I had a job as of August 2008.

When I say ‘not having a job’ I mean not having a training job… there are usually plenty of non training or ‘trust grade’ jobs available.

Then I reapplied for a few jobs in the second round of applications and had an interview and subsequently was offered and accepted a job in the West Midlands area.

Yesterday I was unpacking my things in a lovely new apartment in Birmingham.  I have been assigned my first year of medical training there and am starting a Neurology SHO job next Wednesday

I’m starting a new job

And figured it might be a nice way to chronicle the changes in training and my progress on my path to little old lady hood

It’s like a grown up diary

Gone are my teenage blogging days of “I like this boy” “We went out tonight” etc

Anyway I’m very tired and will write something more productive soon

I am awake gone 2am.  This is horrific. I love twilight shifts, bar the fact that it means you don’t get any evening, because we start our shift at 4pm and finish at midnight. I normally go to sleep between 11pm and midnight, so in theory my day isn’t that different from a normal 9-5 (not that I have done a 9-5 in the last 4 months but I digress!) but when I get home from a shift of neither Accidents nor Emergencies I cannot sleep immediately. And like today, no adrenaline required at all for what I saw today, in fact, I think I admitted only one patient… and a fractured neck of femur is pretty no-brainer.

I feel like writing something about the fact that I only have 15 emergency shifts left but right now, I really need to attempt to sleep. Otherwise when my alarm goes off at 9:30am, once again, I will remain in my warm beautiful bed until noon.

Not what I am right now, and not exactly what I definitely will be come August 2008.  But it certainly feels that way. At the end of January I applied for medical training jobs, medical as in to be a Physician as opposed to a Surgeon or Radiologist.  I was on nights in the Emergency Department at the time, working hard and sleeping even less due to having to fill in the forms.  I had a meeting with one of my previous Consultants who analyzed the form with me and suggested some changes.

They were all sent off and I forgot about it. Until a friend received an email saying she had an interview for one of the jobs I’d applied for, guess I hadn’t been good enough for that one.  And then I found out the job I REALLY wanted (in the area where my boyfriend lives and works) had made offers for interviews…

Two rejection emails later and it’s becoming a worry.  Apparently my CV isn’t sparkly enough to get me a medical training job.  Certainly my colleagues and patients would (I’d hope) say otherwise.

But what these places see is whether you have presented at a national meeting or completed multiple academic posts.  They don’t see you managing an acute LVF with oxygen saturations of 89% despite GTN and an hour of CPAP.  They don’t see your knowledge possessed when caring for a 13 year old asthmatic and their worried mother.   And they certainly don’t hear the 87 year old lady with a broken hip tell her daughter what a nice doctor you are.

None of that seems to matter anymore… and that’s why we stop believing in medicine, why last week I thought giving up was the best answer.

But then I remember the faces of my patients when they can catch a breath again after my treatment, when their families say “thank you Doctor, for everything you’ve done” (after I’d thrombolysed my first MI!) and even when you don’t win the battle with pathophysiology (and sometimes just physiology in the old) and then I remember the actual reasons I studied medicine and got to where I am today.

I did this not to impress someone who sees me as a faceless application form but for those who see and meet me everyday.

Another crappy attempt at a blog by myself…. Maybe I will actually do some updating, I used to find the whole blogging thing as a great relief and feel that at the moment, I need some of that. Oh, and eventually I will edit the CSS and do something myself