Saturday, February 24, 2007

Rule number one of blogging

Never post when slightly drunk.

I have to admit that my last post (on the shambles that is MMC/MTAS) was posted when I was drowning my sorrows over finding out the deadline had been extended with a bottle of nice chilled white wine. This may account for the slightly melodramatic, 14-year-old, style of writing.

However, despite being slightly inebriated when writing it, my thoughts on the matter are still the same. Although in the cold, sober, light of day I am probably slightly less likely to swear and sulk about it so much. But the general point still stands. I doubt I will be shortlisted and I will be out of a job with no other skills/experience to do anything else and I will, obviously, not be a very happy bunny.

In my personal life I have discovered that the fiancé is back from Iraq in a bit (week on Monday) for a week's leave. I can't believe how he is coping with all the MMC/MTAS stress and having to operate as a medic in a war zone. Kind of puts things into perspective a little.

Friday, February 23, 2007

My true thoughts on MMC

Oh how I hate MMC, how I hate MTAS, how I hate being a doctor right now and how I hate being me.

I probably have 6 months left of being a doctor, after all, who on earth is going to shortlist me? And even if they do I now have to wait even longer to find out because of the fecking eejits. Of these 6 months I have spending half of this time in anaesthetics, a worthy cause but not the speciality I love. That is Emergency Medicine (of which I know anaesthetics is a part but hey...) and I only get to spend 3 months there.

I admit, I haven't tried hard enough as a medic. I never strived to sit memberships exams for the various colleges out there, I was always perfectly happy being a Senior SHO, or even just an SHO. I didn't become a doctor for the letters after my name and the experience of being a college member. I became a medic to do what I am doing now, helping people, making people better, easing their pain and suffering and enhancing my diagnostic skills.

Unfortunately this counts for jack-shit with MMC. Letters after the name is what they're looking for. Career minded medics is what they want. People dedicated to the furtherance of the NHS, not their patients.

Well fuck that, they got me and I may not be any of those things but I know that when I am on good form I am a damn good and empathetic doctor and that is what I care about, not being what MMC wants me to be.

So I may be unemployed in August and yes, I'll act all non-chalent and pretend I don't care. But between you, me and the gatepost... it's going to hit me fucking hard and I don't know how I'll cope. After all the stress of university didn't agree with me very well so fuck knows how I'll take being unemployed and not having the qualifications or life skills to do anything else.

But no one will care anyway because the government will have filled it's quota of junior doctors with the people they wanted and no one will give a toss about those left out to rot with the rubbish.

Tuesday, February 20, 2007


I have been seconded to anaesthetics for 3 months. Whilst this is somewhat bad (as it means I have to leave the beloved A&E department and all the hilarity that involves) it is also good as I am now working a daily shift pattern that will see me working either early (8am - 5pm), late (3pm - midnight) or a night shift (11pm - 9am the following morning). This is of course good news as it means shorter days. However, being a anaesthetics SHO means I have to go back to doing on-call work, which is bad.

On the whole, so far anaesthetics looks good and I'm managing to incorporate some ICU work into the secondment too. Apparently the trust thought I needed to "spread my wings" and although I have completed a lot of the other necessary rotations related to A&E (paediatrics, general surgery, critical care etc) I have never been attached to an anaesthetics firm so it is all a learning curve. Let's just hope it's a good learning curve.

Saturday, February 03, 2007

Friday evening

It was a weird and wonderful shift last night and quite harrowing at times. I arrived just before I started to a waiting room full of patients, which is never a good sign as it invariably means there are a lot of frustrated people as they have been waiting a fair while and last night was no exception.

The first patient I saw was a 12 year old girl with a suspected fractured wrist which she had sustained from falling off a kerb whilst wearing those wheelie shoes. Her father who was accompanying her was rude and aggressive and kept telling me that they had been waiting for nearly 3 hours before they were seen whilst people who had arrived after them had been seen first. I tried to explain that the department was very busy and that his daughter would have been assigned to a triage category reflecting her injury and that patients are seen not in order of time of arrival but in order of clinical need and seriousness of illness and/or injury. The father then blew up in my face and accused me of not caring about his daughter’s wellbeing and suggesting that her injury was trivial. I bit my tongue and said that the girl needed to have an x-ray to see whether her wrist was fractured or not and gave him the x-ray form and told him to make his way there. It turns out that she probably has a scaphoid fracture, but these being notorious to not show up in initial x-rays and not wanting to send her home merely with a tubigrip, when she was exhibiting all the signs of a bone injury not a muscular injury, I have referred her to be reassessed by the fracture clinic next week where they will re-examine her wrist and take another x-ray, by which time if it is a scaphoid fracture the break will show up and I gt her wrist put in a cast as a precaution. I also gave the father and daughter some social advice on the use of ‘Heelys’, in relation to this incident.

The next patient was a more harrowing case. A 24 year old male who arrived on foot with his girlfriend after having a severe headache at the back of his head for a few hours which came on suddenly and was worse than any other headache he had ever suffered before. Now that sentence rings alarm bells at any doctor for a diagnosis of subarachnoid haemorrhage and sure enough he was exhibiting other symptoms; he was nauseated, had vomited, had photophobia (dislike of bright lights), neck stiffness and was becoming sleepy. I sent him off to have a CT scan to confirm the diagnosis, which it did – subarachnoid haemorrhage as a result of a burst berry aneurysum, and on his return put him in resus just in case he lapsed into unconsciousness and made a referral to the neurosurgeon (at a different hospital). The ambulance arrived to transfer him to the neurosurgery department and I discovered a few hours later when I rang to see how he was getting on that he died on transfer to the hospital, probably from the aneurysum rebleeding. Now I know that I couldn’t have predicted this and I did my best but I hate it when things like that happen. Subarachnoid haemorrhages are one of the things about emergency medicine I hate. They are very rare, thank goodness, but tend to affect young normally fit and healthy people and unfortunately there isn’t really any way of knowing who will survive and who won’t.

After that there were the usual Friday evening cases of alcohol related injuries, people having got into fights, the odd depressed patient attending A&E because they felt they couldn’t cope over the weekend and their CPN had gone off duty at 5pm so could they access the duty psychiatrist/crisis team and a few domestic violence cases, one serious and three non-life threatening, all with police attendance.

Then my last patient of the evening was totally bizarre. I would like to say that I thought I had seen most things in emergency medicine and the nurse who assessed this patient had told her “not to worry because we’ve all seen everything before”. Thing is, I had heard of patients like this, I have had colleagues deal with them but I had never treated one. She was referred to me by a male colleague as she was insistent on a female medic, and after discovering her problem I could understand why. She told me that she had been feeling upset and lonely and so had decided to have ‘a play’. Unfortunately she decided that as she was lacking in a vibrator or dildo that she would use a carrot. Trouble was she had got a little bit too excited and the carrot had snapped and whilst she had been able to retrieve half or it the other half was left inside. Normally I would have had a little snigger to myself over this (and don’t berate me for it because I’d like to know anyone who wouldn’t) but she sounded so embarrassed and upset and thought that I’d judge her (she was 58 and clearly thought that I would think that 58 year old women shouldn’t have sexual urges) that I couldn’t even find it that funny at the time, however typing it now I am smiling. Anyway, once I’d treated her and when she asked me my advice (which was to possibly expend some money in Ann Summers) and I’d given her a script for some generic antibiotics (carrots are not the cleanest items) she left, thanking me profusely. In fact as I left my shift she was still sitting outside the department waiting for me to thank me again and she tried to give me £10 as a way of a thank you present but I obviously had to refuse. She also praised the way I’d handled the situation and said the department was brilliant because no one had laughed at her or been cruel about her. I just smiled and walked off, feeling awful because I know the gossip that was going round the staff room in relation to her (that I didn’t partake in) and felt quite appalled that I could laugh about it with colleagues when the patient thought I had acted so professionally.

Another night shift tonight, except it’s a full 12 hour one, let’s hope Saturday night isn’t quite as eventful as Friday evening.

Friday, February 02, 2007


So I am trying to complete my MMC application before I go to work but the bastard computer is not letting me access MTAS and my hard drive seems to be in melt down. *screams quietly to herself*

I start work at 5pm and am only on shift until 11pm (short shift woohoo). Am praying for a quiet evening so I can calm down slightly and try and take my mind off MMC.

Doubt it will happen though, after all it is a Friday evening and I doubt I'll manage to get away at 11 on the dot. Still at least it's only a half shift.

I've discovered recently that thanks to MTAS and MMC you have to be thankful for the small mercies in life.

Thursday, February 01, 2007

I Hate MMC


That just about vents my anger over MMC. I am offically useless and am going to be unemployed.

Why? Because I am not experienced/qualified enough for ST3 training in Emergency Medicine as I don't hold Part A of MCEM or equivalent. So am stuck with ST2 places in ACCS - Emergency Medicine and ACCS - Acute Medicine and 2 CTM specialities.

I'm just a useless doctor and because I haven't pushed enough to further my career I'm now screwed. Plus I'm opting for the 2 speciality/2 UoA option.

Just hope the fiance has more luck with his application as he can only choose 2 specialities and his application is being processed by one UoA - West Midlands deanery - on behalf of the Defence deanery.

This is such a cock up.