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Column I am frustrated, I am committed, I am only human: I Am Your Doctor

After a series of illuminating articles about life of a hospital doctor today, Dr Bríd McGrath has asked nine other doctors to share personal insights about the everyday challenges and rewards of their working lives…

THIS SEPTEMBER, the results of a ballot for industrial action will be published by the IMO.

I asked other doctors for their insights into their job. These are some of the stories of Non-Consultant doctors in Ireland today; some of the highs and lows of the job, seen from people at different levels within medicine.

Thank you to everyone who told their story…

Michelle (31, Specialist Registrar):

Why become a doctor? People may find it cheesy or clichéd, but the thing that keeps me going through 36 hour shifts is the human interaction. Snippets of humanity and kindness shining through the chaos. That’s the best part of the job, what puts it in perspective.

People keep you going. A salute and knowing smile from the passing porter cheers you up.  A cup of coffee from the nurses 28 hours in – so welcome. Seeing the cleaner in good form at 6:30am reminds you the night is nearly over. A hug from a senior doctor when you are tired and irrational, ready to cry, means the world. Comforting the Intern you’ve found crying in the sluice room, and telling them that you’ve been there too, helps you as much as them.

Patients keep you going. A frail old lady who smiles through the pain as you examine her. The anguish of the young wife, who lost her husband: you could barely keep it together as you told her the news. The pain from a right hook to the face fades, when the wife of a dementia patient explains that he was the gentlest person while he was still well.

The frustration comes from the system. A patient’s frustration becomes your frustration while you both wait so long to get tests done. Telling them “I don’t make the rules”, telling them “I’m doing my best to get this done” doesn’t change it.

Getting home after a 36-hour shift, you’re comforted by your nearest and dearest, who deal with the fall-out of these shifts. Their patience is rewarded by you falling asleep during dinner: the pleasure of sleep!

Then you get up and do it all again the next day.

I am your doctor.

Sarah (25, Medical Senior House Officer)

I did medicine because I enjoy interacting with people: there are so many great characters out there – I wish that was what I got to spend more time on. I don’t like being so busy with paperwork and administration that I don’t get to listen to the patient.

Maybe I should become a psychotherapist?

I am your doctor.

Aideen (35, Surgical Registrar):

I am a 35-year-old woman: I have spent half my lifetime in medicine. In one month’s time I will receive a piece of paper that says I have completed all possible training. I will have spent thousands of hours working, thousands of my income on education, and hundreds of hours worried that my efforts are not enough.

My stories are like my colleagues’ stories: working through illness, personal turmoil, and deprivation of sleep, food and toilet breaks. The worst stint was working 73 hours within an 82 hour period.

I have been bullied, and to my shame, bullied others. I realised I was falling into the trap of treating others the way I had been treated. My self esteem faltered and I began to believe I truly was a nasty person. I had the insight to get help, but not everyone is so lucky.

For years I put off thoughts of relationships and family, while I put my training first. I want to be a wife and a mum, but at present I live in another country to my partner. It’s a necessary part of my training, but that doesn’t stop my heart breaking every time I board an airplane. I am fortunate that he is so understanding – numerous colleagues have had their relationships break under the strain.

That said, I get great joy from my job. Fixing people is an incredible privilege. Taking away pain or worry is an amazing feeling. It used to bug me when patients said I looked “so young”, but now it makes me grin. I’ve learned that chatting with patients about normal things: clothes, sport, dogs… it lets them see that we have something in common, and that I am concerned for them on an individual level.

I love my job, I just wish there was a better way to get to this point in my career. Training shouldn’t cause people’s personal lives to fall apart.

I am your doctor.

Siobhan (34, Paediatrics Specialist Registrar)

I came to talk to you about the imminent arrival of your very premature baby, at just 24 weeks. I held your hand and passed you tissues as we talked about his name, how tiny he was, how hard his life could be, but how we would try to give him the best possible chance… and how we might also have to accept the reality that he might not make it.

That same day, I’d worked a 28-hour shift while I was 24 weeks pregnant myself. I fought back tears before I saw you. I worried about how I would cope with your pain and distress, barely able to think about the baby growing inside me. I had dinner a 1am, and worked on. An incredible nurse sat me down for a glass of water. She had to force me to. I was so busy.

I am only human.

I am your doctor.

Mike (24, Medical Senior House Officer)

I moved to a peripheral hospital as part of my training. It’s supposed to be good for our training, but a lot the reason we are sent to these hospitals is to keep them open, to preserve other people’s jobs and community. They require a service, they need doctors, and without training-scheme doctors, the hospital would be shut down. However, this means moving away from my family and friends.

When I started medicine I used to love rowing, but my schedule no longer allowed me to join a club. The schedule changes week to week, with late clinics and on-call, and tiredness. I began running instead, but sometimes it’s hard to keep that up too. I never know what my schedule will be.

My girlfriend is also a doctor on a training scheme. Right now, she works 150km away from me. I don’t know where she will be working after Christmas. It’s hard: medicine takes over your life.

I still love my job 80-90 per cent of the time, despite the strain. NCHDs are always under pressure to deliver frontline services.

They say “pressure makes diamonds” and that we might be better for the experience. However, it is a very fine line.

I am your doctor.

Hilary (27, Senior House Officer)

It’s something that always made me feel better, being well-dressed. Obviously, if I was on-call, I’d wear scrubs and runners. Working long shifts can take a toll of your self-confidence, you feel greasy and unwashed. If I could fit a shower in I would, but just changing into my proper clothes made a difference. When I started as a doctor, I used to wear high shoes.

Sometimes people would say, “I don’t know how you can walk in those”, but I did. Other times people would say “It’s nice to see a glamorous doctor”, and that would put me in a good mood.

When HR started to “notice” the way I dressed, I felt there was a sexist undercurrent to it. My clothes were “too fitted”, “too bright in colour” and “uncomfortable to work in”. The few female Consultants might wear high heels, but my heels were “not appropriate for a young doctor”.

I felt my individuality was being attacked. At first I resisted, as far as I was concerned I was dressed professionally, and not wearing anything that a young female solicitor wouldn’t wear, for example.

I began to wear lower shoes, but the matter continued to be pursued, relentlessly. A disciplinary procedure was begun against me which, if it had continued, would have damaged my career. The IMO intervened. Disciplinary procedures are normally for failures in patient care.

The experience marked me. I work in a different hospital now.

Now, I always wear scrubs and runners.

I am your doctor.

Mark (26, Senior House Officer)

I did medicine because I wanted a challenging career. I like having the opportunity to be kind to people when they are at their most vulnerable. I also like seeing the journey of patients from admission to discharge, hopefully a journey back to better health.

What I hate, though, are the hospital politics. We’re trapped in a system where sometimes we have to work 20-30 extra hours per week without pay.

We don’t get a real choice.

I am your doctor.

Jennifer (33, Specialist Registrar)

Medicine is a journey.

You start as an Intern: scrambling to acquire skills while trying to figure out the fax machine, learning to be diplomatic while you deal with so many staff and patients, asking senior doctors questions which you know they must find trivial.

As an SHO, you learn to shelter the Intern. As an SHO, you spend more time with patients than with your family, trying to figure out their plan of management. You spend so much time with your team as an SHO, it forms a bond that stays for life. At the same time, you study for some of the toughest exams, and prepare for audits and academic papers.

As a Specialist Registrar, you carry the “Medical Bleep” at night, and know that there will be no rest. You feel alone, as you juggle the needs of various people with life-threatening issues. You have to co-ordinate with nurses and Interns, while dealing with the next crisis.

You rush your apologies, as you run to the next arrest or Resuscitation.

Medicine is about breaking bad news to families, shattering hopes. Medicine is about paying more attention to other people’s health and well-being than your own. Medicine is about navigating the politics that can affect your career.

Medicine though, is that precious moment of survival, joy and hope, giving you the strength to go on.

That is why, I am your doctor.

Dave (24, Senior House Officer)

The other night, after a particularly busy 16-hour shift in the Emergency Department and Theatre, I went up to the wards to take blood samples for a patient. I’d had no dinner.

A patient in the same room was handing around coconut buns, and gave me one. I inhaled it, it smelt so good. She then pushed the box into my hands and said “You look like you need them more than me!”

It made my night.

I am your doctor.

Dr Bríd McGrath asked the contributors above to share their stories. To read  articles by Bríd, click about her own experiences as a hospital doctor, please click here.

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