the christmas of a disheartened doctor

it has been five extremely busy days. work has been punishing as always with insufferable late finishes.

the big plus was that my good old bro-seph from Vancouver has been in town so we have been schmoozing around london all week. it has also been quite heavy from a beer perspective and i have had to tolerate his insistence on drinking Newcastle Brown Ale which, for those uninitiated, tastes like tepid hard water. i on the other hand much prefer the gaseous slip of monsieur kronenberg.

but i have been trying to condense the best and worst of London into a few evenings and i certainly have a had an absolute ball. we were privvy to a performance by the worst singer-songwriter in the world at the 12 Bar on Denmark Street. there are photos and video footage which i shall endeavour to post.

needless to say i am shattered by 2am bedtimes and 6.30am wake ups, in addition to the sheer amount of crap at work such as the inability of a handover to be completed at 5.30pm, not because of sick patients but because people are too busy getting cups of tea, discussing their plans for the holidays etc.

ah yes holidays.

as mentioned before i am NOT going to be seeing any loved ones this year (excuse me, for the THIRD year in a row) but instead am getting ready to go into the hospital. it would of course be impossible to organise a rota where the holiday period shifts are equally divided amongst staff so that everyone gets at least one day off. no much easier to completely screw one doctor over (well two - the poor bastard who has to do the day shifts over xmas). so today after waving off my friend and then snatching a few hours with my special ladyfriend before also waving her off, i have been twiddling my thumbs at home. she has kindly left me loads of presents to open on christmas day and made a hamper for me to take in on christmas eve (she is the best!) but it's no way the same.

this christmas eve, santa will do his on call (1 in 365) whizz through london whilst i shall be on the ward trying to make the best of it. and then i shall return home on christmas morning (though i am not sure how because there is no public transport and hmmm of course the hospital has organised transport for its workers not) to my cold flat, maybe eat my turkey dinner for one or perhaps forgo it in favour of sleep. then, whilst families in the rest of england sits bloated in front of the telly, i shall begin my trudge again into work.

i love medicine. everyday i work as hard as possible and try to do the best for the patients even when my motivation levels are below zero.

but, i really did not sign up for this continual soul whipping.

anyway (this is sincere) wherever you are and whatever you are doing, have a great christmas everyone.

[i am listening to one of my favourite songs in the world: one of these things first by nick drake]

saturday sun

it is very exciting this weekend. the weather is gorgeous, i am not working, chelsea play arsenal and tomorrow...

... the canadians arrive.

[i am listening to the decemberists]

what are the chances of that happening

today i have mostly been wiping my fucking nose and tolerating that boring into your eyes feeling when you get the 'flu. i also got the short straw again by having to do all the frigging central lines too (big drip lines that go into big veins either deep in your neck or charming groin) and then two people decided to have cardiac arrests simultaneously (they are both ok by the way) so lots of running around. so once more i left late (not that i have a problem staying late for sick people) and what's that? oh hello there hospital management. oh really? you've done the audit and i'm working less hours than ever before? well i guess i can't disagree with your study. of course it's fine to cut my take home pay by £500 a month. no, thank you.

i was gagging for a pint but cannot do anything without having to wipe my nose every two seconds and so all hopes of beer have disappeared out the window.

i really cannot wait for christmas when incidentally i am on nights (23rd Dec to 29th Dec.)

"what did you get for christmas?"

"four new admissions."

"what did santa bring you this year?"

"nothing. santa does not bring anything for naughty boys who stay up all night."

you could not fucking make this up. you really could not.

ps. absolutely categorically NO photos. the whole point of this blog is that i remain arrogant behind a shallow veneer of anonymity (despite now having 3 mates on here)

[i am listening to ben folds, songs for silverman]

and my apartment smells of rich mahogany

the herculean trial that was the membership of the royal college of wankers exam Part 2 is thankfully over until the imminent resit and loss of a further £290 (yes £290 - $600 for the Canadians - i know you're reading this.) i can only hope that the tossers at the college had a bloody good piss-up the night before the exams. i can only imagine the scene in the smoking room (i don't even know if they have one but i bet they do):

"i say sebastian we certainly have excelled ourselves this year!"
"ha ha! you're absolutely right charles! i think it is sheer genius that three times a year we continually set the most esoteric of questions, make sure that anyone who does not sit the exam hits a career brick wall and manage to make them pay us for the privilege!"
"ha ha! we're great we are! more champers?"
"is brucellosis rare? by the way what time do the whores get here?"
" very soon i hope. i'll get the lube! thank you junior doctors! i'm going to put this on my weblog tomorrow. ha ha!"

i did suggest that after the exam we partake in a wicker man style burning of the college but opted for the pub instead. (vegas was of course present, on a quick sojourn from the north - his blog will be darker than ever this week as the poor fella is on nights again.)

i was also pleased to hear that the american department of homeland security managed to kill someone who did not possess a bomb/was not a terrorist. a close shave. will this be another jean charles de menezes? or will it be swept under the carpet with all that illegal war/torture/insane foreign policy nonsense?
[NB. i haven't actually caught the full story on what happened there although given that it's not on any of the american news websites at the moment i imagine my gut feelings are correct. i did however read an interesting piece on paris hilton's lawn display at her home on whore island]

back to school tomorrow and that is not depressing at all.

RIP Richard Pryor

[I am listening to Bittersweet Bundle of Misery by Graham Coxon]

Your exam question for the evening

you are called to review a 26 year old doctor in London. he is currently at a career crossroads of sorts partly due to the fact that the profession he is working in is dying a slow painful death under the weight of beaureaucracy, and, that life satisfaction is at an all time low because of the vast amount of time invested without reward in said profession. tonight he is attempting to review a series of topics for his postgraduate examination tomorrow. however fatigue is clearly setting in and you note his heavy eyelids of exhaustion as he thumbs through yet another book of practice questions. you note no rashes and he has no pets but has travelled to western canada earlier this year.

what will be the MOST appropriate way to manage this patient? (select best response from five)

A. sit down with the patient and explain to him that everyone has doubts about their direction in life at some point. this is most likely a transitory period and if in a few months he still feels this way then perhaps some time out to rejuvenate and reflect may be very beneficial. as for the exam, it is not the be all and end all and also can be sat again if necessary.

B. slap him about and kick him in the nads because he's an annoying fuck and deserves a good kicking.

C. nod sagely while he drones on with his "nah nah nah but what is the point if medical training is being sacrificed for meeting government targets nah nah nah" and see if there's anything worth nicking from his flat. hmm... 20 GB 4th gen ipod in corner... doesn't appear to work though...

D. pick up his immaculately compiled revision notes, rip them up then taking a dump on the shreds whilst saying "how do you like that bitch? how do you like that?"

E. intravenous antibiotics and urgent per rectum examination

5 minutes allocated. answers tomorrow.

[I am listening to Hope by R.E.M - formerly Leonard Cohen]

Little things

i'm about to make my way in to tackle the beast. delightful.

at least the bus stops outside my house.

and at least the imperial war museum looks radiant in the winter sun.

[I am listening to young pilgrims by the shins whilst doing some cramming]

Some people are wankers

i've had some troubling news. i was informed by a good friend that one of our old registrars (senior doctor) committed suicide. we'd both worked with him when we were doing surgery in our first year fresh out of med school. he was a great doctor with the driest sense of humour ever and a glowing career. we always knew he was pretty eccentric and did suffer from depression but obviously something changed over the past year or so. i don't know what and probably never will.

I won't go into the background too much. there's a slightly disparaging article from the local press here about the coroner's report. what's worse, however, is this (scroll down to nov 29th): a frivoulous piece of shit that actually makes light of the fact that he committed suicide.

i'm never one to be PC. but, to belittle and poke fun someone who obviously had severe mental health problems and then TOOK THEIR OWN LIFE is a pretty cheap shot.

needless to say my mate and i have written pretty terse emails to the author of the article. i might post my email on here later.

let me know if you think i'm overreacting. i don't think i am.

on a somewhat brighter note, another good friend has also joined blogdom. you can see his site here, also continuing the white on black colour theme that is slowly becoming the watermark of disillusioned medical blogs. go see the confessions of a venial sinner.

[i am listening to arethra franklin, say a little prayer for you]

Flunking

i am rapidly failing this exam. 10 days to go and i still have loads to do, no study leave, three on calls and increasing amounts of crap at work to deal with.

i am looking at dermatology/haematology slides before going to bed, reading notes on the way to/from work, doing questions when i get home, etc. i am even more drained than before.

tried to be positive at work today (monday and all) and was frustrated once again. as NO-ONE (nurses/porters/radiographers) seemed to give a shit that one of my patients (not very sick at all, routine investigation booked from friday) needed a chest x-ray i wheeled him round to the department myself, sat for fifteen minutes while he had it done and wheeled him back to the ward. because i knew that if i didn't no-one else would, no-one else would care except me and him, and at the end of the day i'd take the heat when it wasn't done. i hope all the taxpayers in this country are glad that they paid for my six years training and my current salary to be a porter.

so frustrating. i am so annoyed (not really at that - i had a good old chin-wag with the patient on the way to radiology - he's written ten novels!). grrrr. and so very tired.

thinking positively now. tomorrow i have the 8am X-ray meeting to look forward to... and then the on call till nine...

D&C may be away for a little while until after the exam (next weds/thurs)

[i am listening to Only You by the Flying Pickets]

The road less travelled

apologies firstly for the lack of communication. i was recuperating following the trials of the course and yet another weekend on call. i was so busy doing the course that i didn't really have time to let the horrible belly aching anticipation of a weekend set in. and when it came round to it, it was quick and relatively painless (though not for my patient who needed a chest drain - think of a hosepipe plunged into the chest wall and you're not far off. ouch.)

tonight i struggled to get much studying done so instead opted at about 10pm to go meet a guy i grew up with. he was meeting some other friends for a beer and asked me to come along as it was local. he's moving abroad in three weeks and i probably won't see him for some time so i thought now was as good as any night.

it was weird. our lives have diverged so much. we used to spend all our time together from about 5 to 15 years old. but i don't think we could be any different. it was still a good laugh. but... strange. i'm not exactly sure how to describe the feeling. it just didn't seem natural, like when i'm around my friends now, which is all the more peculiar as we have more history than people i know now and regard as my closest.

he was saying at one point (a little intoxicated - he'd been in the pub some time) that he was jealous of me which came as a real surprise and i did feel a little uncomfortable. i suppose it comes down to frames of reference. he has no concept of how difficult i'm finding things at the moment (though let's make it clear my life is no homeless in quake ridden pakistan or bombed baghdad) but to be fair i have no idea of what his life is like. not really anyway. i was struck by how unsure of himself he was despite his essex swagger and gift of the gab (i have inadvertantly given away my background...) and thought underlying all the gags and banter we had that there was this tinge of melancholy. i don't know really. as i said our lives have really gone in different ways.

i wonder what will happen to him when he leaves the country. he's going to canada to live with his fiancee. i hope he'll be happy and i wish him all the best.

will i see him again? honestly? probably not. we are so different now. and although i know that, it makes me very sad. when you're tiny you think that now is forever. it's only later that you realise how transient moments actually are.

will stop now as things are getting too dark! i did see a dog to day wearing a little red jumper which made me laugh. as if he said "hmmm what shall i put on this morning? i know! something bright as it's so miserable outside!"

[i am falling asleep to staralfur by sigur ros]

who's got a gun?

my ipod has just died.

this stupid picture of a sad face has just come up on the screen and i have spent the past two hours doing all the bollocks that apple suggest on their website.

i am actually going to have to kill myself.

time for bed before i have a stroke.

[i am listening to The Promise by When In Rome but obviously on the computer and NOT on my ipod]

The Fall

no, this is not my equivalent of "Despair" on Nip/Fuct (he's ok by the way) but actually a reference to it officially being autumn!

i LOVE this time of year! it's really cold but it's bright and sunny, the leaves are crunchy on the ground and everyone seems so cosy in their hats, gloves and scarves. well, as cosy as you can get on the tube at rush hour.

and as you can tell i survived my week of nights. the last night was horrifically busy and i had a very ill man indeed. he had suddenly deteriorated about an hour into my shift to what we call peri-arrest (about to arrest ie. stop breathing/heart stops/both.) there were a lot of hairy moments overnight but we managed to keep him this side of alive and in the morning he was much better, sitting up, off his oxygen mask and asking for breakfast. i was pretty happy and left work feeling content. that's the first time that i've felt like that in ages.

i've spent the weekend enjoying myself. no studying, no medicine, just some fun times (and sleeping). got to see some old friends, some of whom had lots of news (i tink you know who you are) and there was of course the England game. what an awesome match! though i have overdone the beer. lucky...

i am now off work till friday (when i work the weekend again) but at a course. it's funny sitting in a lecture theatre again and it's a little irritating being surrounded by annoying doctors who ask inappropriate questions of the lecturers.

"oh yes. i have a question. no over here. look at me. it's got nothing to do with your talk and isn't going to benefit anyone else in here - in fact it's going to have dubious benefit for me but i'm still going to ask it because frankly isn't the sound of my voice great? look at me. me baby."

it's in the middle of town, in an area where several university colleges are clustered. i was looking around at all these 18/19 year old freshers (not in a pervy way - well maybe for a few minutes) coming in and out of all these grand old historic buildings and was wondering what it would have been like to go to college round there, instead of having spent my uni years around hospitals.

i'm quite upset by all the trouble in France. (not putting a link as it's on the front page of everything) so much of the media seems to concentrate on putting the blame on someone/something (eg. ineffectual measures by successive governments to address their most impoverished, ghetto-ised communities) without coming up with any solutions. and as much as we'd like to think we're cultures apart from the French, from a social structure frame of reference a lot of British cities are VERY similar. you only have to take a walk around my hospital's catchment area to see that. there is undeniably tension.

all of which means i am SO disinterested in the Tory leadership campaigns of the two davids. they should both be put on lithium (perhaps they could get Patricia Hewitt some too. just a thought.) i am pleased that (Dr) Liam Fox is out because he's quite quite toxic (as one of my lecturers once said) and feel the same of Kenneth Clarke. that tosser has already screwed up the NHS once as health secretary AND he's deputy chairman of British American Tobacco. Blatant hypocrisy? Fucking nuts more like.

finally i am excited because firstly someone i have missed immensely over the past two months comes back to london next week. hooray.

and also another buddy of mine from across the pond is visiting just before Xmas. he has recently got married (though sadly i don't think his charming wife is coming along) and i was well chuffed to have been invited to the wedding in Sept in Vancouver. you should have a look at his record label Copperspine Records.

good times :)

[i am listening to Lovely Day by Bill Withers. awwww!]

Strange Days

night 6 of 7

i can't sleep at the moment because although it's really quiet a) i'm not allowed to sleep and b) there isn't anywhere to sleep. well there is an on-call room but it's about seven minutes from the ward (too far in case something goes horribly wrong) and it's a bit like the place Buffalo Bill from Silence of the Lambs lives in only not as homely or fragrant.

tonight is actually the quietest it's been yet. i've still managed to make a complete five course meal out of the simple tasks i had to do this evening. sigh.

i've decided that i'm the worst judge of character ever. i've just had a long chat with one of the doctors from A&E who i always see poncing about and acting like a complete dick. he's very posh and i must admit i'm very prejudiced (hopefully my only prejudice) towards posh accents, completely irrationally. anyway, turns out he's really lovely and we had quite a good laugh. i really must stop writing people off after five seconds of exposure.

i don't know if you've been reading the papers this week but it's been completely bizarre. i am convinced that the world has gone completely utterly nuts.

obviously there's the great news that Kaiser Tony's attempt to detain people for 90 days for being brown skinned/bearded has been quashed. i'm sure he's not been the same since he had his supraventricular tachycardia ablated. bloody cardiologists.

also apparently there's a certain percentage of british children that believe that chips/fries are made from apples. un-fucking-believable.

and patricia hewitt. enough said. it appears kim-jong-tony appointed her health secretary for the sole purpose of whipping the NHS' rotting carcass a bit more. "make sure it's completely dead Pat." she of such einstein-ian proposals as giving hospital buildings constructed for NHS use to the private sector. and today she appears to have at some point gained enough credentials to become an oncology specialist [Hewitt "has left NHS toothless"]

well now the news round is over i'm going to go and copy the blood results from the computer to the blood results folder. somebody call the crazy police because i need to be arrested.

[i am listening to Pink Floyd]

I Am My Job

one of my good buddies has just informed me that he has started his own blog. i am a little embarrassed because firstly he says that it was inspired by this one and secondly his writing is much more accomplished.

i don't think he will disagree too much if i say it's (also?) about a search for something missing.

please please go and see it here.

Resident Evil

it's night 3 of 7 and it's going OK so far. well i've managed to get time to put this post up so it can't be too bad.

there have been lots of emergency admissions from casualty so although i've been kept busy it's been a good busy. busy looking after people as opposed to paperwork busy. again there have been some quite difficult cases, one in particular involving a 20-something guy who has really been through the wars with lots of hospital admissions. too many things to go into but suffice to say some people really do get dealt a harsh hand in this crappy life.

i'm pretty tired surprisingly as i don't usually start flaking out till night 6 or 7. i think i tried to go into this set of nights a bit more positive than normal so maybe it's that (emotional energy expenditure or something). i'm also trying to keep myself going with a technique that one of my friends suggested (Vegas who runs the Nip/Fuct blog.) he suggests psychologically splitting the week into 4 nights and 3 nights. so i've only REALLY got one more night left. hooray.

to end with i just wanted to say that i apologise if this blog is a bit too negative and "dark" (which is scarily the adjective several people have used to describe it) - it's not really meant to be. i just put down a stream of consciousness when i start typing. yes there's a lot of frustration but honestly i am still quite cheery in real life! a lot of people who haven't seen me since i started MOADD (have you caught on to my insistence of using that acronym?) are quite surprised when they actually speak to me and find me the same as i've always been. not the jaded, scowling, anaemic cynic they expect.

i would also hate anyone to think that i go to my patients and say:

"how are you today sir? not so good? well you should see the shit i've been doing and how crap this day has been. so yeah why don't you take these antibiotics and get yourself and your pneumonia out of my fucking face."

not all of them anyway. only the ones that have hurt people.

so, for the record, i am not severely depressed. (that can change, however, as i have just seen the football scores.)

and just to prove i am not entering a dark dark place, here is a story from the onion about a big doggy to warm you to the cockles of your hearts and maybe to below your cockles, to the sub-cockular area. (points if you post the song title and singer in comments)

http://www.theonion.com/content/node/29848

[i am listening to Robbie Williams because i can't get another station on the radio in the office]

Night Fever

what's that?

it's november 4th 2005? really?

well that can mean only one thing...

it's time for a week of nights.

yes that 6 weekly funfest of rocking into work when everyone else has gone home to sort out all the crap that should have been done during the day, and pacing the spooky corridors at 3am trying to find a coke machine that works, has returned.

i'm sure i shall be informing you of how it goes (why are you holding your head in your hands like that?)

in other news:

had a good day yesterday! got into work to start the usual "copy the blood results from the computer which isn't working into the bleeding blood results folder because the printer doesn't work," when i was asked by one of the registrars (the one that i did my last weekend with) if i could go and help her with a sick patient on another ward. well i wasn't going to say "no sorry i'd rather sit here with all this paper" so off we toddled.

turned out he was bloody unwell and needed lots of stuff doing to sort him out. so one hairy transfer to our HDU (high dependency unit) and one central line (like a big drip line but one that goes into one of the more massive veins in your groin or neck) later he was "stable". poor guy though. i don't think he will do very well. he's about 80 and not in very good nick in general, exceptionally friendly (we'd often talk about our common support of a certain premiership football team which shall remain undisclosed in case i lose readers) and with a very supportive wife. because he's got so many other medical problems the amount of medical intervention that can be done is limited (ie. his physiology would not be able to tolerate for example general anaesthetic for an emergency operation). i always find this difficult - knowing how far to go when treating someone who is this sick. the decision is normally taken out of my hands (ie down to the consultant) and in this guy's case our management will be what is known as conservative - ie we're not going very far at all. difficult.

also went to clinic which was good. nice to have a change of scene - and get off that bloody ward. still got to do my letters from clinic... grr...

and finally: the high point of the day was that i went for a late drink with one of my old bosses from when i worked in intensive care to see if he could sort out my life. he's a decent bloke and it was good of him to take time out to listen to my woes. obviously i didn't get the elusive answers i was looking for but it was really worth getting another person's perspective, especially as that person is someone i respect and not one of the TOTAL WANKER consultants that you come across in day to day life. and then the whisky came out and conversation degenerated into decent bands, good films and toilet humour (the recipie for an awesome evening.) but i'll talk about the general "career" gist of the evening tomorrow (i see your head in your hands again.)

anyways.

off to put my flares on. it's time for some (week of) night fever.

[i am listening to Island In The Sun by Weezer]

Motivation

things are pretty low today for no good reason. i'm off sick with some vague gastro symptoms. (somatosization? depression? lazy bastard?) would normally feel a bit guilty for going off sick (despite the fact that i've taken maybe 1 day off every 2 years for sick leave) but anyway. they'll manage at work.

had a good week off. got some studying done (though not as much as i'd hoped), caught up with lots of friends (you forget how many people are around you when you never get to see them) and managed to chill out.

then back at work yesterday and it was the same old crap. running around asking people to do tests, schedule them correctly, admin, etc

oh yeah. the most ridiculous thing yesterday was trying to send a patient home (for god's sake)

1. one of our dialysis patients is admitted in the early hours to a liver ward (Ward 1) as it's the only place with beds
2. night doctor for our team goes over to see her, thinks she's fine, and makes the plan that she's got a very mild chest infection, she can have her dialysis in the morning and go home with some antibiotics if all is ok.
3. i go over to see her first thing. she is fine, no temperature, clinically well, bloodwork is all fine. i agree with my colleague's plan that she should go to the dialysis unit, have her dialysis and then go home.
4. dialysis goes fine. i see her again afterwards. she is very well and keen to go home
5. at 5pm i do her paperwork and say to the dialysis team that she can go home with her meds. they tell me that she has to go back to Ward 1 to be discharged.
6. i trudge round to Ward 1. staff there tell me that she has been moved to another ward (Ward 2) because they needed the bed and she was off the ward the whole day. i say i've done all her paperwork can you not just discharge her anyway. they say no, they've already moved her to Ward 2.
7. i go down to ward 2. they say they don't know who the patient is as she hasn't arrived yet. she is still on dialysis. i explain that i think she will be coming soon as she's finished dialysis but she can go home.
   
8. ward 2 staff phone up dialysis team and say why can't she be discharged from there. they reply because she is officially admitted onto Ward 1 they can't discharge her from the dialysis unit.
9. ward 2 then tell me that patient will have to be admitted formally before they can be discharged (ie. be assessed by a nurse, blood pressure taken etc)
   
10. i say this is a bit mad because she can BLOODY WELL GO HOME.
11. ward 2 say she can't go unless she's been admitted and then discharged.
12. i leave paperwork with ward 2 staff and decide if the only person who can go home without being admitted/discharged is me, then i am going home

thought i would get out pretty early (5.30 ish) but ended up leaving at 6.15pm. 45 mins of nothing. if she had been ill or needed my medical "expertise" in any way i would have absolutely NO PROBLEM with staying behind 45 mins, 1 hour, 3 hours or whatever. this, however, was once again a waste of my time.

i hope she got home at a reasonable hour.

[i am listening to Somebody that i used to know by Elliott Smith]

MOADD scoop: Harriet Miers is not human

it was in the press today that Harriet Miers, Dubya's bessie mate from way back when, has withdrawn her position as nominee for head of the US supreme court.

as i'm sure you're all aware (being the well informed, good looking and funny people you all are) her nomination had drawn loads of heat (as robert de niro might put it in the michael mann film of the same name) because she was a bit crap in terms of upholding republican ideology and also because it smacked of wanton cronyism that she was put forward as a candidate just for being George W's buddy.

anyways, what i think is even more interesting is that George and Harriet bear a STARTLING resemblance to 1960s English stage variety double act Ray Allan and Lord Charles, previously last seen on Des O'Connor tonight... curiouser and curiouser.



[i am listening to Deceptacon by Le Tigre]

A Toxic Book

i've just been in Foyles (great central london bookshop with the BEST coffee shop in london - Ray's Jazz on the first floor) and nipped into the medical to pick up some more books for my exam (see i am doing something productive with my week off...)

anyways i was at the counter when i happened upon this book called Making Sense Of Your Medical Career. now although it's actually written for medical students, i thought that maybe i should have a flick through to see where "it all went so wrong boo hoo" for me. so i did.

OH MY GOD

this is a book that actually sets out (to poor little naive medical studes) that the only way to progress in medicine is to network network network at every opportunity, kiss as much arse as possible, that you must must must publish a research paper as otherwise it's career over and, in one section (the relationships section), suggests that one should decide whether random chats with people in the corridor are actually going to benefit one's career in any way, and, that one should as much as possible try to cut out encounters that are not going to further one's ascent up the career ladder. it actually says that (my paraphrasing).

so the question that must be asked is

what fucking planet do these people come from?

the guy who wrote it isn't even a fucking doctor yet. how did he suddenly become qualified to tell people how they should run their lives?

i mean seriously - cut out chatting to people if it doesn't further your career???! what?! i did laugh out loud at a "relationships" section - i doubt that the author could ever sustain any kind of relationship except maybe with Hal, the murderous computer from 2001: a sapce oddyssey.

the cynics amongst you could say "actually mate you're the one with the fucking career crisis at the moment" and i'd say "who's round is it? i think it's yours." but joshing aside, without getting a big head, i have "achieved" everything that this book is trying to get medical students to achieve.

the thing is i did the COMPLETE OPPOSITE of everything the book preaches should be done.

networking? fuck that. would rather be having a laugh down the pub.

eliminate chit chat? fuck that too. i love my non-sensical exchanges with the bloke in the newsagent when i'm buying the paper.

as a result has my career suffered? well not by this book's yardstick. i've done well in exams, published, got a job at a "prestigious teaching hospital" and what's the secret? well i'd like to say that i tried to be a nice bloke at all times, treated people the way i would want to be treated and never looked down on anyone. instead of networking/eliminating frivolity/etc may i suggest that people try and do that. there you go, my words of wisdom. and that didn't cost you £15.99.

as for this toxic evil book (go check out the website for a kind of watch-a-car-crash reason) my advice to any medical students is don't waste your money.

i'm starting to worry more and more. if young medical students are looking at books like this and using it as their guide to life then the NHS is even more fucked that i initially feared.

the day i stop believing that you can "make it" in life without becoming a sycophantic wanker is the day i shoot myself

grrrr.... where are my antihypertensives? night night.

[listening to she fell into my arms by ed harcourt]

A week without the bleep

good afternoon

i am at home, listening to some tunes and having a cup of tea.

bliss

i should of course be studying and it would be a lie to say that i haven't done anything today - i did try to work through a few questions but yawn it's so comfortable on the sofa.

oh yes. i remember i alluded to three complaints letters i had to write. well they are to...

1. IKEA: cunts (see below)
   
2. Ed's Diner: a really bad chain of wannabe retro American diners. popped in yesterday to the one in Soho with a friend for a cup of fucking coffee and the jumped up little shit behind the counter directed us to a cafe down the road. what kind of fucking diner doesn't let you come in for coffee? grrr.
3. Work: probably the most important one (i dunno if i'll actually do 1 and 2). Now you guys might realise that i'm not exactly happy at work so imagine my delight at coming home from holiday a few weeks back to be told that MY PAY HAS BEEN CUT

FUCKERS FUCKERS FUCKERS FUCKERS

yes they've cut my bloody pay. and i'm working more hours than ever before. i really can't believe it. what the hell are they playing at? so yes now i have to write a letter applying for "pay protection". legally if you've been working at the same hospital but rotating departments they can't cut your pay (according to our shitty toothless union the British Medical Association) but the NHS are complete wankers and do what they want. or pull so much paperwork in front of you that i'm sure half their staff just cut their losses as they can't be arsed to jump through 5 million hoops.

so add that to the list of reasons why i'm a disgruntled doctor.

anyway at least i'm on leave.

[listening to Teenage Riot by Sonic Youth]

When Tolstoy finally finished War and Peace...

... he realised that although his toils had produced a masterpiece, it would never top my achievment of finally PUTTING UP THESE FUCKING BOOKSHELVES.

ladies and gentlemen (and i know there are people visiting this page amazingly - over 200!) i give you my new shelves.

[i am listening to kissability by sonic youth]

I am so going to bed

not going to put anything on tonight as i truly am shattered. was absolute carnage today at work though i was working with good company so it was a good laugh.

anyway. i'm off for a pint. then beddy byes. sorry the past few days have been lame.

tell you what. i'm going to hold off the blog till tuesday when i have something interesting to say and... ALL THE BOOKSHELF pictures in the world.

see you soon

[just been listening to Country Honk by the Rolling Stones]

Something for the weekend

I have spent precisely 4 hours awake in my own home these past two days.

I had the pleasure of doing the on call again today in the hospital. left work about 8.45pm, got home at 9.30, had something to eat and i'm now tapping away at this in bed.

it was really busy again today.

one of the doctors called in sick so there was myself and this other guy covering the ward. it was carnage. we have a lot of ill people and admitted a couple of also unwell people who needed sorting out.

and i always end up leaving at least 30min late because i feel too bad letting the night dude come on to loads of things to do. sadly though i'm beginning to think that although it might help them out:

1. i am not getting paid any more to spend extra time in hospital
2. no-one is actually going to thank me for it
3. i'm going to cut into my 'free' time

which is pretty selfish and all but... i dunno. it's worrying because i don't like the person i'm becoming. god - to be where i was five years ago - all wide-eyed and MUCH less jaded.

and tomorrow i have the pleasure of the weekend at work too. i hope for my sake it's better than today.

oooh yes! and then i read this

'i'm paid too much a doctor writes'

it was originally an article in the New Statesman the other week and has been picked up by the national press. this guy is a bit of a cock. everyone knows nurses don't get paid enough and should get paid a fuck load more (as should pharmacists, domestics, etc) but this guy has been working 6 weeks and with his position is unlikely to be doing nights or weekends. i would really like to see whether he thinks he deserves his money after he's been on for 7 nights straight, and each night being CONSTANTLY paged about problems that go from 'bollocks' to 'near cardiac arrest patients.'

Anyways. tomorrow i promise you can have pictures of the bookcase.

And guess what? two of my good friends are coming down for the week from monday and also from the 24th October i am on

STUDY LEAVE for a week - no work. Yoo Hoo!

Nighty night

[i am listening to Can't Stand Me Now by The Libertines]

Goodbye Morph - Hope you are happy in clay heaven

as a quick post script i just wanted to pay tribute to the legend that was Morph who tragically passed/melted away today in a fire in the Aardman Animations warehouse. (Link to the news article)

a tragic loss to the entertainment industry.

there was a very moving obituary from Tony Hart in the Guardian G2 today too.

very sad *wipes tear from eye*

see you laterz

The bookshelves are up; the career is going down

well to be honest today was a bit better at work. not so much of the running round organising things but actually a bit of medicine in practice.

had this very sick patient who is still sick but stable. i hope they're ok overnight. it was pretty satisfying to get her as sorted out as possible and comfortable. i guess now i can just hope for the best.

anyway i'm going to make this quick as i'm shattered after my on call...

by the way. THE SHELVES ARE UP! pictures tomorrow (can you wait?!)

[i am listening to Easy Like Sunday Morning by the Commodores]

The work of a trained medical professional

anyways about today

well it was painful again. i had lots of stupid things to do. i spent about an hour in total on the telephone seeing if one lab (lab 1) in the hospital could send another lab (lab 2) in the same hospital a set of slides (slides as in to look at under the microscope). the chain of events was as follows:

1. doctor from different team reviewing one of our patients asks if the slides can be sent to another lab for a second opinion by another expert... fine. no probs.
2. i call lab 2.
3. they say they do not have the slides as lab 1 have not sent slides over to them yet.
4. i call lab 1
5. lab 1 says they are aware of the slides i speak of
   
6. lab 1 says they however cannot release the slides to another lab unless the person who analysed them in the first place give permission for them to do so (fair enough - confidentiality)
7. i call person who analysed slides to ask for permission to release. they say "no probs mate"
8. i call back lab 1 and tell them big man has said ok to go
9. they say they cannot find slides and will call me back
10. i hear nothing from them for one hour
11. i call back lab 1 who tell me that actually they did send slides to lab 2 last week.
12. i call back lab 2. they have no idea where slides are. didn't realise that slides had been sent. they will have a look again. they will also call me back.
13. i do not hear from lab 2. i call lab 2 back. they say they are still looking but it is now 4.30pm and nearly hometime so not much will be done.
14. i leave my number and number of doctor working overnight so they can call someone when they do find slides. they say "cheers" but they're all going home. best to call back tomorrow and see the progress.
15. i tell reviewing doctor (see point 1) about the chaos. he is very pleasant and thanks me profusely for trying to sort it out. i realise this has been a waste of time.

to be fair not all of my 'work' today was like this but 98% of it was calling people, ordering things on the computer, emailing lists to people, etc. so perversely i leave work at about 6.45pm thinking that i'm glad i sorted out all the little jobs (bar the slides) over today so that tomorrow the ward will run smoothly.

then it dawns on me.

i've not actually done anything that my cactus couldn't do.

there are plenty of interesting (personally, intellectually, academically) patients on the ward with quite complicated things going on with them. some are very sick and i'm always amazed by the resolve and strength of character of some people when they're ill.

i haven't had any time to talk properly to any of them about how they feel, what they're worried about, etc all the stuff that a good caring doctor should do (cliche but true)

i haven't had any time to look into detail about some of the more bizarre rare problems that you don't see normally in medicine that a few of the patients have so from a learning point of view it's also rubbish.

and i'm knackered now! i'm so tired! from doing fucking nothing productive! from pushing paper all day long! by the time i've cooked dinner it'll be bed time. bollocks.

the tragic irony of it is there are thousands of people in pakistan now in need of help.

here is the BBC's take on it today "Aid begins arriving in quake zone"

i could be doing anything out there now which would be of more use than points 1 to 15 above - like clearing rubble or fucking anything. better than moving slides about the place that's for sure.

i am starting to resent now that the bullshit that i've been doing all day has sapped physical as well as mental energy.

well i'm going as the longer i spend on the computer the less sleep i get.

see you tomoz (maybe) - i have cod fillets in the fridge tonight. yum!

[i am listening to somwhere else by razorlight]

IKEA and their bookshelves

evening all

so have just got home. how was your day?

have just made myself a bloody good cup of tea and am still staring at despair at those shelves on the floor. will have to leave them another night. i am really starting to resent it. it's like an unwanted guest who rocks up and stays at your place uninvited for several days whilst at the same time eating all of your jaffa cakes.

here is a picture of the fucker. smug isn't he.

[am listening to the scientist by coldplay]

I Hate Medicine And Want To Leave

so this blog - why?

ok so i work a senior house officer (a junior doctor, 2 years after graduation) in a large teaching hospital in London.

i went into medicine as a fresh faced (though not as handsome back then - i fucking age well) essex lad with hopes of "making a difference" and "helping people" even though everyone at the time said you don't really.

well 8 years later i'm hating it.

i love the subject, love the patients, love the intellectual aspect. the problem is i don't love it enough to justify spending a seventh of each year working nights/weekends/late shifts.

as each day goes by i'm resenting the fact that it takes up so much of my life. i would rather be travelling, listening/playing music, doing a job i enjoy.

i really don't know what to do. in a way i'm glad i'm being honest to myself that i'm not getting anything like as much out of it as i used to but i don't know what to do about it.

apparently i'm not alone in feeling this way.

what is it about medicine in the NHS/medicine today that is making it so unappealing? i'm getting pretty sick of defending the NHS (which i still maintain is one of the few good things left about this country) when i'm so miserable in it.

that and what to do now is the reason for me foraying into the internet. this blog is supposed to be a way of finding out why good people (hopefully me being one of them) are feeling so disillusioned working in what should be a blinding profession.

the plan

there isn't one really at the moment but here's as far as i've got:

1. i finish my job in august 2006
2. stick it out till then
3. get some exams (you have to do post-graduate exams to go into a speciality) as if my life goes tits up then i've got something to fall back on
4. take 6 months off, maybe a year
5. travel - South America is calling
6. er.......
7. that's it....
8. you should always have an even number of list points

for the record: I DO NOT WANT TO DO GENERAL PRACTICE OR GO TO AUSTRALIA/NZ - which seems to be the only advice people have.

so there you go

that's the point of this blog... vaguely.

only 14.5 hours before i have to get up for work tomorrow. that, my friends, is depressing.

coffee time

[i have been listening to the bucket by kings of leon]

Pile of crap bookcase

i am hung OVER

last night degenerated somewhat. as i mentioned we were at the white hart, then baltic which is on blackfriars road before heading over to the Pit bar underneath the Old Vic. the latter is pretty good if you're in the area for a late night drink as it's open way past pub closing. fucking bizarre clientele though - a mixture of theatre-goers, luvvies and wasters. better than cubana up the road which has recently ascended completely into chav status IMHO. probably because there's so many goddamn suits in there all the time. run by doctors from tommies up the road so i hear... must be crap.

it was the bishop's leaving do (just finished his PhD in pain... of all things) and yes am feeling rough today. bloody good night though.

anyways

this bookcase is really really pissing me off. it doesn't bloody fit together. don't worry - i don't have those hampers. i haven't completely descended into an existential crisis yet. i hate ikea (the one in croydon is particularly grating).



[i have been listening to Evil by Interpol]

Bookshelves and Snoozes

so actually i've not done a lot for this blog today though i have figured out how to use it a bit better. anyways it's far too late to do anything at the moment but i promise to be less mundane tomorrow.

i have struggled with trying to put together a massive set of bookshelves and have discarded the stupid instructions with a healthy dose of disdain...

i'm off down the pub for post football chat (england are bollocks - i shall add england manager to my potential job possibilities when i leave medicine - aha! there is a clue for you about the nature of this site....)

it's the white hart in waterloo, just tucked away behind the station... a current favourite. here's a link (The White Hart in Timeout)

see you in the morning (though i'm pretty sure i'm talking to myself)

MOADD

saturday! and MOADD (as i hope this blog shall be referred to on the "street") is up and running. i think i'll leave it a bit longer before i tell you why i decided set this up (stop salivating in anticipation please) so that i can actually work out how to use this properly.

will be back shortly

adios for now