Layla's space

With all its sham, drudgery and broken dreams it is still a beautiful world.

Tuesday, February 19, 2008


Correction - this post was written on 4/3/08, not 19/2/08 as was originally given by dodgy blogspot thingie.


Can't sleep. Probably because it's four in the afternoon. I got up at 7am and went to work, but was contacted by a panicky medical staffing person at around 10am begging me to do the night shift tonight. The SHO currently on nights has an interview tomorrow, and despite the fact that he informed them of this a few days ago, they haven't found anyone to do his night shift. Actually, I'm pretty sure they hadn't looked for anyone. All fairly typical.

Why didn't I tell them to sod off? Not through any attempt at philanthropy, I'm afraid - they bribed me. I'm preparing for interviews next week (although I still haven't heard whether I've got any yet - more about this in a bit), and am doing Friday, Saturday and Sunday night shifts. So my immediate thought was, no way, this will totally screw up my interview preparation, bugger off. But then they said:

'Go home now, do the night shift tonight, then you can have Wednesday, Thursday and Friday off. The other SHO (who has his interview on Wednesday) will do your night shift on Friday, so you only need to do your Saturday and Sunday nights, and we'll still give you Monday to Wednesday off next week as you would get anyway after nights.'

My interviews, if I have them, should be on Tuesday and Wednesday next week. Three whole days off to prepare! Fan-bloody-tastic!

I checked with the other SHO on my firm (who had been on nights herself during my hepatitis escapade, which was the reason for all the panic about cover at that time), who said it was fine with her. I checked with the SHO with the interview, who was just grateful they weren't going to force him to come and do the night shift himself and was happy to do the Friday night. I then grabbed it with both hands and high-tailed it out of there.

I've been home since noon. I've watched Ashes to Ashes, Freaky Eaters and 2 episodes of Bizarre ER on iPlayer (the last three were complete bollocks but filled the time). I've had lunch and made Eton mess (along with an impressive mess in the kitchen). I'm going to attempt to have a nap again but I have to be up at 7pm. Ho hum.

I'm starting to feel a bit guilty and paranoid about doing this now. All I've got in my head at the moment are these interviews, the Clin Onc one in particular (if I've even got one). If I don't do well at it, I'm essentially fucked jobwise. I need to get a Clin Onc training number, in London, at this attempt. So hence when I heard the details of this 'deal' I pretty much jumped at it without thinking. I didn't check with my SpR or Consultant, not that it should matter to them as there is still an SHO covering the team and this level of cover happens regularly due to normal night shift patterns. I did check with the other SHO, but now I'm thinking it's a bit shit for her as she'll obviously be busier without me there, and she should have interviews next week as well which she's preparing for. Plus the SHO with the interview shouldn't, technically, have to do my Friday night shift in return for my doing his Tuesday night - as far as I know it should count as interview leave. But getting him to do it means that medical staffing don't have to pay me locum rate as I'm still doing three night shifts in total. Hmmm.

Well, it's done now. I just need to do this night shift and then work my arse off for the next three days. I also need some fucking interviews.

The MMC process remains ridiculous and unfair. Basically, everyone who was allocated an 'ST2' job (based, remember, on a thoroughly flawed application system - the late, unlamented MTAS) has first dibs on the SpR numbers in London (OK, OK, ST3 jobs, whatever).

A couple of weeks ago we had to rank three specialties in order of preference (despite the fact that myself and most SHOs I know only want to do one thing). We then had to fill in extensive application forms for each of these three choices in the space of a week. Fun fun fun.

The interviews for my chosen specialties take place in one week, and I've heard bugger all. No-one else that I know who has applied for those specialties has heard anything either, so I'm not too concerned. I just have no idea if I'm going to be attending one, two or three interviews next week, or none at all. I don't know which of the three quite different specialty interviews I should be preparing for, if any. There is a shitload of work to be done to prepare for each if I want to do well. I'm fed up of the uncertainty.

I'm basically only preparing for a Clinical Oncology interview, my first (and realistically only) choice. That's the one I don't want to bugger up. But I may well find that I've not got an interview for that, but have one for my second and/or third choice specialty, and have to re-prepare all over again at very short notice.

Oh bollocks. Now I feel guilty, stressed and angry. Time for a nap.

Sod the SlimFast, get hepatitis!

I have lost nine pounds in weight over the past week.

NINE POUNDS! Cue ridiculous little dance....

The downside is, my liver hasn't been working. It's a longish story so I'll cut to the chase: ate some oysters, felt flu-like for a few days, then started throwing up, then went to A+E with hideous right upper quadrant (ie liver) pain. Seen by A+E SHO (sorry, ST1) who didn't enquire as to the severity of the pain or offer me pain relief, didn't examine me properly (kind of an OSCE-style examination, ie going through the motions without the aim or ability to pick up any clinical signs) and fucked up my blood test (I have HUGE veins, this is pretty hard to do and indeed has never been done before). Lo and behold, my blood tests come back and my liver enzymes are up the spout. ST1 is rather bemused, but is coming to the end of her shift and clearly wants rid of me so packs me off to my GP so he can organise my ultrasound and referral to a gastroenterologist.

Long story short, I still don't know what it is. It's not hepatitis A, B or C, it's not CMV or glandular fever. Still waiting for ultrasound and gastro appointment. Feeling better, starting to eat, back at work tomorrow.

About work. I imagine that if one of my colleagues called me to say they had hepatitis, felt like crap and could I cover their patients that day, I would say 'Of course! I hope you feel better soon, please don't worry about work, we'll sort it out.' I would, I'm sure I would. Even if I had a million things to do and was too busy to cover, I'd tell them that and then go and find some other colleagues to help with the cover. My experience was:

'Oh. Well I'm really busy on my firm at the moment, so I don't know if I'll be able to cover for you.'

I suggested a couple of other SHOs who might be able to help, emailed her my patient list/jobs list and gave her the bleep number of my SpR. What did she do? Fuck all. Didn't see any of my patients, didn't use the list, didn't ask for help. I spoke to my SpR later (I'd already called to say I wouldn't be in that day but called again to say I'd been signed off for a week):

'Oh. Well the SHO you asked to cover hasn't done any of our work, the patients haven't been seen and they're not getting us a locum.'

Well, what do you want me to do? I'm so fucking sorry my liver doesn't work, I can't eat and I feel like shit. Shall I come in and vomit on the patients? Would that help do you think? Shall I come in and make a hideous chemotherapy prescribing error and kill someone?

It made me so fucking angry. Mainly from the obvious lack of concern and support from fellow doctors, but also because it made me feel guilty and actually consider whether maybe I should just go in.

Why are doctors a) awful patients and b) so bloody unsympathetic to their colleagues? We don't take our own advice when we're ill, we have to be on death's door to take a day off sick, and if somebody does go off sick we act like the entire hospital is going to implode because of it. I know we're spread as thinly as possible, there is very little 'give' in the system to allow effective cross-cover in the case of illness and it is therefore always challenging if we're short-staffed. It's just the bloody attitude. From the 'caring profession'.

I'm not looking forward to tomorrow. They found a locum to cover some of my days off, but I know there'll be a pile of crap that hasn't been sorted out. It's the same in any job. The main thing I'm not looking forward to is seeing the people who made me so bloody angry last week.

Obviously, not all my colleagues behaved in the same way. I've had calls and texts saying 'Come back when you're ready, everything's fine here, don't worry, get well soon'. I wish everyone was like that.

Oh, and one more thing:

Don't eat raw oysters, boys and girls. It's not big and it's not clever, and it nearly killed Michael Winner.