Heart, Breaking

The beginning of a new job is never easy.

It’s always fraught with all the usual sorts of difficulties that come with changing jobs. How do I get a chest X-ray after 5pm? How do I get a cup of coffee after 5pm? Where are the toilets? Why do none of my computer passwords work? Why does induction never cover any of the questions that nobody knows they need answered until the middle of the night? I once said that hell was other peoples’ kitchens – after a first week with everything taking three times longer than usual because nothing is where muscle memory thinks it should be, I think that Sartre might also have had something to say about other peoples’ cannulation trolleys.

But those things are the small potatoes.

I’m an SHO – and that hasn’t stopped sounding ridiculous in my head yet; just ask the poor baffled nurse whose page last week was returned with, “hi, this is the FY1 on call, oh, shit, no, no, it’s not, it’s the FY2 on call, never mind, what can I do for you, hi, it’s Beth” – in a job of which it has never been said, “Eh, it’s OK.” I worked with a lot of people last year who had been the oncology SHO, and the only thing anyone agreed on was that it’s a job you either love or you hate – nothing in the middle, and, really, mostly hate. I got used to the sympathetic looks I got when my colleagues found out what I’d be doing in August.

I think that I’m going to love it a lot.

(It’s all right; they all already knew that I’m a bit mad.)

And I think that it’s going to break my heart a lot.

I didn’t realize how apathetic I’d really been about my last rotation until I started doing a job that is making me fall head over heels with medicine again. I’m doing the kind of job where I’m able to get to know my patients inside out. I’m doing a bit of receiving and I’m getting to a bit of clinic. I’m working with really lovely people. I have days when I get to give good news, and those are the best days. I’m learning interesting things. I still think that radiotherapy happens as if by magic, even after sitting in on radiotherapy planning for the best part of a Friday afternoon. I’ve got a lot more responsibility than I did as an F1 and I find that all kind of terrifying, but when I need help, as I frequently do, help comes.

But. I’ve delivered more bad news and made more cups of tea in the last two weeks than I had in the twelve months before that. I’ve been in clinics with people younger than me who have been told that they will not be alive in a year, and I’ve heard those people say thank you — I still don’t know and don’t think I ever will know how a person even begins to process something like that. I’ve signed my first DNACPR. I’ve told families the worst thing that anyone will ever tell them and made the phone call that no one ever ever wants to receive. I’ve come home from work and had tears with the cats. I will not have any tears left by December. And in this job more than most, I think that if I didn’t feel like this it would mean that I wasn’t doing it right.

I think that the next four months will end up having a huge impact on the kind of doctor I am and the kind of doctor I want to be.

It doesn’t matter that I don’t think that the kind of doctor I want to be is an oncologist. I’m learning things that are more important than what kind of anti-emetic is used with what kind of chemotherapy, and they are things that will always be valuable, wherever it is that I go next, and that I will never ever forget.

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3 comments

  1. Ah, well said, as always.
    You can look at it as if it’s going to be dire, or you can look at it as if, “well, I’m going to learn some things.”
    Leave it to you to love it. ☺

  2. My reflection on spending many, many hours talking to people about their mortality is that we are changed by those conversations. There’s something about encountering people at a place of vulnerability, a place that we only reach by exposing our own vulnerability, that is life changing. Perhaps good doctors and good chaplains are risk takers – willing to push the boundaries a bit in order to respect the humanity of the other.

  3. Again, marvellous post. I’ve been reading your blog for a few years now. You were my inspiration on days when I felt I’d never get to medical school and you continue to prepare and inspire me for what is to come. If I end up being even half the fantastic, patient-centred Doctor you have shown me it is possible to be, I will be one very happy bunny.


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