This week I have been mostly reading…

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One of the unexpected bonuses of my article being run by The Guardian, was that a psychologist got in touch with me asking if I would review her new book, which will be published later this month. Caroline Elton has worked with doctors for many years, providing counselling and occupational career support, and she is writing about the psychological effects that medicine has on those who work in it.

I read her book, “Also Human” on my way to and from work last week, and it was a surreal experience. So many themes in my life, and so many of the ways that I approach and justify situations, that I had assumed were unique to me, were on the page in front of me. The themes of the book are explored through her interactions with various doctors over the years, and her unique insight as an outsider commenting on the peculiarities of medical training really made me take stock. Several of her observations resonated with me – from the assumption in medical school that you will make a good doctor purely because you have an aptitude for science and perform well on standardised tests, to the lack of psychological preparation for medical students as they are flung into their first foundation jobs, and have to cope emotionally, as well as practically, with people’s lives depending on their decisions.

She explores the issue of empathy fatigue, which is something I am struggling with at the moment, and the comment by one of her patients that “Medicine is a bit like a cult”, struck a chord deep within me. Often, staying in medicine is easier than leaving, and sometimes that is all that keeps us going.

The lunacy of all new doctors starting on the same day in August, and allowing senior doctors to take leave that week; the lack of psychological evaluation for prospective doctors, and the unwillingness to accept that some medical students just may not have what it takes to complete their training – whether academically or emotionally. The inability to accept that doctors are human, fallible, and capable of falling sick, and above all, the reticence to call it a day, and change profession. Even when it is psychologically damaging, and we know beyond doubt that medicine is not for us, still we persist.

I would encourage anyone considering medicine as a career, and anyone within medicine feeling unfulfilled, or considering a change, to read this book. It contains within it things that we all know, but fail to consider, and it has truly changed the way I think about medical training.

Paediatric Pearls

Things I have learned so far in kiddies ED:

  1. Bubbles have magical qualities and fix tachycardias ALMOST every time.
  2. There is no such thing as a “quick look” at a child in triage.
  3. Play specialists = HEROES.
  4. Early ametop application in triage is one of life’s greatest gifts.
  5. ALWAYS take a second cap gas because the machine demands one as a sacrifice.
  6. Sometimes kids just get rashes, and we don’t know why.
  7. All children in London are constipated.
  8. Parents never give paracetamol, for fear of us not believing that their child was in pain/hot. We berate them for it, and then don’t believe them that their child was hot at home if they aren’t hot here.
  9. I can now identify which antibiotics someone has been given based on what colour it is, what it tastes like, and what bottle it comes in.
  10. Suctioning bronchy babies and watching them instantly perk up before your eyes is one of life’s great pleasures.
  11. Sometimes a sympathetic face and time to listen is all it takes. Parents’ scope to worry about their children knows no bounds, and reassurance costs nothing. Be patient.
  12. A good number of midwives scales are broken.
  13. If the umbilical cord looks infected, it usually isn’t. When it is, it is a BIG deal.
  14. Getting a line into a 1 day old baby gives you the best high.
  15. Paramedics and GP surgeries NEVER have paediatric sats probes and this frustration will be felt DAILY.
  16. When you get cocky about your abilities you will inevitably do something insanely stupid like glue a child’s eye shut.
  17. When you finally know the doses for paracetamol and ibuprofen without looking them up you feel like a GOD.
  18. SOME babies ARE cute, and you have to remember to give them back to their parents when you are finished examining them.