I work in a really scary job. Everybody knows that. The Emergency Department is a terrifying place full of chaos and carnage, blood and death. Except most of the time that just isn’t how I think of it.
I am one of the world’s biggest cowards. I am terrified of pretty much everything. Scared of talking to my daughter’s teacher, of saying hi to a mum in the playground, of being alone, of the dark, of the telephone, of filling in forms, of travelling, of new places, new situations, pretty much anything new. People who know me away from work seem pretty amazed I manage to leave the house let alone work as a doctor, let alone in the most unpredictable of all specialties.
This week I have been staying alone in a hotel, away from home. I arrived by train to a city that I knew one small corner of well many years ago, in the pitch black autumnal evening. I couldn’t find a taxi and had no idea how to make my way across the city to my hotel. After a brief period of panic I found apparently the only taxi in town, and then spent a rather nerve-wracked journey wondering whether the man driving me had just murdered the real taxi driver, the body shoved in the boot, and was planning to murder me next (he ended up being a very sweet man who gave me money off my trip after finding out I was an ED doc, telling me how lucky he was to have such a wonderful health service). I spent most of the hours I spent in my hotel room imagining somebody breaking my door in and murdering me, or the building burning down.
So yeah, I am a coward. I cannot deal with the unpredictability of normal social interaction, or the fear of any unknown situation.
In my Emergency Department though, well there I feel safe. I have known many of my colleagues for many years and I trust them with my life, absolutely. I have their backs to the very end, just as they have mine. Our devotion to each other gets us through every shift, somehow, whatever hellish situation may face us. Knowing that we have to make tough decisions, potentially life and death decisions, with very little thinking time, is somehow a powerful focuser of the mind. At its purest moments I think it is very like mindfulness, you can only be absolutely in that moment right in front of you, and everything else fades away.
I am well aware that many doctors hate it. There are people who panic and fall apart, who are unable to make a decision, can’t keep up the pace. And believe me there have been moments that were absolutely terrifying, but somehow I seem to have managed to find my little piece of Zen right in the eye of the storm.
I grew up with a very narrow idea of what success looked like. It was full marks in exams, being top of the class, going to a good university, getting a good job, earning lots of money. For a lot of my earlier life I managed to fulfill that narrow definition. I was the girl who resat my chemistry A level module because I only got 84%, and although that is still an A it wasn’t as good an A as I had wanted. I worked hard, but that hard work was enough to get me the successes I had aimed for.
At various points life threw me a bit of a curve ball, when I made a last minute change to my university plans and ended up with an unexpected gap year. When I didn’t get the surgical training post I had wanted, and then didn’t really enjoy the one I had. And then most disturbingly when I decided there were other things I enjoyed more than working non-stop.
As with every other area of my life, having a baby was the biggest curve ball of all. I discovered that I couldn’t be a ‘successful’ parent just by working hard at it however hard I worked my daughter didn’t want to eat, sleep or not cry in the way that I had expected. At some point in those early years, probably while she was once again refusing to nap anywhere but in my arms, and I was stuck on the sofa with nothing but the Internet to entertain me, I came across this picture:
Now, this picture seems bloody obvious to me, but when I first saw it I’ll admit that it blew my tiny mind. In one very simple picture I realised that pure hard work alone was not always the key to success, that sometimes you had to go backwards, or take side steps, or try something completely new before you even realised that you were actually making progress. I could see it so very clearly demonstrated to me every single day in this small person sleeping in my arms, I could see her learning and experimenting and failing and learning every day. With her I found it incredible, this beautifully squiggly path to discovery, so why had I never seen it in myself? Why had I always berated myself for every single perceived failure, every backwards or sideways step? Why had I given up when things were going in that smoothly perfect upwards slope?
I had my thirty seventh birthday last week. I am in no way at the point in my life where I had expected to be at this age. My life has ended up being far more complicated yet beautifully simple and far more wonderful than I had ever expected it to be. You may have read about my rather late in the game decision to aim for consultancy after nine long years of trying to convince myself that I never really wanted it anyway, after the path turned out to be rather more squiggly than I had envisioned. I have decided to embrace all the experience I have, and try to use it to be a better doctor than I ever hoped. I have been absolutely working my arse off for my imminent exam, whilst also taking on other firsts, such as my first time teaching on an Advanced Trauma Life Support course starting tomorrow, and then getting qualified to teach on other courses too later this month. As well as the exams I have huge amounts of paperwork to get in order, and years worth of evidence that I need to start collecting. At earlier points in my life I would have been put off by how much harder I had made life for myself, I would have been discouraged and given up. Now I think I am old enough to know that things don’t always come easy, that it often feels like you’re going backwards, that you don’t even know which direction forward is anymore, but I have faith that I can keep learning, that I continue to move forward even when it doesn’t always feel that way, and that as long as I keep going I can get where I need to go. However difficult and scary that can be at times.
So for any of my senior colleagues who may read this, prepare yourself to fill in a whole load of forms for me, and one day, in many years time, hopefully I will be calling you equals!!!
Parenting is a funny business. In this day and age at least there are thousands of decisions we make for our children, some after great deliberation, sleepless nights and heartache. Some whilst barely even noticing that a decision is there to be made. Some are because that’s what your mother did and her mother did, or that lady down the road who always seems to totally have her shit together. Some decisions you don’t realise how absolutely perfect they are until much later when everything has worked out fine. Some you look back on and wonder what the hell you were thinking. Some you continue to dwell on for years to come, still unsure if you did the right thing.
I think the weight of all these choices, combined with our fear of doing the wrong thing for our precious children, is at the very heart of the “mummy wars”. Well, the advertising companies and social media can probably take some blame too, but that is for another post…
The mummy wars, for those of you fortunate enough to not understand the term, is this need that some women seem to have once they become mothers to justify the decisions they made. And so they set up camp with the other women who made those same choices, to form a little tribe, to help them validate their choice. In order to make their decision feel even more robust they have to be negative about others who made other choices. And there you have the natural birthers vs the c.section mums, the home birthers vs the give me all the drugs, breast vs formula, co-sleepers vs cot in a nursery, stay at home mums vs full time workers, purée vs baby led weaning, and on and on it goes infinitely. At the end of it all though, they are all children and we are all their mums, and we chose the thing that seems best at that precise moment, for that child and this family and we probably all do ok in the end somehow, through all those great choices and all those mistakes too.
One of the very most debated about, panicked about, lost sleep about and cried about decisions I have made is how to educate my daughter. At the time those decisions needed to be made she was having quite a hard time, struggling with separation anxiety, communication difficulties, fear of change and new experiences, and all of us really feeling totally stretched and overwhelmed as a family, it didn’t seem there were any good choices. We investigated her staying on somehow at her amazing outdoor preschool, a local part time steiner parents co-operative, flexi-schooling, state school, the bank-breaking private school option, or full time home schooling.
We looked around one of the highly recommended local schools and didn’t particularly like it. We agreed to apply for it and then see what happened. We didn’t even look around the other nearby school which I had only heard bad things about, and which was the only school in town to have a bad OFSTED report. We definitely didn’t apply for it. We were told that the other schools in town were massively oversubscribed and we were way out of their catchment area, so didn’t even bother with those.
Youve probably guessed that when the fateful email came my daughter had been allocated a place at the failing local school with the terrible reputation. Well obviously she wasn’t going to go there, we would have to keep investigating our alternative options and consider if our family could really cope with the reality of home schooling.
I am a big fan of home schooling. I really like the idea of it. I follow loads of home schoolers on social media and really admire what they do. Between us, me and my husband have a pretty diverse education and personal interests, and even have a teaching qualification, though admittedly that is for adult learners. It kind of fits with our vaguely hippy parenting style that we have fallen into, and locally we have a thriving home school community, even friends and neighbours who did it, to help us along the way. I thoroughly disagree with the way the Conservatives have steered education and abhore this culture of constant testing and tiny children being expected to understand what a conjugate noun is. I worried that state education was a tool to turn my child into an automaton ready to work for the rest of her days in a soul destroying job.
At the same time, we were really struggling with her. We were struggling to get through each day and the idea of her being at home full time, with us somehow being able to help her grow into the best person she could be, the most knowledgable, skilled, creative, worthwhile human her potential allowed, without all going totally crazy and crumbling under the pressure, it felt impossible. All our other investigations seemed to reach dead ends, and none of the options felt right.
With our offer of the school place came an invitation to an open day to look round. So after writing it off, we thought we should at least do that.
And we really liked it. It was a lot smaller than the other school we saw, friendlier, calmer and more welcoming. The kids seemed really happy and really engaged. The outside space was great. Loads of fun things seemed to be happening.
After much heart ache we decided to go for it. With the very clear plan that we could pull her out at any time if we didn’t feel it was right. And she went.
And she loves it. My child who barely talked now talks constantly. My child who had never drawn a picture now writes long stories with illustrations. She has gone forwards in leaps and bounds and I am totally in awe of her and the lovely teachers she has been so lucky to have.
I still follow loads of home schoolers on social media and still have friends that it really works for. And I guess I’m jealous that it seems to work so brilliantly for them, when I really don’t think it would have worked out for us, definitely not at that time. Who knows what the future holds though. On some of these homeschoolers social media they use the hashtag #thisiswhathomeschoolinglookslike and sometimes I look at their feeds and feel a bit sad, a little like I failed my daughter, and like they’re probably better parents, better people than me. But so far, well we seem to be doing ok with this decision so far. So here are some #thisiswhatschooleducatinglookslike meant slightly tongue in cheek!
And this autumn, well we filled in my Sons application for the same failing, bad reputation school which my daughter has loved and thrived at, and I haven’t lost any sleep over it.
There is one day left of our school summer holidays. In just one more day we will be back battling early mornings, teeth brushing before lunchtime, having to wear actual clothes, and make it to school by quarter to nine.
This time last year we had all lost the plot, and spent the last fortnight screaming at each other. This year I really hoped it would be different, and I am very pleased to say it has been!
With one day left to go I am actually feeling sad at the thought of my daughter being away from us most of the day, five days a week. I can’t believe how quickly it has passed, and I will be mourning the passing of the holidays on Wednesday morning.
The main difference this year? Massively lowering my expectations. Taking some leave so I actually see my children a little. Being relaxed if most days are PJ days. Asking the kids if they want to go off on a big adventure today or if they’d really rather play Lego and watch Andy’s Prehistoric Adventures on repeat AGAIN. It’s been being relaxed if they wear dressing up clothes to the supermarket and accepting that any trip out must include pretty much constant food if there is to be any chance of enjoying it without a meltdown.
Not to say we haven’t had any adventures. There have been train journies across the counties to stay with my Mum, theatre trips, cinema trips, meals out, splashing on the beach, and meeting heroes (my Son’s hero, not surprisingly a CBeebies presenter!)
And there has been lots of eating, lots of TV and movies, lots of creative play, reading comics and magazines, seeing their family, swimming, colouring, arguing and rough and tumble, cuddles, collaboration, and an awful lot of fighting over that one Lego piece they both absolutely have to have.
It’s been pretty good really, even if we didn’t make it through many of our big plans.
And then on Friday morning my son starts preschool. His first time ever being away from us. Looking forward to some child-free time and he seems to be really excited about it too!!!
Imposter syndrome is a concept I am hearing discussed more and more often, usually in relation to women, defined as a feeling of being a fraud, inadequate, undeserving of our successes despite the hard work that it has taken us to get to our positions.
Last night I finally got around to watching the first episode of Trust Me, a TV program about a nurse who steals her emmigrating friend’s identity and qualifications, to start working as a middle grade doctor in an accident and emergency department.
There were many aspects of it that I found unrealistic. The fact that there only seems to be one nurse working in their department! The relaxed way in which they stroll around, rule one in ED – always walk fast! Even if you’re not actually busy it will look like you’re busy so that you don’t get interrupted every two seconds. The lack of constant interruptions was also laughable. Working in ED is worse than living with a toddler. It is impossible to have a conversation without ten different people asking you to do something else for them throughout.
The biggest falsity, and the thing I probably find hardest about real life emergency medicine, was after their big traumatic trauma cases, they retired to the coffee room and talked about it, and let off steam and threw something. In reality you would be straight back into the twenty other patients waiting for you, having to apologise to each of them for how long they’d had to wait, keeping that smile and sympathetic look on your face at all times.
There were many things that totally resonated though. I have felt exactly those feelings that that character has felt, on a fairly daily basis.
Don’t worry. This isn’t where I make some big confession. I did go to medical school. I have two degrees to back me up, and several hundred people watched me graduate. I have lots of people who could back up that I was in those lectures, those exam halls, those clinical sessions. Friends who could confirm the many hours I sat holed up in my room studying, the endless practicing physical examinations. I have done all that. I have the certificates.
And since then? Well since then I have twelve years of actually being a doctor under my belt. I have seen and done so much. I have practiced my craft over and over and I literally can do it in my sleep, as almost every dream I have had in the past twelve years has been patients and emergencies and clinical dilemmas.
And yet, I can still totally understand that feeling of being an imposter. It is something that hits me at some point in most shifts. That sense of fear and anticipation when the team is stood in resus awaiting a trauma patient, not knowing quite what will appear as the ambulance trolley crashes through those doors, wondering for a second if you will be enough for the situation which will face you. That combined adrenaline of every member of the trauma team standing there in those seconds before the patient arrives, that is a very potent chemical state!
I think there is a strong element of the nature of our medical education which can foster this imposter syndrome. For any non-medics reading this, the principle message of medical school is “See one, Do one, Teach one.” Which means that somebody shows you something once, the next time you are expected to do it yourself, and the time after that you apparently have the skills to teach somebody else. Now this is becoming less relevant these days and training has become more rigorous, but there is still that mindset floating around.
The first time I reduced a dislocated ankle, something the character on the program had to do, I was an orthopaedic SHO with my registrar in bed on the other end of the phone. His advice was, “look at where the bones are, then put them back where they’re meant to be.” That was the sum total of his practical advice. So that is what I did. And the patient was ok, as was his ankle. I have honed my technique considerably since then, and do my very best to be slightly more supportive and instructional to my juniors.
The character also had to do a trauma chest drain, one of my least favourite procedures ever. If anything she made it look far too easy. It is hard work having to push a totally blunt pair of forceps through somebody’s chest wall. And I always get a moment when my finger is inside somebody’s thoracic cavity, a moment of total disbelief that this is what I do. There is a moment in Robin Hood Prince of Thieves, where Alan Rickman’s deliciously loathsome Sheriff of Nottingham talks of digging Robin’s heart out with a spoon. I hear that line in my head every single time I do one. I have now taught other’s how to do them on a regular basis but that sense of disbelief stays with me.
I’m sure that my Imposter Syndrome is a massive factor in my decision to sit my fellowship exams, and hopefully pursue consultancy at some point in the future. I feel that I need exams, certificates, outside validation to prove to others that I really can do it. I got tired of people saying nice things to me, telling me I was a good doctor, and not managing to really feel it inside. I’m not sure if any amount of qualifications will totally take that feeling away, but I’ll give it a go.
The revision’s going well though. I am really loving engaging my brain again. I feel more like myself with revision notes all over the walls and a timetable of revision topics stretching ahead of me.
Doing it with children is so hard though! They are almost as distracting as those ED nurses interrupting every five minutes!! It’s going to be a very hard slog, my sanity may not survive, but it’s something I need to do.
This is going to be one of my more meandering posts, which I apologise for. Feel free not to read guys!
Now I am not religious. I never have been. I mean I was christened as a baby, I went to church schools throughout my education, I went to church on Sundays and Sunday school every week as a younger child. It got to the point where I was around the age that I should be getting confirmed. And at that point I had another of those conversations with my mother which stayed with me. She told me a story, of when she was the same age as I was then. An elderly aunt of hers told her that if she got confirmed, then this aunt would leave money to my mother in her will. At that point my mother decided that she didn’t want to be confirmed, and she wasn’t so sure about this whole religion lark.
Now my mother does have a stubborn streak, and there may well have been an element of not agreeing to this deal just to spite her aunt. I feel there was more to it than that though, a sense that true belief is not something that can, or should ever be bought. That conversation reminded me, that even at that age I had a choice about what I believed in, and that it shouldn’t just be a natural progression to be confirmed because that’s what the other children in my Sunday school were doing. At that point I chose not to be confirmed, decided that I didn’t believe in the God they had been teaching me about for all those years.
I stopped going to church or Sunday school from that point onwards. I decided that I believed in lots of other things instead.
I believe in humanity, that the majority of people are genuinely trying their best. I believe in the power of the natural world, to regenerate and heal and evolve. I believe in thought and art and the pursuit of knowledge. I completely believe in love and a little bit of fate thrown in there too.
I’m not sure if any of the rest of you guys with siblings spent much of your childhoods dividing up your parent’s belongings for when they eventually died. Me and my older brother devoted quite a lot of thought and discussion on exactly which of my parent’s belongings we should both inherit. I am now 36 and both my parents are still going strong, but those childhood conversations still felt pretty important at the time. We both started off with a long list, which included most of the same items, obviously. We would end up bargaining through these, “I’ll let you have that, as long as I can get this.”
My childhood bargaining skills were just as good as they are now, and eventually after many years of discussion we had agreed. My brother would get everything, except for one book. One extremely precious book! (A book which, now I think about it, my brother probably had no actual interest in at all, but his bargaining skills are much better than mine!)
When I was about eight years old my parents got dressed up one night, making the extremely exotic trip into London for the opening of an art exhibition. Now my parents were not exactly the going out in their finery to London types, nor the art exhibition types. Whilst books were always revered, art was not exactly big in our house. This exhibition though was being sponsored by the company my father worked for, and I assume their night out was all on company expenses, so off they went. It felt very exciting and glamorous to my eight year old self. The next day I was shown The Book.
A huge, heavy, beautiful book produced to accompany the exhibition. I believe they may have been given to them for free. It was put away on a shelf in my father’s study, where we were not supposed to enter (almost all the times I seriously got in trouble as a child were because I had snuck in and taken something I should not have, like an illicit pencil sharpener, or other such forbidden temptations).
I spent many, many hours of the proceeding years sneaking into the study unseen, lifting this heavy book from its shelf and studying the photos inside. There are pictures inside which are burnt into my memory forever.
Pictures which were instrumental in forming the way I view the world.
My small fingers have turned those pages, traced out the lines of those photos, over and over. There are probably many years of my DNA smeared into the fabric of the paper.
This book meant so much to me. Enough for me to bargain my rightful inheritance away happily.
A couple of days ago I was given The Book. I was busy cooking dinner, hands full with pans and whisks, and the book was shoved in my face, with the carefully chosen, ceremonial words of “Oi, do you want this?”
Now this was not exactly how I’d imagined it. Once the anticlimax had worn off it was pretty exciting. Apparently my parents had been discussing it, had decided that the book should be mine, they knew how much I wanted it. Mum had discussed wrapping it and presenting it to me. Ceremony is not really my Dad’s thing though.
Still, it felt pretty monumental. It took me back to that eight year old. The one who learnt many of her concepts of humanity and war and love and death and history from stolen moments studying these photographs on the floor of her father’s study. The one who valued those insights over all her parent’s worldly possessions. It made me assess where I had come from that small child, and that actually, maybe I’m doing ok, maybe I’m doing my best too.
This morning my Dad informed me he’d managed to order another copy of the book online, from some second hand bookseller. He was very proud of his ingenuity, that he could give me their copy but not even have to do without it themselves. This book that neither of them had probably looked at im years. I went on Amazon and found you can buy it off them for just over three quid. Bargain!
Suddenly I questioned the worth of this book. This book that had meant so much to the child me. That still held so much of that child between its pages. The fact that this book was seemingly so instantly replaceable. These days of instant internet access, where you can find any piece of knowledge, any object, any image, any opinion, so instantly, does anything really have true value anymore?
The childhood me knows better though. Hopefully my children will grow to know better too. I know that the awakening these images brought in me is priceless and always will be, even if you can get it for three quid off Amazon. And yes, I am still perfectly happy to have bargained away my inheritance for it.
I am on holiday. I needed this. My rota kindly gave me an absolutely soul-destroying, body-crippling, brain-melting week to finish on, meaning I spent the entire first 24 hours in bed, barely human. I only have two shift ahead of me for the whole rest of the school holidays, and even then September is sedate as well after I worked far over my allotted hours and they are finally paying me back. I am appreciating the break. So much…
Already I have had a very positive physio appointment, which left me literally bruised but with some appreciation of the progress I have made and my path forwards. I had another lovely meeting of book group, and a great choice of next book which I am thoroughly enjoying. I savoured a politic rally, with a chance to hear my hopes of a left-wing future offering a more equal possibility for my children. I have had a wonderful family theatre trip in the beauty of Heligan gardens and a fabulous celebration of ten years since my first shambolic, hungover and slightly awkward date with my now husband.
It was a good start. Just the start I needed.
On Sunday I got on the train with the kids, leaving my husband home alone for over a week, whilst we come and stay at my parent’s house.
We are spending the week seeing lots of their cousins, with the older children going together to swim classes every morning. It has been great for them to spend time together, we sometimes feel so far apart so it’s good to build those family connections.
I have also managed to fit in a day of adventure with my old uni housemate and her kids. Sunshine, fresh air, miles of walking, dens to build, obstacles to climb, ice creams to eat, and tales to catch up on.
Holiday times are strange though. A life outside of reality. Even staying in the country, with familiar people and places and homes, it still feels foreign. Too many echoes of time passed, of past selves and half forgotten histories. There is time to reflect on these too, and that reflection is not always comfortable. Thinking of who I used to be, how I thought my life, and the lives of my friends would turn out. Remembering back to my days as a new mother, with a tiny baby that felt like the most enormous responsibility and the greatest mystery.
Today, I lost my three year old son in Sainsbury’s. One second he was there, and then he just wasn’t. And he was nowhere. I ran down every single aisle, over and over, head swivelling crazily looking for a tiny mop of white blonde curls somewhere. And they were nowhere. I was so sure he must have been taken. There was no way he could have completely vanished in what is a pretty tiny store just from wondering off. I had visions of the rest of my life wondering where he had gone, and never knowing if he was safe or if he was sad. Above all I just missed him, was so sad of all the amazing moments of him that I would not be there for, all his laughs and jokes that I wouldn’t hear…
After ten minutes utterly frantic, there he was happy as could be, riding on the Thomas the Tank Engine ride, completely oblivious of my terror, grin plastered across his face. I promptly burst into tears whilst he kept grinning, and my daughter burst into tears too.
I have felt pretty exhausted for the rest of the day. That was all of my emotional expenditure for the year. They have had a relaxed day of classic kids films, Lego, and illicit YouTube videos about Minecraft on their older cousins phone. I have managed a few hours of focused revision, which so far is going pretty well, and feeling really productive.
I hope everyone else is enjoying this rather wet summer, and maybe managing some reflection too, even if sometimes it feels a little uncomfortable.
I have written recently about the effect that small positive choices have made on my life, and my mindset. I am eating better, being more active, doing daily exercise, taking more time for myself, and doing more of the things that I love. The more I do, and the more small successes I have, the more motivated I feel to push myself a little bit further, try something a little more challenging. I have spent a lot of time reflecting on where my life is right now, and where I eventually want to be.
All these small choices have led me to make a really big decision, or it feels pretty big to me. I wanted to share that big decision with you guys, because sometimes you just need to put it out there, so that everyone knows, and so hopefully you’ll help to remind me how much I really want to do this, even when it gets hard and even when I feel completely discouraged.
There have been several small incidents at work recently, several innocent off-hand conversations, and particularly some very kind comments from people that have really made me pause and take stock. I do think that I am a good doctor. I have a lot of practical experience, common sense and clinical acumen that mean on a day to day basis I am able to do my job competently. But is that really the same as doing my very best?
Its a very long time since I have really had to engage my brain, since I have got the text books out and studied the theory behind what I actually do on a day to day basis. I had resigned myself to the fact that I would be a specialty doctor forever, and if I am, then that’s ok. It’s a job I love. But that was never my plan when I started. I always just assumed I would be a consultant one day. So, maybe I still can…
I still have potentially thirty years of my career ahead of me. My youngest child starts at preschool in a few short week’s time. I am finally starting to feel less overwhelmed and finding time to do other things. What if I spent some of that time actually using my brain, doing some study that can only help take all of those years of experience and make me an even better doctor, maybe one day that doctor that I actually wanted to be all those years ago when I first started this journey.
So here I am, publicly sharing my decision to start sitting my exams to one day become a Fellow of the Royal College of Emergency Medicine. I’ve ordered myself a text book, I’m going to clear myself a study space, and I am totally going to do this! And if I sound like I’m giving up on myself, feel free to give me a kick up the backside!!
Next Wednesday, the first in August, is an important one for all doctors. It is ‘affectionately’ known as Black Wednesday, and marks the day, across the country, across the years, where all newly qualified doctors officially start their very first jobs as doctors. Not only that, but all doctors in training posts move jobs, often move hospitals, to continue onwards and upwards with their training, gaining new experiences and new responsibilities. It tends to be a little chaotic, with thousands of doctors across the country needing induction to new systems, software and most importantly, fire safety guidelines. The gaps on the ward tend to be covered by the more senior doctors or doctors like myself in non-training roles who are staying firmly put in their chosen hospitals. The sensible consultants book their summer holidays perfectly to return once some semblance of normality has returned to the hospital.
My own inaugural Black Wednesday was twelve years ago. Here is how fresh-faced I looked in the weeks leading up to this…
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I have absolutely no photos from during my first year as a doctor. I think that says a lot! I can assure you I would have looked like I’d aged at least ten years.
When I started first year doctors were still called house officers. They are now F1s. I worked my house officer year in a huge tertiary hospital, full of professors and leading experts in their fields, with many consultants particular specialty being belittling house officers. It was a crazily intense year, the steepest learning curve of my life (excel for my first year of motherhood) and changed me forever. I had all the exams, all the theoretical knowledge and clinical practice that was expected of me before taking that house officer bleep, before running the patient list, but the realities of it still came as a huge shock to me. I was the doctor who would be on the ward at least half an hour before I was due, and leaving at least two hours after I was supposed to finish, and lunch breaks were an unexpected treat. I guarded my patient list with my life, I probably tended it more diligently than I have my children. As the house officer nobody knew my patients better than I did. I was there with them on the wards day in, day out. I knew their families, I listened to all their worries and celebrations, I tried to placate all their complaints. The ward nurses were essential to getting me through each day, often being the ones to actually show me what the hell I was meant to be doing.
I lived on M&S ready meals that year, I lost stones in weight, and was a size 12 for the only time in my adult life. I ran up and down more staircases than I can possibly remember, all in my kitten heels.
The most intense of all my jobs was vascular surgery. Our list was always huge, with far more patients than we could realistically be expected to ever manage. They were also incredibly sick, with failing hearts, kidneys, lungs, with flesh rotting from their bodies and blood vessels that were either closing off or bursting. They were also, as a general rule, the most stubborn, cantankerous patients I have ever met, (the consultants tended to have similar personalities) refusing to give up tueir beloved cigarettes regardless of how often they had to return to the operating theatre to have more and more pieces of their limbs cut off. In that job I routinely worked twelve hour days when I was expected to work eight, and was permanently exhausted.
It may come as no surprise to people who know me that this was my favourite job of all time. I loved my cantankerous patients. I loved looking after complex comorbidities and terrifying medical emergencies. It was a trial by fire and it forged the doctor I would become. Despite the long hours I would leave my bleep number with the registrar on call, to get me in to help out in theatre if any exciting emergencies came in. Usually house officers struggle to get to theatre, but late in the evenings and weekends I would come in my own time to assist. As a house officer my first surgical procedures were an above knee amputation and an embolectomy. Having done my best to avoid theatre as a medical student I had now truly fallen in love with surgery and had discovered the kind of doctor I wanted to be. Not the cerebral sort, sat in an office scratching my chin and postulating clever diagnoses, House-style, but instead getting stuck in, and handling emergencies.
During that job I experienced a lot of death. Unfortunately that comes alongside the very sick patients and the emergencies. It was particularly hard when these were patients I had come to know very well through all those hours on the wards. I had to come to terms with it pretty quickly. I don’t really know how that happens, how you get used to death, but it does. It has to.
I did initially go into surgical training, but life happens and it soon became clear that emergency medicine holds all the thrills and sick patients and practical skills I had loved, but also allowed me to clock off once my shift had finished, knowing that somebody else was able to look after the patients I had admitted, able to look after the new patients attending. It allowed me to do the medicine I love whilst staying vaguely sane, and not wake in the middle of the night with palpitations at all the work I had left unavoidably unfinished.
Twelve years on and that very first day stays with me. I remember how terrified and out of my depth I felt. I remember how a snappy, humiliating comment from my infamously mean registrar reduced me to tears on my very first ward round, and I try my hardest to be supportive to the junior doctors I now support. I often feel like I haven’t managed, when the conflicting and endless demands of my role lead me to be brusque and dismissive when asked for help. I try to remember how that feels.
Twelve years on and I am still learning. Still very much learning. In fact yesterday’s shift challenged me anew, reminded me how it feels when a request for help is dismissed or misunderstood, reminded me that I can’t be complacent, that I will always be learning, to the day I blissfully retire. And that’s ok. We’re in this together, and those new doctors starting next week will have more to teach me, and hopefully I’ll be able to teach them something too. Hopefully in years to come they won’t be writing about that mean doctor who made them cry about when they first started. Its a very rare thing for me to cry on the job these days, thankfully, but I’m also thankful that after shifts like yesterday’s I have not become so used to it now that I can’t still have a cry on my walk home.
And here I am now, after the ravages of twelve years of medicine (and the two sleep thiefs I have for children!)
Today was officially the first day of our summer holidays. I think last year I was really excited about this, except for the fact that I was working pretty much continuously all summer, with hardly any time to actually be at home with the children. I had this nostalgic memory of idyllic long weeks of adventure from my own childhood. Potentially memories that bear little similarity to my mother’s recollections of those same weeks.
This year I have slightly different feelings heading into it. I am now more balanced about the fact that we may well have some lovely fun times, but there may be some pretty hellish moments where I feel like disowning both children. And that these moments may actually be more like a couple of weeks…
Less than twenty four hours in and we haven’t had the smoothest of starts. Last night we celebrated the end of term by heading straight into town for dinner at a rather fabulous burger place followed by the first ever whole family cinema trip. Until now I had felt out three year old was too young for the cinema so he has always missed out, meaning that cinema trips have always been a special treat for my daughter and one parent. My son is now pretty good at paying attention through a film and knows when to be quiet, so I was hopeful that a trip to see Despicable Me 3 would be a wonderful family way to start the holidays.
It started well enough, and apart from a meltdown over a pink highlighter pen I was feeling positive. This was definitely assisted by my special treat of an aperol spritz cocktail to wash down my burger. The first fifteen minutes of the movie were great, all of us laughing along with an 80s classic soundtrack behind the chuckles. Around that point though my son decided that actually Despicable Me 3 was absolutely the most terrifying thing he had ever seen in his whole life (the whole Star Wars and Harry Potter back catalogue apparently have nothing on Gru in a bubblegum mankini!)
Deapite cuddles, reassurances and boob (the great cure-all), I ended up carrying him out with at least half an hour left of the movie, worried that his wails were disturbing the rest of the audience. It was not quite how I had imagined the evening going. Add that to the epic bedtime with two very hyper children, and I felt a little broken before the holiday had even started.
This year I really have tried to lower my expectations. I have a couple of things booked in, an evening of outdoor theatre with a company I know the kids have always enjoyed in the past, a storytelling session at the incredible Minack Theatre, and a train journey to stay with my mother, their beloved Mimi, for a week in the middle. Apart from this the six weeks stretch ahead with absolutely no set plans. I am quite in favour of the idea of letting them get bored, the concept that boredom is the birth place of all great adventures and inventions. I do not mind some days where pyjamas never come off and the tv stays on all day. I have definitely felt that towards the end of this term my daughter has been very much in need of some totally unscheduled time to recover from the demands of her first properly academic year of school. However, for when TV becomes monotonous (I’m hoping that eventually it will!!) and cabin fever sets in, we have created The Bored Board for ideas of cheap, easy things we can do locally, or even without leaving the house, to all enjoy over the summer.
We’ll see how we do this year. I’m hoping that low expectations, embracing pyjamas and tv, whilst making some time for adventure, will lead to a holiday where I survive a little better, and like my children a little more at the end of it. But who knows, a simple trip to the supermarket this morning nearly had me packing my bags and leaving already today, so wish me luck for the remaining 43 days. Good luck to all the other summer holiday parents too! Any tips gratefully received.