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Diary of a CT1 – Moving On and Acting Up

December 19, 2016

It’s that time of year when I usually write about changing over jobs, switching up my flavours of medicine. Recalling all the useful lessons and insights I’ve gained from my outgoing job and cursing that I’ve traded places just as I’ve found my place. But not this year. This year, still working in Respiratory Medicine at Ysbyty Rhywle.

Instead, I keep calm and carry on (for two more months in this rotation) and watch as the Foundation doctors change it up. And I doubly sad, because I’ve lost not one but two FY1s. There was the ward F1, who I with glee discovered was a secret Pokémon nerd, and the on-call F1, who I spent every on-call in the Rhywle with. I’ve watched them put four months of being actual, real doctors under their belt. I’ve watched them go from quailing at venepuncture and cannulation to inserting catheters into genitals groaning with prostatism with ease and aplomb. I taught them what I could along the way, about prostatic genitalia and other things. I’ve watched them grow from meek, unsure medical students to my doctorly colleagues. They even sass me now. (They grow up so fast, he sighed, wiping away a tear).

They’ve gone off to Surgery and now I have two new F1s to play with. They’re a little more sure of themselves but they’re still diamonds in the rough. For God’s sake, my on-call F1 can’t even do a high-five! How am I supposed to work with this?!

The anger is a defence. Really. I’m sad. I’m relinquishing two colleagues – and dare I say, friends? But there’s more to it. What of all the SHOs and SpRs I’ve worked with before who I’ve left behind in the previous chapter of my künstlerroman journey? Is this how they felt (or were they glad to see the back of me)? Time makes a fool of me. I’ve gone from Luke Skywalker to old Ben Kenobi.

scarface-and-bugsy

Me and my old SpR. Tales from a different age.

The other thing that is curdling my seasonal spirits is a paucity of registrars. On the wards, a number of our registrars are evolving into consultants and there is currently a lacunar on our ward rounds where they should be. The other SHO and I divvy up the work the best we can but it’s an odd situation. In a double reflection of the F1s; firstly, we’re taking unsure baby-Bambi steps on patient management and care that they would have skipped through with ease; secondly, plainly, I miss them.

This is where I have grow into Obi Wan Kenobi, from Ewan McGregor into Alec Guinness. It’s the art and science of Medicine. I have my good days – The consultant gave me a solid thumbs up for my deft management of a severely wheezy patient. Hell yeah!

1x05obiwan

Artist’s impression of the Med Reg

Then there was a recent batch of night shifts, where our Med reg had been felled by something nasty and viral. Increasingly frantic emails by Medical Staffing found a locum SHO willing to “act up” as the medical registrar. But as he was new to the hospital and its various demons and gremlins, we agreed that I would hold one of the registrar bleeps, the one concerned with the sick and very sick new admissions since I would be clerking in A&E anyway.

So a third bleep, in addition to the two bleeps I normally carry overnight. People jokingly remarked on my new fashion and I forced myself to laugh to.

That’s when the call come in; “Are you the Med SpR?

screams-internally

“Well,” I replied diplomatically, “I’m holding the Med SpR bleep…”

At first, it was nervewracking but we mostly survived until dawn. There were a couple of transfers from other hospitals, which were much like any other referral I’d normally get. (With the addition of “Why do they need to come here?” to “Why do they need to come in?”). I also took a few calls from the F1 (the new one, who can’t high five) and the ANPs on the wards. That’s the main learning point from play-acting as Med SpR – So many interruptions! Maintaining momentum was like getting water to flow uphill.

There’s more to learn. There’s always more to learn. But now there’s a little less to learn. And the new F1s still need me, just not for all the same things as before.

I mean, if not for me, who is going to teach these fledgling doctors how to high-five?

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