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Diary of a CT1 – A Majestic Salmon

August 22, 2016

It’s been an odd kind of year so far. Got an interview for Core Medical Training. Didn’t get a job. Reapplied. Got married! Came home early from honeymoon to attend a second interview. Got a job! Closed the loop on an audit and received a commendation for a different audit. All this on a background of strikes and protests and negotiations and referendums. Needless to say, my self-esteem has slingshotting this year like the tides on a restless beach.
ChS0OuFWMAQNl5NAnd now we arrive at yet another August, yet another new beginning. I am now a Core Medical Trainee, with the goal of being an even better jack-of-all-trades and perhaps master of some. The winds of fate have blown me westwards to Ysbyty Sant Rhywle – After a long journey in the wilderness in Imperial College, St Elsewhere’s and Worthwhile General, I have (nearly) returned home like a majestic salmon.

The first thing I’ve noticed is that the FY1s are getting younger. When my current house officer colleague was born, I was playing with Thunderbirds Tracey Island. Admittedly, not much of an age-gap but it can only lengthen. Get behind me, vulturous Time! Aside from being a baby-faced memento mori in a stethoscope, they’re keen to work and keen to learn.

The FY1 on the next ward asked me to supervise her inserting a urinary catheter, her first as a doctor. I could see she knew the theory but still lacked the confidence to put it into practice properly. There was Instillagel and penis flying every which way – but I let her fumble her way through it, providing a guiding hand just at the end so the catheter would go into the bladder and not turn the patient’s prostate into Emmenthal.

I remember so clearly when that was me, so timid and nervous with every move. But practice becomes routine becomes confidence. And now I’m teaching the next generation. Just how and when did that happen?


But as I’ve learned so much over the last two years, there’s still much more for me to learn. I spent this last weekend on-call and it was an on-call to rival the best of them. When did 12 hours get so long? And so draining? The upside is that I have a real good team of doctors to work with, and we’re rota-ed to the same shifts so we can really work as a team. One of the more senior players, a wise and kind CT2, offered to supervise and assist me perform a much-needed lumbar puncture on one of his patients.

(A lumbar puncture – LP – is a procedure where we insert a long, fine needle into someone’s spinal cord from the back, to sample their cerebrospinal fluid, the goop that the brain and central nervous system floats in. Very important if you suspect meningitis or subarachnoid haemorrhage)

I thought back to the FY1 and the catheter. Two years on and I’m back on the other side of the examination couch. I knew the theory, even practiced once or twice on silicone prosections, but finally here was my chance to step up. I was nervous but the CT2 guided me through it sagely. We got that crystal clear fluid and the patient got their diagnosis. I did that. Me.

I clambered to the top of medical school to land at the foot of the Foundation Programme. Then I scaled the Foundation Programme and I find myself here at the start of another journey. Leading ward rounds, clinics, sticking larger needles in deeper places…

Let’s get started!

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