Grumpiest doctor

In the last 2 days, about 3 of my colleagues have commented that I am the grumpiest doctor they know. One of them even went so far as to say that “she doesn’t even enjoy what she is doing.”

They claim to have made their comments in jest, but these comments really jolted me into reflection.

Am I really such an unhappy doctor?

At this stage of my training, perhaps I am. I am still re-living the nightmare of 1 month ago on a daily basis- every time I think I feel a little bit better, something else happens to put me right back into my place of misery. Adding to that, I have an educational supervisor from hell- she demands me to do this and that, then buggers off into the fog and provides no guidance or support whatsoever for me to achieve all these lofty plans that I have no interest in. Thirdly, there has been little teaching and learning where I am working at now. To be fair, there have been half-hearted attempts at teaching. I always have a great desire to ask questions, to explore thoughts, to learn new skills; but when the teachers appear disinterested, my enthusiasm runs dry. Fourthly, the patients I have been seeing recently have been sick as dogs. When I have been to review these patients on the wards or in A&E, I have so regularly found myself thinking “sh*t, they look like they are going to arrest on me anytime soon.” I have had to scoop and run with so many of these critically unwell patients, many of whom I then spend the entire day with as my “private patient” trying to resuscitate and stabilise on the ITU. Transferring someone to CT scan with pH 6.9, unrecordably high lactate, on 40ml/hr of adrenaline and a systolic BP of 80? Check. Jumping onto a patients bed to intubate a morbidly obese Down’s syndrome patient with a difficult airway during a cardiac arrest? Check. Hugely difficult to ventilate patients post intubation? Check check check. Anaesthetising a grey and clammy patient at a remote site that I’ve never even been to for an interventional radiological procedure requiring awkward positioning? Check. Having to place invasive lines in massively coagulopathic patients with platelets less than 10 or INR more than 10? Check. My sphincters have never been clenched so much in the space of 2 months, and my adrenal glands have been so plump from all the adrenaline needed to help me fight or flight through these massively stressful situations.

Finally, the junior doctors in this country have been/ are being shafted by the government. They are proposing new contracts that will remove safeguards against overworking doctors. They want “social hours” of working to extend from 7am to 10pm Monday to Saturday (i.e. no recompense for obviously antisocial working- seriously, who values their 9pm Saturday evenings the same way as 9am on a Tuesday morning?). Doctors are essentially doomed to a 30% pay cut under their proposals, whilst the people in authority have recently given themselves a 10% pay rise so that they are “paid the right rate for the right job.” And? Does this same rule not apply to us? What is the right rate for being at work 3 out of 4 weekends in a month? For having lunch at 6pm or missing meals altogether? For being vomitted or even spat on? For having to examine bits of people’s anatomy that will make your stomach turn? For enduring the melange of odours that the body is capable of producing? For all the difficult decisions that need to be made? For having to face death every single day? What is the right rate for having to study for extremely difficult professional exams in our own time? For having to pay thousands of pounds to sit said exams? For needing to pay for medical defence, college registrations, professional development courses? What is the right rate for sacrificing such a large part of my own personal and family life so that I can look after you?

So yes, I am miserable. I am depressed and demoralised. This is not what I signed up for when I was 18 years old and fresh out of junior college.

But I know I need to smile more. Other people do not need to be at the receiving end of my misery.

Come on, J. You were not like this before. You don’t have to become like that now.

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