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Thoughts before starting..

I am due to start my induction for my FY1 job next week, meeting with the current doctors who I will be taking over from and learning what is expected from me. I will learn how the hospital works, meet the consultants who I will be working with and then on the 2nd of August, will start working in my first job as a junior doctor.

I have been trying not to think about all of this and instead have enjoyed the past few weeks jetting off to sunny beaches across Europe and enjoying a pint with friends. But as the big day gets closer, my thoughts have started to focus, like a black hole drawing them in towards the centre of gravity. Here are just a few of my thoughts.

 

  • Working as a junior doctor at the age of twenty three.
    I first thought about this fact in my first year of medical school, but it truly punched me in the face just a few days ago. I feel proud of the medical training I have received. I feel privileged with the experiences I have been given; from acute hospital wards to community visits, the deep recesses of poverty to the prickliness of fortune. I can insert cannulae into veins (after several tries) and interpret an ECG from a patient with chest pain (as long as the pathology is obvious). I can take a pretty good medical history and interpret blood test results with relative ease. But in just under two weeks, I will also be expected to deal with the extremes of humanity. I will see families torn apart, children separated from parents, spouses holding their last grasp. I will talk with people who have lived more life than I have, offer advice to patients who know more about suffering than I ever will. I will be expected to offer support to those who see no point in living and those who have no other choice. I will offer my hand to those who are struggling and my heart to those who have no where else to turn to. And all of this is expected from me at the age of twenty-three. That is a scary thought.
  • Being at the bottom of the pile (again)
    Most of my life has been spent climbing on a ladder, only to begin again at the bottom of the rungs. We begin in nursery as sweet little toddlers until we reach the heights of primary school, looking down at those poor little kids still trying to walk. And then we start again in secondary school, our first day spent in awe as we look at all those teenagers above us, their bodies twice as tall and their faces so mature. We begin to climb up the hierarchy again, through puberty and friendships, GCSEs to A Levels, until once again we are at the top of the school ladder. We have become the kings and queens of our little bubble, the ones who we once held with such reverence only a few years before. This process begins again in medical school, as you go through your first year wondering whether you deserve your place, to your first day in a hospital where everyone but you seems to know what they’re doing. Until one day it’s your graduation day, and you are the one looked upon with respect once again, by those A Level students who want to get into medical school and the medical students who want to be able to graduate.

    And so it begins again. Here I am at the bottom of the ladder; the F1, the House Officer. I have become so used to these feelings of anxiety and confusion. The new person on the block, the one who doesn’t have a clue where equipment can be found, how the place is run, the names of all the people, the lack of knowledge and experience. And as I look at the steps above me, that is one heck of a ladder to climb once again.

  • The Passivity of the Medical Student
    Having spent five years as a medical student, I have become used to being a passive being. I am used to being present at ward rounds as the person trailing along at the back, occasionally carrying a pile of notes or running back and forth to the radiology department. I am used to sitting in a classroom while a white haired clinician recites the symptoms of an asthma attack, or sitting at a desk as I ram my brain for any recollection of what I have just read. I am used to sitting in the corner as the consultant does all the work, or presenting a history to a team of doctors while they deal with all the documentation, investigations, management plan and communication. I am used to simply being present rather than an active member of a team.

    Oh, how this is all going to change in two weeks time.

Thoughts before FY1

Patient Confidentiality is an Illusion

 

Let me hide behind this flimsy curtain and revel in all your secrets. Let my voice resonate throughout the ward like a trumpet blast. Let me chatter on about your depression and the recent loss of your son; your long history of unemployment and your feelings of hopelessness and despair.

Let me speak about your struggles in a corner brimming full with strangers; of your difficulty walking to the bathroom, of your incontinence, of your loss of independence. Let the whole world listen to your life story as you are left on display to be gawked and stared.

Let me shout loudly down the phone a mere metre from your presence, bellowing your blood results, your HIV test, the signs of Pneumonia upon your Chest X Ray.

Let me leave your medical history shining bright upon a computer screen, a glow that beckons strangers amidst the chaos of the hospital bay. Let the very recesses of your body be left open within our corridors for everyone to dissect; every detail of your life story left unguarded upon our open screens.

Let me have a ‘quick chat’ with your family in the heart of our hospital corridor; let our conversation float over tides of strangers and friends, bowed heads over shoulders as if they cannot hear.

Let me discuss your worries and fears like a paper aeroplane thrown around the office floor. Let me grumble within the side room with the entire hospital population outside the open door.

Let me moan about your complex needs, your difficulty to bleed, your stubbornness to fight off infection in the centre of the canteen.

Let my voice rise over commuters heads on my train ride home, my curt walk and formal dress giving rise to my profession. Let me chuckle as I discuss your medical history while dining in the best restaurant in town, let me unleash a sigh over my dessert as I talk about your end of life care with your niece sitting two tables by.

Let me forget how your hospital stay is but a chapter within a story; that every life is filled with secrets to which I have been granted a sacred key. Let me forget the loudness of my voice, the arrogance of my saunter, the secrecy of disease, the shame behind every illness.

Let me take away your identity the minute you walk through our open door.  

Thoughts before FY1

From Medical Student to Junior Doctor

I am a final year medical student due to graduate in July 2017 and start my first ever job as a Foundation Year 1 Doctor in August. This blog is here for me to unleash my fears and woes, documenting my upcoming journey which will undoubtedly be an incredible experience.

I have an interest in reading and writing, so this blog will also be interspersed with my thoughts on Literature, along with random offerings of Philosophy and Psychology, of which I have an amateur interest.

I look forward to what the rest of this year brings, and I hope my ramblings brings some insight into the life and workings of a junior doctor in the modern day NHS.