glasgow

Welcome to Glasgow – Ten Years On

It had been a good conversation. We had had a good rapport. We talked about what he liked about where he worked, about the book we were both reading and our mutual love of Sebastian Faulks, and about my microbiology research and what I thought I wanted to do when I grew up.

At the end, we shook hands and said how nice it had been to meet each other and then it was time for me to venture back into the dark cold evening in a strange city.

“Have a safe trip home,” he said. “Are you driving back to Geordieland tonight?”

I paused in the act of gathering up my things. “I’m on the train and I had a sodding disaster of a journey to get here, so heaven knows what it’s going to be like getting back,” I said.

A couple of hours earlier, I had been disgorged from the Edinburgh to Glasgow train onto the platform at Queen Street. My journey to Scotland had been delayed by a tree on the line outside of Kings Cross, leading to an hour of pacing back and forth beneath the departure boards at Newcastle Central Station. On a train, finally, I made a flurry of phone calls, making frantic promises that I was still planning to be there that afternoon. Just north of the border, an announcement was made over the PA that due to unforeseen technical difficulties, which I would later discover was a felled power cable in the Central Belt, the train, which had been scheduled to take me direct to Glasgow Central, would terminate in Edinburgh. Edinburgh Waverley is a labyrinthine behemoth of a train station and I’d only been in it a couple of times, and always for a leisurely stroll to the Playhouse. As we pulled in, I was first off and barrelled past the crowds of people swarming around the station on the mid-January afternoon, squeaked apologies and little old ladies flying every which way. I made it onto a train to Glasgow with less than thirty seconds to spare.

I blurted this story out. The filter between my brain and my mouth was plainly lying scattered in pieces somewhere along the tracks of the East Coast main line.

“Oh,” said the man who had been interviewing me for a place at medical school. “Well, good luck.”

That was ten years ago this week.

I am still occasionally asked why I chose a medical school in Scotland. There were 25 medical schools in England during the application cycle in 2006-2007, after all. My usual answer is that I was running out of places to apply to, which people take as either a joke or as a sign that they’ve committed a social faux pas on a par with starting up a dinner conversation about how much they liked the Twilight series.

I applied to medical school for the first time in 2002, when I was in sixth form. In the UK, the maximum number of medical school applications that could be made in one cycle at that time was four. I applied for the second time in 2005, at the beginning of the final year of my BSc. My third application was going to be in the autumn of 2006, when I was in possession of an honours degree, my old room in my parents’ house, and a customer service job in the public transport industry that I hated. It doesn’t take Alan Turing to realise that by the time I whittled down medical schools to places I hadn’t already been rejected by, places who accepted graduates, places whose graduate admission criteria didn’t include A-level requirements that I didn’t meet, and places that didn’t require me to live in either Keele or Hull, the list was getting quite short. “What about Scotland?” asked someone, and the rest is basically history.

That first day, I saw the medical school, the fence surrounding the ancient university buildings, Queen Street station (twice), and a bit of Sauchiehall Street out of a steamed up bus window. And when I say that I saw them, I didn’t arrive until half past three in the afternoon and it was January 11th, so I didn’t really see them. And then I got on a train back to Newcastle.

I already had another interview booked. It was for a four, not five, year degree; a graduate entry programme with all but the first year of tuition fees and a good chunk of living expenses funded by the NHS. I had two good friends already at the university. It was not in a city that consistently feels like the rainiest place on Earth. On paper, it was perfect.

I returned to England and spent the next two days going quietly crazy. On the third day, I called my mum on my lunch break at work. “I know this isn’t logical,” I said. “I know that it’s an extra year and it’s more debt and I don’t think I care. I’ll go to Warwick for my interview, of course, but if Glasgow offer me a place then I’m moving to Glasgow.”

Now, it is the case that if a person wants you at their university even after you conclude the interview by reciting a monologue on the black hole of twenty-first century rail travel, the laws of good karma and good British politeness do dictate that you probably ought not to turn them down. It wasn’t that, though. Anyway, they hadn’t offered me a place yet. In retrospect, it was a bold thing, and not in a sensible way, to start making plans for what I’d do if I was made not one but two offers. It would have been bold for anyone, but for a person who before this had been rejected by nine medical schools across what was by then three application cycles and who had concluded that interview in that way, it bordered on foolish.

It was, however, exactly what ended up happening, and eight months later, just like I’d said, I packed all my worldly possessions into a Transit van and moved here and I’ve never left.

It has been a decade since I first fell off a train into the arms of this place that I knew nothing about.

Bold. Foolish. Rash.

Maybe.

In that decade I’ve not had a single regret.

I can’t explain any better now than I could have then what it was that happened that day — something that tugged hard on my instincts, that paired me to this glorious city and told me that we were for each other. How do you explain what home is? I don’t, but I knew it when I saw it.

The Doctor That Glasgow Built

This past weekend was the (mostly) completion of the closing down of five of the hospitals in this city and their transfer to a new hospital in South Glasgow that so far as I can tell mostly contains furlongs of corridors.

I exaggerate, I suppose. I’ve been in the new place just enough to have decided big and confusing, and I don’t work there really although doubtless I will at some point. I expect eventually I’ll adjust, and I expect eventually everyone will stop wandering around like a crossbreed between frightened rabbits and lost sheep. There is no question that the buildings that have closed are no longer fit for purpose, and have become increasingly even less fit for purpose over the past ten years as apathy and not-here-for-much-longer have set in.

But the days and nights I’ve spent in them are ones that have been the making of me as a doctor so far, and sentiment is a powerful thing.

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If I could take a single memory from the old hospitals, it would be of standing at this window as one of the worst nights I’ve ever had finally ended; when, inexplicably and unexpectedly, the sun came up and everyone lived.

Life After The Foundation Programme (Good Things Come To Those Who Wait)

As of last Friday, I have completed the (form-filling parts and educational requirements of the) Foundation Programme.

Do you remember when I was just starting it? It was five minutes ago. Yet, here I am, ePortfolio all ticked off and six weeks of acute medicine away from being not quite so much of a baby doctor anymore.

With the improbable but still very looming prospect of Life After Foundation, I’ve been committing what is probably a grave sin. I’ve been telling my FY1s about what happens come autumn when they sit down with intimidatingly long job application forms and start to be bombarded with well meaning careers advice. I’ve been saying that the thing to remember is, if they are offered a job that they do not want, they are under no obligation to take it.

You are not told this.

I did not realise it myself until a few months ago, and it blew my mind when I did.

You see, applying for FY1 jobs, fresh out of medical school and/or still suffocating underneath a pile of finals revision, we did have a bit of an obligation to take what we were given and be grateful for it. We had provisional registration with the GMC, and to achieve full registration (and so be employable as doctors) we were required to complete our allocated FY1 jobs. No questions. No arguments. Bags packed and off to Shetland, if Shetland was where the UKFPO believed your destiny to lie. I was given precisely the job I wanted and within reasonable driving distance of the city I wanted to be in, but others did not have such good fortune. After working for two years in a job that was allocated by that kind of system, you do find when the two years are over that it’s played a few tricks on the mind. It was a lingering bit of that mentality that led to me saying things like, “Well, I’d like to be able to live in Glasgow, obviously, and that’s what I’ve applied for, but I’ll have to go wherever I’m sent.”

A lot of people do take the first job they’re offered, of course. Like me in FY1, some people are offered the training post they want or the location they want or a one-way ticket to Australia, and I am thrilled for them. And I’ll grant that there’s something to be said for not going too far in the other direction; after all, quite aside from the rest of it, the bottom line is that you need to be able to pay rent in August.

In February, I learned that I did not have a place on the Core Medical Training programme in Scotland.

(An aside for the non-medics and the non-Brits. CMT is the next step for a person who wants to be a hospital doctor in a medical specialty. Where the Foundation Programme theoretically included a little bit of everything, this is the stage where I’d drop things like surgery, paediatrics, GP, etcetera. There are equivalent programmes although of varying lengths for folk who do want to be surgeons or GPs or paediatricians. If you’re familiar with the North American system, whether legitimately or because of Gray’s Anatomy, this part is a bit like a residency in internal medicine.)

The offers for CMT in my region were released on a Tuesday afternoon in early February. On that particular Tuesday, I was in the middle of my Advanced Life Support course. It was also the Tuesday that I was due to collect a new car, my old one having died a final death on the hard shoulder of the M74 in the rain at the end of the previous week. It was also Equal Marriage Day in Scotland. It was a week of mixed emotions. But the offers for CMT are released by text message, and let me tell you there are few more crushing ways to learn of one’s imminent unemployment than to be the only person in a room full of your peers to not get that text message.

The good news was I was not considered unappointable by the good people who had interviewed me. A pleasant surprise, considering I’d forgotten the word for amiodarone in the middle of my interview.  I was merely quite far down on a reasonably lengthy list. So, you wait for good news to come to the people whose applications to CMT were a second choice or who had expressed an initial preference to work somewhere else in Scotland. The automatic next step is to go into the second round of applications, where the jobs that are left over are opened up to people who haven’t got one in their first choice of region. I expressed my intention to do this and even had a bit of a poke on the CMT website. Scotland was oversubscribed and so my options in Round 2 would be restricted to England and Wales. In my head, I was saying, “But I don’t want to go to England!” (Sorry, England.)

Eventually, I nudged high enough on the Scottish waiting list to be offered a job in the North.

Aberdeen, Inverness, and places where a 3G signal goes to die.

By that time, I had had a good talk with an excellent friend. She had sliced through my mad panic to remind me that with GMC registration comes decisions and options and not taking that which is foisted upon you. I had started to look into some of those options — fixed-term staff jobs and clinical teaching positions and locum work, and my well-worn and fatalistic mantra of “well, I’ll have to go where they send me” had been abandoned and deservedly so. I had stopped muttering about England and I spent perhaps five minutes considering the job Oop North — not an indictment of Aberdeen but an abiding love of Glasgow, this dear green place with my beautiful city that adopted me with joy and contains my home and my community and my life, where, once I’d been reminded that I could choose, I was never going to not choose.

(I was angry and determined when I came home from Synod. If I’d come home from Synod with the knowledge that I would soon leave my cathedral and the Diocese for a job two hundred miles away, I’d have been inconsolable. It isn’t entirely about that, but it is a bit about that.)

I am in no hurry at all to be a consultant. Please, let me put off that terrifying day for as long as possible. I think that doing different things is good and that more experience is good. I’ve spent a lot of time on the scenic route, and I’ve never regretted taking it.

A couple of years ago, writing in InspiresI wrote this: “If I’ve learned anything in that decade and a half, it’s that being a doctor isn’t a being but a becoming. […] My journey hasn’t ended. I’ve only stopped to buld a cairn at the roadside, and when I get up, the horizon will have shifted and I’ll have settled new dreams and new responsibilities onto my back as I step back onto the path to continue a journey that may not have always taken me along the straightest or simplest of routes but that has been all the more worthwhile and memorable for it.”

Still true.

I’ll be reapplying to Core Medical Training this autumn with the hope of beginning it in August 2015. I’ll try not to forget the word for amiodarone this time.

In the meantime, I’ve accepted a job for the coming year as a clinical fellow in Haematology.

Not what I’d planned when I first thought about it a year ago. Not an option I knew was going to exist. But different and exciting and worthwhile. It might even be better than what I had planned. I’m looking forward to starting in August and I think it will be good for me

Clutha Vaults

I arrived home late last night to the news that a helicopter had crashed into the Clutha bar on the north bank of the River Clyde.

Yesterday, watching events unfold through social media and the BBC, it felt like all of Glasgow was staying awake with me. This morning, as the rest of the country turned on their televisions, I woke up to calls and text messages from family and friends in England asking if I was all right. And towards the end of the day, I got a couple of phone calls that made me realise that the whole world has been watching.

So. I wasn’t involved. I’m fine.

I was at an end-of-rotation night out in a restaurant on the other side of the city. It had been my twelfth day of twelve days on, and if I hadn’t been out with colleagues probably I would have been asleep before it happened. Instead, I stayed up with two friends, both medics, the three of us all looking at our news feeds in mounting horror and trying to figure out what we were supposed to do — go into work? to our hospitals or to the nearest also-receiving EDs? phone in? stay put and wait for the phone to ring? It’s a very surreal experience, sitting on Twitter at one in the morning and cursing yourself for never having asked about the major incident plan. In the end, after much frantic Googling, we stayed at home and went to sleep, reasonably reassured that we would be called in if we were needed.

There have been eight confirmed fatalities. There are still people trapped inside the Clutha. Tonight will be another long one for the emergency responders, for the people working in our EDs, for the families of the missing, for Glasgow. I will be praying for them, and I will be remembering how proud I am of the people of my beloved city and how they responded last night.