Friday, May 05, 2006

Doctors are stupid

I have just finished a week of nights. I am OK, now trying to reverse my sleep cycle and not waste the whole weekend in bed. I am also less concerned about my Texidor's Twinge thanks to the comments received!

One night this week I was taking a break in the doctors' mess when I saw a tired, demoralised mid-30's surgeon come in. He collapsed on the sofa with the 2 pieces of toast he had just fashioned into a sandwich, and scoffed them down really quickly. At that point, his pager bleeped, he answered it and left to return to the wards/theatre/A+E/whatever.

A thought struck me - that was probably his dinner, and possibly his only break of the entire 13 hour shift. Most doctors are the same. They run around doing jobs for patients/nurses/other doctors, and neglect themselves. They don't empty their bladders until the end of the day, they don't eat anything more substantial than the chocolates at the nurses' desk, and they definitely do not take a 40 minute break every 4 hours as they are meant to.

Why? Because doctors are machines? No. Because they have huge humps on their backs where they can store water like camels? No. Because they are so fat they only need one meal a day? No. Because they genuinely want to eat chocolates and crisps and give themselves heart disease as well as shortening their lifespan by messing around with their sleep cycles? I doubt it.

It is because doctors are brainwashed into thinking that they are martyrs. Patients should always come first. Nurses and senior doctors are more important than us. If you have to miss your dinner and your breaks to get more work done, so be it. The NHS does not give a shit about you, Dr. Junior. If you want a reference, you will see as many patients as you can. Of course, if you are so tired and hungry that you make a mistake and someone complains, we will suspend you and ruin your career. It is not our fault. We will replace you with an overseas doctor and screw their career over as well.

Doctors seem to feel that if they don't eat and don't have breaks then that makes them 'better' and more dedicated. Medicine is held up to be a vocation, so you have to devote your life to it and if your spouse/parents/friends suffer as a result so be it. Medicine is your life and you will give yourself completely to it.

No. I will take breaks and I will eat good food. If my pager goes off and I am on a break, I will tell the nurse I am busy and will be up in due course. I will let the patients stack up in the department waiting for hours to be seen if it means I get a decent rest and time to myself. It is not my fault that people have to wait up to 24 hours to be seen properly in hospital (after the initial meet and greet by the A+E doctors). It is a lack of funding for more doctors and more nurses. So I will not sacrifice my mental and physical health to see as many patients as I can. I will see them at my own pace and make sure each one gets my full attention and gets sorted out properly. If an emergency comes up along the way I will drop my dinner and run to it, but those occurences are actually few and far between. I will always put my own health at the top of my priorities.

Medicine is not a vocation. It is a job. A job that can be done well or done badly. A job that should involve regular meals and breaks. A job that does bring pride and satisfaction when a patient says "thank you", and allows you to make amazing differences to patients and their loved ones. But it is just a job.


angel, jr. said...

I can't wait to pass these exams and start that job. I loved every minute of my rotations, the sleepless nights and call for monitoring.
I chose it and can't wait to be knee deep in it.
I know I'm just being enthusiastic now. I'll let you know how I feel after one year of residency.

Warsaw Crow said...

I understand your reasoning absolutely. But somehow I can't help feeling that taking responsibility for healing other human beings will alway bring with it a certain amount of deep-rooted 'added significance'.

joey♥ said...

thanks for stopping by my blog. i liked this post. both my parents are doctors, and my older sister is in med school. they always wanted me to become a doctor, but i knew it wasn't right for me. it's been a struggle for me to show my parents that i don't have to be a doctor to be a successful human being. the whole martyr aspect is a good point you bring up, and i'm glad that you have learned to balance and not let it take over your life.

even though you're from the u.k., have you heard of grey's anatomy, the american t.v. show? i had to ask :).

Kate said...

Surely to god actually taking your breaks can only improve your performance...

Anonymous said...

Your post's spot on.

'Ah, but think of the patients' usually means you're going to get screwed by someone who doesn't give a stuff about the patients, because, if they did, they'd give a stuff about you, too.

Anonymous said...

Don't agree that medicine is just a job, not a vocation.

If is was not a vocation, no one, but no one, would put up with the shit that is thrown at us day in day out.

And as you progess up the ladder, the shit still comes; from a different direction and with a different aroma, but it still comes.

A friend of mine who was a very eminent consultant pathologist has just taken VERY early retirement. Too early to access his pension. He is working for the National Trust. He is as hard up as hell, and never been happier. His employers look after him. They say thank you. They appreciate what he does. Hospitals do not do that. They just shit on you if there is a problem. He says that it is only now that he has left the NHS and medicine that he realises how stressed he was and now badly he was treated.

I did a phone in thing on Radio 5 Live. A consultant surgeon who was clealy not schooled in PR called to say how hacked off he was that his trust had stopped providing milk for his tea during the operation list.

It sounded trivial beyond words. And yet, as doctors, we all know what is happening. This guy probably works twice his contracted hours, is in and out of the hospital at all times of the day and night, and does that uncomplainingly becuase he is a doctor. But then he has to drink his tea without milk....and something snaps.

No. You are wrong. It's a vocation. You sure as hell are not in it for the money. And you have not left (yet) to go to work in the city.


Vegas said...

You may be right Dr Crippen. I have no intention of going to work in the city (I have of course considered it). The question is at what point does the individual snap? Your friend the Pathologist snapped, my friends who have left medicine after only 1-2 years have snapped, and those around around me are desperate to snap but are too scared of being jobless.
I think it is wrong for someone to do something uncomplainingly simply because they are a doctor. Am I asking for a strike? Maybe I am. I have a feeling that the vast majority of doctors would feel unable to strike because it would put patients at risk. But perhaps like the firefighters it is worth risking a few small fires to prevent much larger ones in the future. Mrs Hewitt could always ask the army to cover our surgeries and ward rounds in our absence...

Name withheld to protect the guilty said...

Right on--even for people who consider medicine to be more than a job, that doesn't mean we have to kill ourselves doing it. To whom would that be fair?

Anonymous said...

Good for you! Dr Crippen has suggested in the past that the hours hospital Dr's are expected to work is a good thing as you end up "learning some medicine". I am not sure how much of any thing you will be learning after working 100 hrs +.

Yours will never be a 9 - 5 job but keep taking your breaks and eat proprly. Remeber you work to live not the other way around and at the end of the day the buggers can't shoot you (can they ?).

(Easy for me to say I know)


Doom/Blondie said...

Just a job.


I like that.

peace and love


crassy boy said...

I do agree with Vegas and we have had many conversations bout being overworked.

I have been off work for seven weeks now and am starting to feel a lil' patient withdraw. I'm missing those amazing life stories, and our ability to return life to those we can.

On the other side of the see-saw, I have been writing my movie script, manipulating the frets on my guitar, and getting my mom drunk; Events I will never regret or forget.

We must pave and step into our own paths. Follow others and you'll never lead. We both know this.

I live to live.

Anonymous said...

OK... I'm fairly sure there are plenty of wonderful doctors out there. But I have yet to see any of them... and i'm all for having breaks 'n' everything, but "40 minutes every 4 hours" that's a little excessive. even for a 13 hour shift. I'm a student nurse and im only allowed 1 hour break for a 13 hour shift... and I'm not always able to get that. From what I've seen I'm hard pushed to believe that doctors need that amount of break; one incident pops to mind: 4 doctors in the doctors office talking about their weekend.
ME:could you come and see a patient, she has developed stroke-like symptoms
DOCTOR: one of us will be there shortly

10 minutes later a doctor finally showed up.

Got a couple problems here too. You said doctors run around doing jobs for nurses, I wish I could come work at that hospital... I'm afraid it's usually the other way round. I was even asked by a doctor to fill out a cannulation form for a patient he'd just cannulated... something wrong there I think. But you are right about the nurses' chocolates! why do the doctors eat them all and leave none? nurses work damn hard and deserve them, and if you don't think so you should try running around after 6+ patients all of whom want a bed pan right now 'cos if they don't get it there and then theres gonna be an unholy mess to clean up... 6+ times!, off topic slightly but I've never seen a doctor deprived of a nice meal...

Kudos on the patient focus anyway


peace said...

Hat off for you. I didn't dare to let myself think this way. I cut the thought short and felt a shamed. Deep down I know this is the truth.