Living the dream

Life inside the hospital is quite unlike anything I’ve ever experienced. The previous two weeks have hammered home the role of a doctor; the complete lack of glamour, the endless rounding, the tireless adjustment of medications, the utter disillusionment of previously held misconceptions, and the repugnant odours that only the new medical students seem to be bothered by. Ironically, it seems our oxygen saturations fluctuate as frequently as some of the patients as we hold our breath from bed to bed.

Being dropped into the proverbial deep-end - after performing venepuncture successfully only once previously on a plastic arm the subsequent times I have taken blood have been alone, unsupervised, on real patients. The problem with a general medical ward is that the patients on said ward tend to be there for a reason. They have a multitude of different complex medical problems, are quite often elderly, and difficult to bleed. I’ll walk through the ward, noting the various cotton-wool pads covering previous puncture sites, large haematomas and prominent cannulas. The doctor will request a number of bloods, and I’ll skulk over to whichever of the condemned to request permission for a futile attempt at drawing blood. Squaring up to the antecubital fossa, a face full of false confidence as I attempt to make small talk. I’ve even developed my own comedic routine, joking that the tourniquet will most likely be around my neck by the end of the procedure; there’s no business, like SHO business.

Unfortunately the Patch Adams approach isn’t always appropriate. One occasion last week saw me failing to bleed a patient whom I knew was to receive a death sentence once their family had arrived. Despite all the communication skills sessions laid on by the medical school, little was actually said. I think we both understood what was about to happen.

Much of this takes place for the purpose of being signed off in our logbooks. We have to reach the quota, no matter how uncomfortable the situation may be. A teaching round given by the lead consultant highlighted yet another important lesson to me, for when performing a respiratory exam I declared the chest sounds to be unremarkable. Of course, I could not actually hear the expiratory wheeze, but for the helpless screams of “nurse.. nurse... NURSE! I’VE WET THE BED!.. NURSE?!!” coming from the next bed. This carried on for nearly half an hour as we listened to the consultant in stony silence, pretending nothing was happening inches away.