Sunday, 22 June 2014

(Not) Just A Minion

There is a temptation as a junior doctor to refer to oneself as "just a minion". This is particularly true of FY1s/residents, but it persists a fair way up the food chain. After all, we just go around obeying orders and doing as we're told, right? WRONG.

A junior doctor tends to be the first person to be called to a sick patient, whether a new admission or a current inpatient who has deteriorated. Every day we make decisions about whether to start or stop fluids, analgesia, antibiotics etc. We are the ones who decide whether a new admission can wait to be clerked in by us or whether we need to intervene immediately. When we review patients, we are not robots, simply asking a series of questions. We are interpreting (sometimes vast amounts of) information and making complex decisions based on that information. We have spent many years training to become critical thinkers, analysts, problem solvers. It would be utterly ridiculous to then unleash us into a job where we are simply yes-men. Yes, we have limited experience compared to our seniors, but we are still expected to think relatively independently.

A lot of juniors are also under the (false) impression that senior = infallible. This is clearly not true. Sometimes, as juniors, we are the ones who alert the consultants to something important. Prescribing diclofenac as instructed is not a smart move if you recall the past history of gastric ulceration - something a senior may not be aware of (because you took the history, remember?). Your boss may not have seen the latest blood results and it may be up to you to point out the deteriorating renal function or rising inflammatory markers. There are also occasions where your seniors will make errors. Pointing them out doesn't mean being arrogant or argumentative, but a simple "I'm interested, why did you decide X?" or "I was under the impression that you do(not) do that in situation Y" could prevent a patient coming to harm.

One of the main reasons I (and, I suspect, some of my colleagues) dislike the "just a minion" attitudes is that it seems to remove an element of responsibility from the junior, as if their actions and decisions are meaningless. You worked hard at university for a long time. You are paid an enviable salary. You are a member of one of the most trusted professions there is. So stop with the "just a minion" talk. You're a doctor, and what you do matters.

(Thanks to @drbobphillips for suggesting I write this post) 

Sunday, 8 June 2014

"I Did It!"

Despite filling most of my time with work, academia and general geekery, I do have time for the odd hobby or two. People who know me will be well aware that working with children is something I love, and as well now working in paediatrics, I try to fit in some volunteering with Over The Wall and also help to run a Cub Scout group.

Last weekend, we took the Cubs away for a night camping. We filled the day before and after the actual camping with a variety of activities including archery, crate climbing and of course ending with the legendary soap slide (which may explain some of the bruises on my legs...). Any camp purists will be delighted to know we also had an excellent camp fire, complete with lots of singing and toasting marshmallows.

People often question my sanity when I tell them that I spend my rather limited free time in this way (I was actually quite proud when a colleague called me "completely insane" recently...) and sometimes I struggle to explain exactly why I choose to do these things. At camp this weekend, as the kids excitedly told me how high they climbed on the crates or how many bulls eyes they got, I was hit again by the sense of why I do these things. To hear a child say "I did it!" There is something immeasurably special about helping someone to achieve something they didn't think they could do. As a person who has gone through life convinced (for no good reason, although impostor syndrome comes into it) that they are rubbish and can't achieve anything, helping other people discover what they can do is something I feel I need to do.

I still get tears in my eyes when I remember a child at Over The Wall last year, partially sighted and scared of heights, manage half of the climbing wall she initially didn't even want to try because she "couldn't do it", or the incredibly self conscious teenager finally dare to perform at talent night (and give us all goosebumps with her rendition of Someone Like You).

There is a more selfish element to all of this, of course. There's an episode of Friends where Phoebe is determined to show that you can perform a truly selfless deed - even going to the somewhat bizarre lengths of "letting a bee sting (me) so that he could look cool in front of all his little bee friends" - and finally conceding that every "good" act is tinged with selfishness. I enjoy what I do. I enjoy seeing young people achieve and I enjoy knowing that I've played a part, however small, in helping them to do that.. Facilitating this achievement gives me my own "I did it!" feeling. And it's amazing.

(If you fancy joining in the fun, and sharing the "I did it!" feeling, go and browse the OTW and scouting pages.)