Wednesday 30 May 2012

PICU

Last night, watching the Great Ormond Street documentary, I was reminded of the moment when I absolutely knew for sure that I had to be a doctor.

For those of you who haven't seen it, the documentary focuses on a different department in the hospital each week. So far there have been episodes set in oncology, surgery and cardiac transplantation. Last night's episode was in PICU - the paediatric intensive care unit. One of the things I really appreciate about this show is that it doesn't only show the happy endings. Some children, sadly, do not make it. Despite all the advances in medicine over the years, there are some things which simply cannot be fixed. Death is still very much a taboo in our society, and child death even more so. I feel it's really valuable to expose the fact that children can, and do, die. But I digress.

When I was 17, I spent some time over the summer holidays doing work experience in my local hospital. I was shadowing a paediatric anaesthetist and he arranged for me to spend time in all sorts of different areas. By that point, I was pretty sure I wanted to do medicine; I hadn't seriously considered much else since I'd started secondary school. Lots of areas impacted on me during that period I spent in the hospital. I saw some amazing things and some things that made me go home and cry. I heard stories which inspired me and stories which made me feel sick and disgusted at what humans are capable. I don't think I'll ever forget an awful lot of what I learnt then.

Of all of the moments which impacted on me, one in particular will never leave me. I was spending a day on PICU. There were two patients on the ward, a little girl of about 2 and a 3 year old boy. Obviously I can't give further details, but clearly they were very, very poorly. I sat and chatted with the consultant for a while about what was wrong with them, why they were there, what was being done for them. And then he told me that they were both very difficult patients to treat because it was hard to know what was in their best interests. Technology could keep them alive, but was it giving them any reasonable quality of life? It wasn't easy to know.

Later that morning, we spoke to the parents of one of the children. They also had another child; a delightful baby who was just beginning to say her first words. She'd learnt 3 words, alongside her babble. Mama, Dada, and the name of her sibling. She sat on my knee whilst the doctors spoke to her parents. They didn't know what else they could do. They didn't know whether it was fair to push medical treatment. They could keep the child alive. Did that mean they should? Well, that was the question which no one could really answer. After some discussion, it was decided that further aggressive treatment was not in this child's best interests. They would withdraw ventilatory support.

As the Mum and Dad said that they felt withdrawing was the best thing to do, the Mum began to cry. Their baby looked over to her and said, with just a hint of a question in her voice, the name of her sick sibling. I can't explain why, but right there, at that moment, I knew. I had to be a doctor.

Friday 25 May 2012

Showing Off

Ok, apologies in advance. This update is basically me just showing off. Please excuse me, I'm a bit over excited!

I found out on Tuesday I got accepted for my MSc - this came as a total shock as I genuinely expected them to give all the places to people who had more experience. I'm really looking forward to starting. Although it's going to be pretty hard work doing part-time studying alongside being a full time FY1 (and let's not even think about the loan I'll be taking out to pay my course fees), I am a massive geek. Learning new things and keeping my mind busy makes me happy. I'm pretty set on doing paediatrics as a career; unfortunately I don't have a paediatric job during my foundation years, so it will be nice to still be doing something child health related alongside my other work. Depending on time, I think the content will probably be quite useful in preparing for the MRCPCH exams, so I may or may not looking into sitting part 1 at some point.

Continuing on the theme of paediatrics (I'm possibly a bit over keen), I've just returned from a few days in Glasgow at the RCPCH conference. I  think I mentioned before that I somehow won some kind of prize (genuinely unsure as to how/why) which meant I didn't have to pay to attend - a brilliant opportunity as conferences are pretty pricey. My supervisor encouraged me to present a poster whilst I was there, so it really was a couple of days of CV boosting!

I had a fantastic time at the conference. There were 15 other prize winners from other medical schools there, all of whom were lovely. We had a couple of meals out and got on really well. It was nice to know that, regardless of institution attended, we all  felt pretty much the same about starting work (totally unprepared!). I met lots of lovely consultants and trainees who were all super-encouraging. I'm now even more keen on the specialty than I was before.

Right, I've procrastinated for long enough so I really must get back to revising. OSCE in 12 days and all this sucking up will be for nothing if I don't manage to actually graduate!!!

Hope you're all enjoying the sunshine xxx

Friday 11 May 2012

The Final Countdown

After almost 7 years as a student I now feel like I'm into the home strait. One more week of teaching, a few weeks of studying and the small matter of a couple of OSCEs are all that stand between me and entering the big bad world. I am surprisingly calm about this, although provided I pass my exams I will be starting work in 2 and a half months. Possibly I ought to be more nervous about this, especially if day one really is like the bits they show on "Junior Doctors: Your Life In Their Hands" and I take 278 attempts to cannulate each patient.

At the moment, our teaching is all on "professional practise", which is essentially all the stuff that's quite important but noone teaches you. This includes such delights as confirming death, prescribing and fatal accident enquiries. I suspect that actually much of this has been covered in some ilk or other before but I ignored it because it was all "ages away". And now it is not ages away. It is a matter of months. Weeks, really.

This morning we had a session on dealing with "stress and conflict", where we were presented with some rather grim statistics on the mental wellbeing of junior doctors. I was delighted to learn that being female (check) and having a critical father (check - that doesn't mean he isn't lovely) increase risk of suffering burnout during the first couple of years after qualifying. On Wednesday we had a session entitled "support and sanctions" which involved the GMC, MDU and health board HR people telling us not to be naughty or we'd get struck off/fired. Despite these two rather depressing sessions, I'm actually feeling rather positive about starting work.

I had a phone call from occupational health yesterday, and was told they had "no concerns" about my fitness to practise. If you've read my blog before, you'll know that I've had one or two health problems in the past. Although I've played my worries down, I've gone through medical school being a little bit worried that someone would find some kind of loophole which would mean I wouldn't be allowed to start work, so it's a huge relief to know that, from a health perspective at least, I'm going to be ok.

I am keeping myself rather busy at the moment, even though I probably ought to be in the library trying to get the whole of medicine and surgery into my cranium... Last week we had a week off uni and I did absolutely no work at all. I went home to see Mummy and Daddy Learnaholic and had a lovely, relaxing time. Last weekend I went down to Brighton to the National Medical Student Paediatric Conference, which was fantastic. I met lots of lovely people, caught up with some old friends from other medical schools, enjoyed hearing different perspectives on paediatrics and drank lots of wine at the delegate ball.

In addition to uni and revision, I've also started helping out at Cubs (great fun), have a poster to make for a conference in a couple of weeks and applied for a Master's. I suppose I have to justify calling myself the Learnaholic, don't I?!!!

xxxx