Art, science, or just black humour? (My Experiences and Advice)

Member Name: chrispitts

Product:	My Experiences and Advice
Date:	17/07/02 (121 review reads)
Rating:

Advantages: Variety, Money (although other professions offer more), Job satisfaction

Disadvantages: Image (sometimes), Risk of fatal error

"I'm a doctor." That usually gets one of four responses:

1. "Are you? Wow. That's cool. You must be so clever."
2. "Are you? Yuck, I could never do that, all that blood and stuff."
3. "Are you? Right, I've got this pain in my knee..."
4. "Yeah, and?..."

Out of all of these, I far prefer the last one. Why should people be impressed or in awe of doctors. We're just people, after all! Not particularly clever, or brave, or sadistic. We just happened to choose this career, and we get on with it, just like anyone else with any other job gets on with theirs.

But there's a big difference. We're dealing with life and death stuff. Not all day, every day, granted, but if we cock it up, there's a possibility someone could die as a result, and, I guess, if you think about it, that does imply we're either brave or stupid. If a postman makes a mistake, you don't get a letter. If we make a mistake, we kill someone. Ooops. Big ooops.

But here's the clincher. Being human, we do make mistakes. On occasion. Even the best doctors in the world, even the specialists, even the Queen's doctor (possibly, although I can't confirm that, obviously!) - we all mess things up from time to time.

But you're not here to hear about that. You're here to find out what it's like to be a doctor. How I got here. What I do.

First things first, don't watch ER and expect a realistic view of medicine. Even Casualty (although it comes a bit closer), stretches the bounds of realism frequently. The most realistic TV programme produced was "Cardiac Arrest", which was on around 8 years ago. Fantastic. And spot on.

So what have my memorable experiences been? I'll edit them for family-viewing, but don't expect this to be pleasant... Are you sitting comfortably...

I was at Med School for 6 years. By and
large, it was OK. We subscribed to the motto of Work Hard Play Hard, and alcohol flowed freely... We got our first clinical experience in the 3rd Year, at the tender age of 21. Now, most Med Students hit the wards in their first year. At 18. To me, that seems a little young to see some of the things I saw...

Within a week of joining Med School, we were introduced to our cadavers - the dead bodies we were to study anatomy on. By cutting them up. Bit by bit. All year. It was, in retrospect, a fantastic way to learn anatomy, but we were only 18... we got used to it, and got on with it, but the smell of the preservative, formaldehyde, still lingers in my memory.

On my first ward round, an elderly gentleman called me over to the bedside. I leant towards him, to hear him ask, in a very loud voice; "Double scotch on the rocks, please." It doesn't seem like much at the time, but that was the first demented person I had seen face to face. And I still remember it now.

A year later, I witnessed my first death. A lady in her mid-sixties, with liver failure. We knew she was going to die, and she decided to do it when the Senior House Officer and I were by her bedside. She looked into my eyes as she drifted away. She had no relatives. Again, that image remains.

By the time I qualified (lets just skip the horrendous exams - I prefer to forget them), I was a bit stronger, and didn't let things affect me so much. Mind you, the 35 year old lady I formed a friendship with on the cancer ward in my final year upset me by dying just before I finished the attachment.

What did affect me more was the attitude of some of the senior doctors. It's widely regarded to be worse in the teaching hospitals, but some of the "old boy network" doctors are absolute bastards. (Apologies for the bad language). I've been shouted at and humiliated in front of patients, relatives and nursing staff. One surgeon kept a running tal
ly on his operating theatre wall of the number of medical students who fainted in theatre (I, fortunately, was not one of them), and one I know of even physically pushed a medical student out of the ward for, get this, wearing a button-down collar, because he thought they looked "common". Funny now, but just plain bloody annoying at the time.
Tutorials were cancelled because the consultants couldn't be bothered to turn up, teaching was... um... intermittent in quality and quantity, and ritual humiliation was, generally accepted as the norm. Of course, there were some great doctors, really pleasant and good at teaching, but you remember the bad stuff.

Anyway, we've got to qualifying. And I started my house job in medicine. And my most memorable experience was of letting someone die. I didn't kill them. I just didn't spot that something was wrong. I won't go into details, and chances are that they would have died anyway, but I blame myself, and always will. However, there was no complaint (as I said, they were ill, and likely to die anyway), and I got on with it.

Another occasion provided the typical "black humour" favoured by many in the medical profession. I was visiting a ward at night, having been requested to see an old man who was about to die. Death was expected, we had made sure he was peaceful and comfortable, and the nurse and I stood by the bed wathcing him. Then, from the opposite end of the ward, we heard a dull thud. A patient had just fallen out of bed, stone cold dead. Nothing funny in that, you might think. And, no, in the cold light of day, it's tragic. But at the time, we thought it was amusing. Why? To cope. Pure and simple. We're not heartless. We care. But it's a way of not letting it get to you. Find humour in everything. Because many doctors who don't find that release end up quitting, or becoming depressed, or even suicidal.

But some stories genuinely are f
unny. I remember teaching a medical student to catheterise a man. (Pop the tube up the penis into the bladder). She started. She struggled. I asked what was wrong. "Well", she said. "I can't get hold of the penis, it's a bit small!" I had to leave the cubicle I was laughing so much. The poor patient was distraught.

On another occasion, later in my career, I had to do a vaginal speculum examination (I told you it'd be unpleasant). The student midwife accompanied me with a torch to illuminate the area. I set everything up, inserted the speculum, then asked for the torchlight. "Where do you want me to shine it?" she asked...

So, enough of the anecdotes. What have I done, and what is it like.

Well, just because you've qualified and got a new prefix to your name and a few letters afterwards, don't expect the "old boy network" to suddenly leave you alone. They won't. You'll still get bullied. You'll still get blamed for things that weren't your fault. You'll still be generally used as a dogsbody by everyone from consultants to junior nurses. And when you become more senior, hey, you'll probably do it to the juniors too. (Which is why I've now moved into General Practice - less hierarchical nonsense).

My jobs to date then:

1. Medical House Officer - As above. I forgot to mention the 72 hour shifts without a break, but, fortunately, they are cracking down on that, so it SHOULD be a thing of the past.

2. Surgical House Officer - with the best (and sexiest) ever surgical registrar - (Vanessa, wherever you are, you are one of the best doctors I have ever known.) She even bought a long-term patient a bottle of whisky for Christmas. A knowledgable, caring doctor...

3. Elderly Care Senior House Officer - one of the perks of the job is "Ash Cash", the money you get from filling out cremation forms. Not so good when consul
tants disagree with each other about patient management.

4. Accident and Emergency - Too many stories to mention here. A fantastic job. The occasional guts and glory saving lives, interspersed with numerous sprains, broken bones and, believe it or not, sore throats. I actually saved people here, with no other doctors involved. You have no idea what that feels like - bringing someone back from death. (A little side-step here - resuscitation hardly ever works in real life, unlike on the TV. We don't often get people back, but when we do, it's a nice feeling).

5. Obstetrics/Gynaecology - Yes, I can wallpaper my house through the letterbox! Not an entirely pleasant job, because we were treated as glorified blood-takers, but we did assist in loads of caeserian sections.

6. Ophthalmology - Good fun actually. My consultant was regarded as the nastiest in the hospital, but she got on OK with me, so I really enjoyed digging around in people's eyes for 3 months. Working in a dark room all day can give you a headache though.

7. Ear Nose and Throat - Another 3 months spent digging earwax and snot out of peoples heads. A few glory moments, like stopping gushing nose-bleeds, but generally just a stop-gap to GP-land.

And that's where we stop. Because General Practice is another story.

If you are considering a career in hospital medicine, or medicine in general, or just want more gory stories, feel free to E-Mail me (see my profile). I have had regrets about my choice of career on occasion, but, in general, the good times outweigh the bad.

Not many jobs provide such a wide range of options (think of all the medical specialities you can, add a few, and you're still not there...), with a guarantee of a job for life (unless you get struck off), and with the chance of so much variety in your working day. Choose Life, Choose Medicine.

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