You know you've turned 30 when...

Slightly distressed today to find that the annoying adverts at the side on Facebook which normally want to tell me about how to have a flat belly and how to entertain my kids have changed slightly.  I have always presumed they are based on my demographic information and (hopefully) not my profile picture.  However, my demographic information has recently changed to that of a 30 year old, and here are the adverts I have today..

1. FREE Garden birds CD.  "joyful birdsong to help you recognise and enjoy your garden visitors".
2. Purchasing courses.  "study at home.  Chartered Institute of Purchasing and Supply Courses"
3. SHOCKING Wrinkle-therapy "52 Year Old Mother Looks 39 - Dermatologists are Scared and don't want you knowing this skin secret!"
4. Patio awnings from £75 "you don't have to spend thousands to get a great quality garden awning."

I'm sorry - was I 30 or 50?

The joy of complaining

My recent episode of uncharacteristic behaviour began when out shopping with mr moo (my 2 year old).  Walking past a menswear shop in our local shopping centre I noticed in the window, about 1 metre off the ground, an advert to win a "lads holiday in Ayia Napa" featuring a picture of some large and probably enhanced breasts, with strips of fabric about an inch wide covering them (no face was involved in the picture).  I saw mr moo clock the picture as well, and saw him think about it for a couple of seconds, but I don't think his vocabulary was up to framing the question in his mind.

I felt immediately angry.  Mr moo has seen breasts quite a lot of times, given that I get dressed with him around, and there are a lot of breastfeeding mums in our friendship group at the moment (and that I breastfed him until he was 14 months, but that was a very long time ago in his world).  He has recently felt the need to point out "mummy's boobies" when he sees them, but then he also likes to point out "mummy's drink, daddy's drink, my drink" at the dinner table.  I've been trying, by my actions and words to let him know that breasts are a natural part of a woman, private, but nothing to be ashamed of, and primarily designed for feeding babies (although I don't have much hope that last lesson will last him past puberty.)  I'm not ready for him to see the objectification of women, the lust and sexualisation of our culture that I'm sure will impact him all too soon.

But I kept walking, chuntering to myself in my mind about the irresponsibility of the advert and its placement.  It was on the way back that the uncharacteristic moment came to me.  Why, I wondered, was I internalising this anger and disquiet?  If everyone who was offended by this picture walked past without saying anything, it would just stay there, but it was quite likely that a quick comment to the management would make a difference.

Taking my moment of bravery/insanity/becoming my mother in both hands, and mr moo in both arms so he wouldn't make the encounter worse by running away at the crucial moment, I walked up to the middle aged man rearranging clothes on  the sale rack, and asked for the manager.  It turned out he was the manager, so I turned on my nicest smile and politest manner and explained that as a mum, I found the picture inappropriate and especially its position at children's eye level.  He was unphased, and said "oh yes, we've been told to tone it down a bit when we start getting complaints."  I thanked him and walked away, feeling encouraged that he was open to feedback, but wondering why the shop felt it best to push the boundaries of public "decency" as far as it possibly could, rather than just trying not to offend in the first place.  However, I suppose the obvious answer to that question is ... to sell stuff to men.

Today was the first time I've been back there, and, to my glee, the advert has been moved up the window, and the picture now shows three relatively clothed women, including faces!  However, I'm a bit concerned that the immediate success of my first attempt at this particular brand of complaining will seduce me gradually on down this path.   Maybe by the time mr moo is 15, I'll be the kind of toe-curlingly excruciating mother who complains loudly in public about the manners, morals and grammar of complete strangers, causing him to be traumatised for life.

negative voices

It all started this morning when a friend dropped by to lend me a baby door bouncer... My elderly next door neighbour said hello to her and her 1 year old daughter, and she mentioned that it was a lovely day for gardening. He then said pointedly to me, "Yes, did you hear that? it is a lovely day for gardening."

Now our next door neighbour is a retired man (normally really lovely), and obsessed with his garden. As far as I can tell, he spends most of every day out there, despite his fairly advanced lung disease, and it is always pristine and beautiful in every season. Our garden, on the other hand, is a little rough around the edges. It has a wild unmown section at the bottom, which is a deliberate choice to give bees etc some habitat, but I sense he's not too keen on that feature, since some weeds grow there. The beds mostly have easy care perrenials in, because that's all I had time for at the best of pre-baby times. And ok the lawns haven't been mown yet this year, and things have gone a bit "to seed" since the pelvic pain kicked in halfway through pregnancy. But in my opinion it looks presentable. Compared to two and a half years ago when we bought the house and the plot was half rubble, half bed full of weeds, it's practically an oasis.

What was really disturbing was what that simple jokey comment, (which I may have totally read too much into), did to the rest of my day. I was instantly torn between paranoia (oh no he thinks I'm a terrible neighbour and inadequate housewife, gallivanting off to baby groups all week without attending to my own back garden) and anger (doesn't he understand what it's like having a new baby to take care of and how difficult it is to even keep the house clean?). I became unable to focus on the conversation with my friend after she came into the house, even though she dismissed him as a cheeky old man, and then I began to feel bad that I was coming across as scatty and absent and not in control. We talked a little about it at the end, and she said to me as she left "You're doing a great job. Hear that." But sadly this was no use. The negative comment had sunk into my brain somehow and was blocking all positivity out.

By the time I set off for my breastfeeding support group, my brain was a storm of negative voices. I spent the pleasurable sunny walk across the park thinking about my choices as a mother, and spiralling down into self-doubt. I began thinking about what will happen when I go back to work. Currently I'm planning to complete my training working half time, and then get a permanent job with even less sessions than that, if possible. I started hearing the (mostly male) voices of my colleagues at my current practice, who already feel that a year of maternity leave is an extended holiday and that I won't remember anything when I get back. Soft option they were saying to me, don't you care about your career? don't you want your son to go to private school like our children? don't you want to be a partner? Then my paranoid version of my parents voices started, You need to give your time to your child, they grow up so fast... and Christians I have read books by if you have the means you should give up work, God intended mums to look after their children. I began to feel that I will be giving both baby blue and my work less than my best. Next I began to worry what mr me was feeling about me, and projected onto him the view that I spend all week having fun and coffee with my friends, while he slaves away at work. Then I started wondering what other mums think of me, and whether they see me as a failure because baby blue is still in disposables and still has to be cuddled to sleep for his daytime naps. Then my childless friends - do they think I've turned into an antisocial baby bore? Then my own judgements on me - I forgot to clean his tooth again this morning, maybe he'll grow up with tooth decay... I didn't realise he was hungry for half an hour of grumpiness, maybe he's not growing as well as he should be because I don't feed him enough.... You get the general idea.

Fortunately the thought bog was stopped when I got to baby cafe by an hour of chatting to fellow mums, venting my frustrations re the next door neighbour, and feeling a little more that everyone's in the same boat i.e. we're all doing our best. This evening has cheered me up even more, with some affirmation from mr me, and an 8pm decaf vanilla latte at Borders, accompanied by some Marie Claire reading while he kindly manned the baby monitor at home. However, just typing out these frustrations and insecurities and (mostly unfairly attributed) opinions of others has already put a bit of a weight back into my chest.

What really annoys me is that I am still this vulnerable and weak. I was chatting with some church friends last week and bitching about the fact that most church seminars and days for women seem to keep reinforcing the same point - that you are accepted and valued by God, you are His daughter, His princess, you don't have to worry what others think of you. I implied that I'd got that by now, I'd heard it enough times, couldn't they move on to something meatier? Not all women were seething masses of insecurity, I said. Well maybe they're not, but sadly, and mortifyingly, it seems that I still am. I still need this message to sink from my head to my heart. I know this needs more prayer. I know I also need practically to learn to let little comments bounce off me, especially as society seems to judge mums for every choice that they make. I'll never be able to do everything and please everybody. I need to learn to be happy and confident in our family choices and in doing my best. But how? Does anyone have any more tips on how to beat the guilt, insecurity and self doubt that being a mum seems to exponentially increase?

Highs and lows

The best things about being pregnant:

• I have loved feeling the movements of the baby and how they remind me there's a whole other person inside me!
• I really really am going to have a baby!
• People telling me I look great (although suspect they may be just saying what you're supposed to say to pregnant women)
• A good excuse for resting, asking for help and generally doing what I want to.
• Lots of presents.
• Closeness to mr me and having him look after me.
• I've had quite a peaceful, placid state of mind since the end of the first trimester (most of the time).
• Amazement at what my body can really do.
• Constantly being offered chairs, waved across the road etc
  
• Finally the ultimate excuse for going into mothercare and cooing over booties.
• The prospect of a year off work.
• People's kindness in helping us out with all sorts of things.

And the worst things...

• How I felt for the whole of the first 3 months! (ie exhausted, nauseous, vomiting, emotional and a little depressed)
• People who feel it is socially acceptable to comment on your size, eg "aren't you big?" "how many have you got in there?" etc.
• Busybodies. Everybody has some advice to give, even if you show no sign of wanting it.
• Getting the same comments all the time. "I expect you're all ready now then aren't you?" NO! I'VE BOUGHT 3 BABYGROS AND THAT'S IT! I'M A TERRIBLE MOTHER! or "do you know what you're having? what do you think it will be?" ERM...A BABY PERHAPS?
• Symphysis pubis dysfunction. It's a nasty condition that gives you pelvic pain on certain movements, especially turning over in bed.
• Being tired all the time, and therefore less able to sort everything out and make a perfect nest like I want to.
• Heartburn. boo.
• Becoming suddenly unable to talk about anything else and worrying that I've turned into a baby bore.
• Fear of losing friends/ independence/social life etc.
• Fear of labour
• I've been weirdly inward looking, and haven't always felt as sociable as usual. Less urge to write this blog as well, leading to very infrequent posting - sorry.
  
• Having to think about everything I put in my mouth. Am seriously wanting 2 glasses of wine and a plate of sushi!
• Feeling that my body's not my own any more.

However, it will all be over soon and then my life will change forever...

where i am now

Right now I am sitting at the computer in our small, messy front bedroom that we use as a study. I am partly wishing I had the time and energy to sort through all the notes and paperwork in this room, but just now, I don't. The blinds are still open and I can see the deep blue not-quite-dark-yet sky, and hear the boys who are still playing out on the street. I'm huddled in a hunched position with very poor posture, because I feel cold. I'm wearing a hoodie and jeans and my hair is in a mess. I know there are things that I must do, because I will feel better when they are done, but I feel too physically and mentally tired to do them.

Tomorrow I'm travelling to Croydon, because I'm sitting an exam there on Monday. If I pass it, it means I have all the exams necessary to become a member of the Royal College of GPs, and to complete my training scheme successfully in February 09. It means I can be free to just work and live for a while, see people, garden, sort out the papers in this room, enjoy the summer etc. If I fail it, it means another six months of exam anxiety and work, another £1260 to pay, and I will spend our lovely 2 week holiday in Scotland in September working for the exam. It's a practical-type exam - I have to see 13 actors who are playing patients, communicate effectively, ethically and manage them well in the space of 10 minutes each. Quite stressful. I'm quite stressed. But I know I have worked for it.

Instead of typing this, I should be - checking my train times, and the frequency of the connexion across London, checking the exam details, putting a tendon hammer and tape measure into my doctor's bag, working out how to carry my suit without squashing it, packing my case, having a shower, doing my hair, calming my mind down, going to bed early.

I shall go and do these things now. I need to stay calm, but just now I feel numb and unreal. If you have a second, please pray for me or wish me luck. I'll let you know how it goes, and try to blog a little more regularly when it's over.

misc

ok, so last night was not good. i had a bit of a brain mist and all the ward patients decided to get sick, mostly struggling to breathe, which tends to scare me. tonight so far is going a bit better following a shaky start.

at the moment i feel stressed. there are various reasons, but the most significant is that the GP training scheme i am on and have been for the last 2 years, has introduced a new system which involves jumping through a lot more hoops, most of them electronic assessments. i was managing to cope i thought, but discovered 2 days ago that i have to jump through a whole load of them before next Friday. which is not so easy to do when you're on nights. think this saturday might be devoted to studying and preparing for meetings, which is a bit sad. maybe i will manage some gardening or shopping as well.

in the morning i am going with mr me to pick up a van and then we are driving (or rather he is driving, i am sleeping in the passenger seat) to my parents' house in liverpool to pick up some furniture. it's an antique walnut veneer dressing table and mini wardrobe that i used to have in my bedroom throughout my childhood, and loved. we will put them in our (finally) redecorated bedroom and when we buy a new bed, we can move in there. i am so looking forward to having a dressing table again - at the moment my unnecessarily large collection of toiletries lives on top of a chest of drawers in the fitted wardrobe, and gets knocked around by the clothes hanging above it. i am temporarily obsessed by curtains bedding and lamps for the new room.

i miss my church. due to work, new york and visiting home, i've only been able to go one out of the last five sundays. it definitely has an impact on my state of mind. i start to feel isolated from friends, and more importantly, it affects my prayer life and relationship with God, which has a knock on effect on my general mental wellbeing.

i am looking forward to christmas, as i always do - i am a total child about loving christmas, but am slightly sad that i will need to revise for professional exams in january over the holidays. i have been quite efficient with my christmas shopping this year and have most of it done already.

i feel my brain needs a good clear out and i need some focus and organisation in my life. i feel like i'm writing myself a horoscope here. anyway, i shall go and attempt to tidy my brain.

sorry about the lack of capital letters. i'm not in the mood for them tonight.

daysleeper

I cried the other night
I can't even say why
Fluorescent flat caffeine lights
Its furious balancing
I'm the screen, the blinding light
I'm the screen, I work at night
I see today with a newsprint fray
My night is colored headache grey
Don't wake me with so much
Don't wake me with so much.
TheOcean machine is set to 9
I'll squeeze into heaven and valentine
My bed is pulling me,Gravity
Daysleeper, daysleeper

REM

gravity pulling me down to sleep but i must keep going. plan gone from brain, too late for thinking. some time i must sort things out...some time. leg burning again must rest. life whizzes by without me as i wade through treacle. everywhere smells bad. when will this be over then i will rest and also do everything i need to do at the same time.

Nothingishness

I am struggling at the moment with this blog. I seem to only blog when I am doing nights. I also seem to spend a lot of time feeling melancholy when I'm on nights. Somehow I see the negative side of everything. Eg going to New York with a girlfriend is no longer an exciting adventure, but scarey and selfish, because I haven't been away without mr me abroad since we got married. When I finish nights tomorrow morning I will probably become suddenly euphoric - that is what normally happens.

I think I've also not been blogging much because I've had a bout of sciatica, and sitting on hard chairs at computers seemed to be particularly bad for it. It's feeling much better now, but I am starting to feel a little old with all the aches and pains I've had recently.

Life seems very busy at the moment. There seem to be a million things on my jobs list, which I am constantly revisiting in an attempt to feel in control of it. A lot of things are admin to do with my training scheme, and my MRCGP exams are starting to loom large on the horizons of my thought. I haven't had to seriously revise for anything since my finals, and it is a bit of a psychological barrier.

So this is a grumbly post! I apologise, and shall stop now, and go take a little rest before baby checks at 6.30am. Tonight is the night the clocks go back, so my 12 1/2 hour shift is 13 1/2 hours instead. I think this may be affecting my outlook a little.

What I hate most about being a grown-up

Forms. Admin. The general hassle and stress that can be generated by pieces of paper.

Grrrr. Have just spent most of the afternoon searching through bank statements, cheque book stubs and P60s to ensure I had all the right figures to fill out my tax return online. Turns out I was missing just one - my UTR, which is a reference number they give you when they ask you to do the tax return. In fact they didn't ask me to do one, but I wanted to for various reasons, including having 3 different employers during the last tax year, who paid and taxed me at different rates, and because I'd recieved some untaxed income from report fees etc. You would have thought the Inland Revenue would be happy to hear from honest people like me who self-refer. But no, very suspicious behaviour. "why do you want to fill in a tax return?" Perhaps they suspect what I suspect - that they owe me more than I owe them. Now it turns out I may not get the essential bit of information until after the deadline where you have to work everything out yourself. This would be very Bad News given my poor head for finance. And what my dad would say to me when I asked him to help me. I suspect he might feel that i had left things a little too late. But I maintain it's all Their Fault. These are the moments when I wish I was a kid again, and my financial calculations involved mostly wondering how long it would be before I could afford another Sylvanian family.

Nights

I haven't done proper night shifts for a whole year before this week. I did on calls in psychiatry, but they were 24 hour proper on calls that I did from home. There is a current shift from the previous pattern of doing 7 nights in a row of 12 hour shifts to splitting the week into a block of 4 and of 3 nights, which I think is much better, but the many things I hate, and few things I like about doing nights are coming back to me vividly.

I hate

• the constant nausea. especially when dealing with vomit, or the gunk on newborn babies, which was making me feel nauseous last night
• the loneliness. as a junior doctor at night, you are pretty much a lone ranger, you have a registrar, but often they go to bed, or in the case of this job, are busy on the neonatal unit. then there are the nurses, but often they are busy talking about things I don't understand, like off-duty. tonight they are having a bit of a rant about ward meetings and time owing. i don't blame them, but i cant' really join in. then i get home alone in the morning, and only see mr me when i wake up.
• the way my brain stops working. always disconcerting when mistakes are potentially serious. last night i mislabelled a blood bottle and mishandled my jobs list. tonight i feel a bit better because i slept during the day.
• the headaches, bowel disturbances, puffy eyes and general confusion about what day it is.
• the way i eat carbs constantly and put on lots of weight.
• the way i fall completely out of social circulation.
• the emotional lability. difficult patients, making mistakes, getting shouted at, death, extreme busyness can all become overwhelming. last night i cried just because i saw a baby born.
• waking up to find all the daylight hours have gone, i still feel rubbish, i have no awareness that any time has passed since i fell asleep, and i have to go to work in 2 hours. i know i shouldn't complain about this because a lot of people struggle to sleep during the day, but it is a bit depressing to find that the day has just vanished.

I quite like

• the random bits of time that i get to myself, for example the daytime before i start nights. i can't do anything too energetic, normally end up sleeping in and then pottering around sorting a few things out, but it is a kind of peaceful day.
• feeling useful. things you get called to on nights are more likely to be essential e.g. sick patients or deliveries. (doesn't always apply!)
• being able to say "that's a routine job, it can be sorted out in the daytime"
• learning. it's always a good time for learning because you are more likely to have to manage sick patients on your own, or do procedures. unfortunately the tiredness means i am quite likely to forget it again.
• feeling a bit special. always good for a bit of sympathy. you get excused from most daily tasks.
• having spare time to blog at work!

There seem to be quite a few things i like here, but this is misleading. The day in 6 months' time when I don't have to do nights any more will be a very happy day.

Disconnected things

I have a sore throat. I hope I am not getting ill.
My in-laws have been over today and we had a nice time. My mother-in-law was unable to stay out of the garden, so between us we got it tidied up quite a lot.
I am a bit worried about starting paediatrics on Wed. Haven't done any acute hospital medicine since this time last year.
I am currently on call, but haven't been called all day.
I was grumpy with mr me today for no particular reason.
My colleague who has become my friend is leaving Yorkshire tomorrow to take up a new post in the South. I will miss her lots.
The blind at the window is making my eyes go funny with its stripes.
Seeing pictures of myself on facebook keeps making me realise how much weight I have gained over the last couple of years.
Last weekend the friend that I secretly slightly idolise because of her willowy blonde-haired classic beauty got married to a soldier in uniform. It was a picture perfect wedding.
I have really enjoyed the friendships I have made in psychiatry. Felt that the people there were less driven, competitive, materialistic than a lot of doctors are.
I miss my mum a bit.
I am looking forward to the autumn. I hope it is a proper autumn and doesn't just continue to be wet.
I really have to go to bed.

Drained

I am sitting in my clinic room, having just finished seeing my last patient of the day, and feeling emotionally exhausted and unable to focus on anything at all, so thought I would have a little moan on here before attempting to do my dictation. In fact maybe I will do my dictation tomorrow, as I don't feel up to it really. This is really just a self indulgent grumble, so if that is annoying to you, stop reading now. I've just had a day of difficult patients. I saw my most difficult patient on the ward today, and she just fills me with such anger and guilt by a mystical process psychotherapists like to call "countertransference". By coincidence, I was presenting her case as my presentation to all the other doctors at the lunchtime meeting. I was doing this without the support of my team, who are all away this week, and I felt a bit insecure doing the presentation, as I was the person with least experience in psychiatry. Got some useful input from the other doctors though. Clinic this afternoon over-ran, I had several very distressed patients, one patient turned up stoned, and halfway through I seemed to lose my power of decision making and my ability to listen. Most of the time psychiatry seems like a bit of a holiday because we really don't spend as much time seeing patients as any other speciality, but I think that's necessary, because when you do, it's just so tiring... Think I need to go spend some time gardening. That always straightens me out.

doctor/woman fell down a hole...

Yesterday evening, when getting home from work with mr me, I stood on a drain cover on our drive. It was loose and I fell down the hole. Fortunately not all of me fell down because I think I might be more seriously hurt, but my body and one leg went down leaving me suspended between my left arm and right leg on either side of the hole, landing on the left side of my ribs and with one shoe missing. Panicked. Fortunately mr me helped me climb out and got me into the house ignoring the boys who were paused open-mouthed from their game of street football. Then he fed me chocolate and tea and comforted my trembling tearful shock. I was pretty fortunate really - I saw a patient in A+E last year who did a similar thing and fractured his humerus into three pieces. Went to the minor injuries unit for a quick check-up just to be on the safe side, even though I knew what they would say:-

1. your rib may or may not be fractured
2. we don't do x-rays for this because it doesn't alter the management
3. you need to take it easy, take painkillers, take deep breaths
4. if you get short of breath or cough up blood, see a doctor immediately
5. if your rib is fractured the pain will get worse for 3-5 days and may last for up to six weeks

I know all this because I've said it myself a lot of times. Just wanted someone to listen to my chest and prod my back really. The rib that hurts is my left twelfth rib, which is one of the "floating" ribs at the bottom that only connect to the spine, not the sternum, so it's not really hurting to breathe, only to cough and laugh and twist and bend. I was supposed to be on call last night, but called in sick for that and then again this morning. Am actually feeling less stiff, rather than more, today, but do get the occasional sharp twinge. Am starting to get that guilty feeling I always get when I call in sick. I'm not actually dying - what am I doing at home? When I keep still I feel quite comfortable and well. In fact I'm starting to think this whole post is an attempt to justify to myself that I am allowed to be off sick today. Which is ridiculous, so I shall stop it. now.

Worrying Judderings

Oh dear! My poor little car, which has had a bit of a rough time of things recently, seems to be in trouble again. It is terminally ill in the sense of burning oil a bit and not being worth enough money to make it worthwhile stripping the engine down to fix it. Then I bumped it into someone else's car on a very bad day in December. Logically it wasn't worth fixing this dent if not worth fixing the engine. Now this morning on the way to work, it started juddering in an alarming manner whenever I was stationary in traffic, feeling like my old diesel car instead of its usual smooth-running self.

We do seem to have a very bad time with cars. Over the past 4 years we have had 5 of them. Admittedly for the last year we have had to have one each for work, so that accounts for one - and the one that belongs to mr me has done pretty well over the last year and only had about 2 minor problems, so maybe it is just me who has a terrible effect on the cars. Of the others, one was written off by a hit and run in the middle of the night and 2 had mechanical problems that were too expensive to fix. We are forever having this problem - the problem is more expensive to fix than the car is worth, fixing it will be throwing good money after bad and you just know that if you do, next month something else will go. But when you come to buy a new one you don't have enough cash around to get a much newer one, so it starts to go wrong again. Having said all this, I know plently of people, my parents included, who drive older cars around all the time without having this kind of death rate. Maybe we will end up having to get a car loan. But I really don't want to. A mortgage and a student loan feels like quite enough debt for me and car loans are different because by the time you finish paying the item you bought has much less value instead of more, and there's always the possibility bad things will continue to happen to it. Boo. Going to take my little car to the garage after work, so hopefully they will tell me it's just a spark plug, that will be £5 please. Somehow though, I have a dreadful feeling that's not what will happen...

rhinovirus

Well, I had a horrible cold over the weekend. Was feeling quite proud of myself for making it though the winter so far without one, especially considering I have been working in general practice, with a minimum of 3 people per day trying to persuade me that they need antibiotics for their cold. Came down with it suddenly and badly though, spending the first half of the weekend in agony with sinus pain and unable to sleep, and the second half sounding like Nina Simone, but not in a good way. Recovered rapidly just in time for work Monday - doh!

Felt guilty about being ill because this was the weekend we hired a floor sander to create a lovely wooden floor in our back bedroom, and meant that mr me (as he shall henceforth be known) ended up doing all the work. He thought the machine was too heavy for me anyway really, so I sat around helplessly mopping my nose and stuffing decongestants down my throat while he manfully pushed power tools around in his safety googles and ear protection. Didn't quite manage to get the edges done though, so some hands and knees work with some sandpaper and a block may be in order. (by me - I'm not going to make him do that, seeing as the whole affair was my idea).

Had also booked to go and see Sleeping Beauty by the St Petersburg ballet at the Alhambra in Bradford with my sister, and couldn't really cancel having paid for tickets, so I went, and probably deeply annoyed the people next to me with my explosive nose-blowing. Enjoyed the ballet, but was probably a bit more detatched than I would normally have been.

Left work today - took in some cakes and fruit to say thank you and presents for my trainer. Everybody was very nice saying goodbye to me and I deeply enjoyed throwing away large quantities of useless memos and drug company promotions, but was sad to leave. and found the whole thing a bit tiring. So there is an update on my not-very-exciting life.

Moving on...

One of the things I find difficult about being a junior doctor is the changing jobs. Just to explain my current training scheme... I started it in Feb 2006 and it lasts for 3 years, involving six 6 month posts. 3 are in hospitals, 2 in general practice and one half and half. So far I have done a job in A+E and am just coming to the end of my first general practice job. Next Wednesday (it's always a Wednesday - I'm not sure why) I shall start my new post in Psychiatry in a nearby hospital.

There are some good things about this system, but quite a few bad ones as well.

Good things:

• you don't feel stuck in a rut, and you keep learning new things.
• it makes you adaptable and better at getting on with people
• no problem seems quite as bad - eg you find a colleague difficult to deal with, you can say "oh well, I'll never have to see him/her again in a few months"

Bad things

• All the forms!!! Every 6 months I fill out a CRB form, a wages form, an occupational health form, a car parking form, a name badge form, and I have to show up with the same collection of important documents. This time I can't find my passport - not a good sign
• it is unsettling. my wages, my rota, my journey time all change every 6 months, not to mention what I do all day at work. this time my wages are going down. boo.
• because you know from the start, and so does everybody else, that you are only there for 6 months, you just don't invest emotionally in the job and the place as much as you would if it was permanent. and likewise people don't see you as a long term colleague or potential friend in quite the same way that they might if you were staying around. In hospital maybe the consultant never quite learns your name properly, or you don't fight quite so hard against the stupidity of the rota because as above, you know you only have to put up with it a bit longer by the time you've realised how rubbish it is. Or as in my current job in general practice, you're working with a team of people who know they'll probably be together the rest of their working lives. They know each others' families, habits, they remember weddings and births, mishaps, illnesses etc. And although they've all been kind and friendly to me, it's not the same and you can feel the slight (very slight) distance. It makes me sad and means maybe I don't expect to find lifelong friends at work. I think some people are better than me at this, maybe they live more in the moment, invest emotionally even though they know it's only for a short time, and are more likely to see colleagues outside of work and stay in touch afterwards. Maybe it is partly to do with the fact that I find initiating a friendship a little bit difficult. It's that step between "I like you and we chat about stuff and get on well" and "you are my friend and not just a colleague", that I find difficult to get over. Whether this is because of all the job changing, or whether I'm just using that as an excuse for my own hesitancy and insecurity I'm not sure.

Anyway, that was far too long for the content of a bullet point! I will be sad to leave this job - the people are all nice. Particularly enjoyable to rant along with the other doctors about the state of the nhs, the patients, hospital medicine - everybody except us really - at lunchtimes. Have got to know a few patients - some see me regularly as "their doctor" and I've never had that before. Have got used to finding out what happens to people instead of them vanishing off into the ether and never seeing them again, which is what happens in hospital medicine. Anyway, I could happily work here for longer. However, psychiatry sounds like it will be fairly relaxing, I had some good feedback from my GP trainer today, so there's not too much to grumble about. I can cope with moving on.