I felt like a floundering fish as a junior doctor – until one patient encounter
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Version 0 of 1. Take bloods. Request scan. Do discharge letters. Cannulate. And repeat. After six years of training, I remember brimming with anticipation at being unleashed onto the wards on that first day as a junior doctor three years ago. But a few weeks down the line, I found my daily list of tasks always resembled some combination of the above - and little else. I could go days without noticing that I’d lost my stethoscope. But only minutes could pass before I’d be frantically searching my pockets if I couldn’t find my pen. It wasn’t that I’d been expecting to hurtle around the corner at every crash call, white coat flaring behind me, ready to take a running leap to straddle someone’s chest. Or to end each day graciously shaking the hands of lines of grateful relatives, gazing at me wordlessly with shiny eyes. I’d just hoped I would feel like I was making a difference. Instead, I went home each day to rest my sugar-starved brain and aching feet, with a niggling sense of dissatisfaction that I was gradually resembling a glorified PA. But I remember one day working on the surgical ward in one of my first hospital jobs. I took a history from a cheerful middle-aged, healthy man whose wife had dragged him in with some vague abdominal pain. I ordered an ultrasound, mentally putting my money on gallstones. I remember his cheeky wink and the words that followed me out of the room: “Just get me home in time for the footy please doc!” Shattered at the end of that long day, I sat down wearily to check the result. A strange nausea replaced the hunger that had been growling in the pit of my stomach. I was shocked. His liver was riddled with cancer. I went with my registrar to break the news. I’ll never forget how time seemed to stand still. The cheery expression was wiped off his face, replaced with glistening eyes that spoke silently of his gut-wrenching despair. He could think of nothing to say. Neither could I. Later that evening the rest of my team changed over, while my seemingly never-ending shift continued into the night. The new team and I were met by the grief-stricken, bewildered faces of his family. A lengthy discussion ensued, and I was suddenly glad to be there to provide some continuity. The following afternoon, as I scurried around the ward hopelessly trying to make some headway with my job list, I caught him staring sadly into space out of the corner of my eye. Something about his expression made me stop in my tracks. I hesitated momentarily, then firmly shoved the list in my back pocket, and walked to his bedside. For just half an hour, I listened. At the end of the week, I went to say goodbye as he was discharged. “Thank you doc”, he said. “I didn’t do anything.” was my automatic reply. I meant it. He replied, “Just talking to me. And being around, when my family came. I can’t explain it.” In those first months as a junior doctor, I felt like a floundering fish in the enormous, fluctuating pond of the NHS. It was hard to drown out the constant political rhetoric, and ignore the woeful headlines about our ailing healthcare system and its litany of misfortune. Or muster anything but scepticism as the waters were muddied with more reform, and extra funds were poured in in an attempt to satisfy its voracious appetite. With so much time eaten up fire-fighting avalanches of paperwork and wrestling archaic, clunky IT systems, I struggled to find purpose or pride in the secretarial-like niche that had been carved out for me. Related: Black Wednesday: share your stories of the day junior doctors start work But this simple encounter was a stark reminder that we, as the juniors, might find ourselves at the bottom of the food chain in the hospital ecosystem. We might be the first line of target when a consultant loses their temper. Or when a patient vents their frustrations with navigating our labyrinthine system. It’s because we’re on the frontline. But that also means that we’re in a position to spend a little more time answering questions, explaining diagnoses or talking to families. This month, the same as every year, another new batch of bright-eyed medical graduates hit the wards up and down the country. It might not always live up to the picture of heroic altruism we warbled about in our medical school interviews. But that patient reminded me that it’s an undeniable privilege to be in a position to make a difference. And how easy it is to underestimate the power of a kind word, a second thought, or a caring gesture. As Hippocrates said: “Cure sometimes, treat often, comfort always.” Sometimes, sweating the small stuff goes a long way. If you would like to write a piece for our new series Blood, sweat and tears, read our guidelines and get in touch by emailing healthcare@theguardian.com. Join our network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views. |