Saturday, 25 August 2007

At the Coal Face

I see more of our patients than either the Giant or the Mountain Goat. This has some benefits, but also some drawbacks.

Take Gerry, for example. He is an enormous young black man, who had part of his bowel removed. Like many of the patients (and staff), he finds the heat of the ward unpleasant. Unlike the rest of us, however, he doesn't consider himself restricted by social convention, and so spends most of the day dressed ONLY in a small pair of underpants made of string-vest material. Like a little hammock for his privates.

I don't think the Giant or the Mountain Goat are aware of this, because Gerry always manages to "dress up" (i.e. put his gown on) for the morning ward rounds. In my mind, it's the equivalent of any other patient wearing a tuxedo: it adds a sense of occasion and formality to an otherwise mundane scan of his vital observations. I then spend the rest of the day desperately trying not to scan his vitals.

The patients also see more of me. Not in the Gerry way, of course. But they see me getting frustrated when people don't answer my phone calls, when small requests that I made hours ago still haven't been done, when I'm asked to physically carry messages to the furthest ends of the hospital that could so easily have been emailed in the blink of an eye. The rest of the team, hidden away for most of the day in theatre, keep their air of mystery. I, on the other hand, can only muster the physical gravitas and dignity of a man dressed in a small white banana hammock.

I like to think my relationship with the patients is less superficial than theirs. I don't struggle to remember the patients' names, and haven't yet started referring to them by their bed number or operation. That may be because - in my entire professional career - I've had fewer than 15 patients. Medical memory loss (forgetting patient's names whilst remembering intricate details of their medical care and previous surgery) hasn't had a chance to develop yet.

There's a certain protection in being far away from your patients, in clinic or in theatre. I don't have that luxury yet. I'm accosted by everyone on the ward, patients, relatives and staff, whether I'm responsible for them or not. I've lost count of the number of times I've tried to calm down the elderly man with dementia who doesn't understand where he is, let alone that he's only on our ward because they've run out of beds on the floor where his actual doctors work. For a man who's forgotten that his wife died 5 years ago, the concept of "outliers" isn't really relevant.

There are also physical risks. One of my friends felt a niggling pain in her foot, only to realise that she'd stepped on a used needle that some idiot had left on the floor. The ward's a dangerous place when you're just beginning your career. You don't know where anything is, who anyone is, or what you're doing. People seem unsympathetic, and you're constantly trying to hide the fact that you're massively out of your depth.

I'm starting to enjoy myself :)


The Junior Doctor said...

Hey there L.W.

Just found your blog and am really enjoying it - so much so I've Linked you on my blogroll. Keep up the good work!

HospitalPhoenix said...

Keep up the good work LW, it sounds as though you'll make a great middle-grader in the future.

... and if you make the effort, medical memory loss doesn't ever kick in ;)