I am going to stay back with my parents in Liverpool from tomorrow, and not sure whether I'll have time to blog, so just wanted to wish everyone who reads this blog a very happy, peaceful and blessed Christmas. Hope you find some time amongst the manic-ness and consumption-fest to spend with somebody you love and think about the real Meaning of christmas. love doctor/woman xxx
Thursday, 20 December 2007
Happy Christmas!
I am going to stay back with my parents in Liverpool from tomorrow, and not sure whether I'll have time to blog, so just wanted to wish everyone who reads this blog a very happy, peaceful and blessed Christmas. Hope you find some time amongst the manic-ness and consumption-fest to spend with somebody you love and think about the real Meaning of christmas. love doctor/woman xxx
Saturday, 15 December 2007
The Pedestal
I have had one of those periods of my life where my insecurities surface more than usual recently, for various reasons, and one of them reared its ugly head the other night when stressing to mr me at about 1am when we were in bed. This insecurity is one of the worst things about being a doctor.
Rightly or wrongly, when you tell people you are a doctor, they have a certain reaction. Normally it involves the word "wow!", and there is instantly a certain mystique about you that wasn't there before. You have seen babies born, you have seen people die, you have (hopefully) stopped a few people dying, and most people place their trust in the integrity and competence of their doctors. So they suddenly look at you in a slightly different way. Being me, I normally say "I'm a doctor," in a slightly apologetic way, as if to say, "please don't look at me differently" (although I notice I have recently started introducing myself as a doctor, instead of a junior doctor. So maybe I am getting slightly less self-deprecating)
I am getting more able to live with the pedestal that people put me on. Perhaps too much so - sometimes I try to imagine how I would feel if I wasn't a doctor any more, and I realise that I am slowly depending more and more on my career for my sense of self. I am well aware that pride lies that way, and I attempt to "consider everything a loss compared to the surpassing greatness of knowing Christ Jesus my Lord." (Phillipians 3:8) I know that I need to work more with God on finding my sense of identity in Him and not in the things I have or am here in this world.What I still find very hard to live with is the nagging fear that one day I am going to fall off the pedestal.
Medicine is a lot about the way you present your knowledge. E.g. you have a young female patient with a chest pain which sometimes occurs at rest, on breathing in, then goes away again after a few minutes. You ask a few questions and it sounds like a chest pain related to anxiety. That is your diagnosis. You know that there is probably a tiny percentage chance that it is something else. But the risk calculator instilled into your brain by practice is telling you that this tiny risk is not worth investigating for. Do you tell the patient all this? No. She is already anxious, you don't want to make her more anxious. So you tell her in your best reassuring manner to try a few simple measures to reduce her stress and that the pain is nothing serious. To safety net you maybe ask her to come back if things don't improve. For the patient to go away happy and to get better, you need to come accross confident. This "bedside manner" that doctors have to have can sometimes feel like an act. You are taking on the anxiety, so that the patient can stop thinking she is ill. But the general public often seem not to understand that the art of diagnosis is, by it's very nature, a sophisticated type of educated guessing. In many cases there will be some uncertainty. But if your educated guess later proves to be wrong, the patient may forever think you are a bad doctor, even if 9 out of 10 colleagues would have done the same thing.
Then there is the question of knowledge. The volume of medical knowledge is vast. It covers all diseases from prematurity to senility, and from every system of the human body. It is almost impossible for one person to know it all. Especially with some of the questions I get asked in my day to day life, eg "why does my tongue hurt when I drink pineapple juice?" or "is it usual for one twin to be left handed and one twin to be right handed?" But if a patient, or worse, an aquaintance who is asking you medical questions, suddenly finds that you don't know the answer, sometimes they look at you like their world is tumbling around their ears. Because doctors know everything.
Maybe some doctors know everything. Gregory House, for example - he knows everything, and that is very lucky, because he has the most statistically improbable caseload of conditions I've ever seen. I have met a few who seem to remember every footnote from medical school. But the vast majority of doctors know about the conditions we see every day in our chosen field, and for the rest we depend on remembering some of the information, knowing where to find the rest of it, and recognising when to refer to somebody else.
I find it very hard to be under the constant pressure of being expected to be some higher form of human being, who never gets things wrong or doesn't know the answer. It doesn't help that I am naturally rather ditsy, and tend to bump into things a lot. Sometimes I can see people looking at me thinking "well, at least she's not a surgeon!" after I have done something particularly dyspraxic. I am getting better at coming across confident and all-knowing at work, but in my day-to-day life, it's just not me. I'm too honest to pretend I know all the answers all the time. Sometimes I love to be somewhere where nobody knows what I do, and I'm just a girl, just another person on the street. I also regularly fantasise about being a housewife, and not bearing this responsibility that sometimes seems so heavy.
I am well aware that I tend to live my life far too much through other people's eyes, and worry constantly about what others think of me. I think for this reason I feel these pressures more than many of my colleagues. I am also aware that a lot of what I'm describing may well be me projecting my own insecurities onto others, and imagining they are mentally criticising me when in fact they are doing nothing of the kind. I don't think it helped that in my first few years of medical school, my housemates were constantly commenting "I can't believe you are going to be a doctor, you're so dozy/clumsy/I can't believe you're going to skip a lecture!" etc. I know that I am a bit scatty, always have been, and this is something I have to fight daily in order to make sure I practice safely by staying organised. I never go beyond the reach of my competence, and I am honest with patients about this. Maybe if I can deal with my inner critic, I can start to let the rest of the world think what it likes about me.
Rightly or wrongly, when you tell people you are a doctor, they have a certain reaction. Normally it involves the word "wow!", and there is instantly a certain mystique about you that wasn't there before. You have seen babies born, you have seen people die, you have (hopefully) stopped a few people dying, and most people place their trust in the integrity and competence of their doctors. So they suddenly look at you in a slightly different way. Being me, I normally say "I'm a doctor," in a slightly apologetic way, as if to say, "please don't look at me differently" (although I notice I have recently started introducing myself as a doctor, instead of a junior doctor. So maybe I am getting slightly less self-deprecating)
I am getting more able to live with the pedestal that people put me on. Perhaps too much so - sometimes I try to imagine how I would feel if I wasn't a doctor any more, and I realise that I am slowly depending more and more on my career for my sense of self. I am well aware that pride lies that way, and I attempt to "consider everything a loss compared to the surpassing greatness of knowing Christ Jesus my Lord." (Phillipians 3:8) I know that I need to work more with God on finding my sense of identity in Him and not in the things I have or am here in this world.What I still find very hard to live with is the nagging fear that one day I am going to fall off the pedestal.
Medicine is a lot about the way you present your knowledge. E.g. you have a young female patient with a chest pain which sometimes occurs at rest, on breathing in, then goes away again after a few minutes. You ask a few questions and it sounds like a chest pain related to anxiety. That is your diagnosis. You know that there is probably a tiny percentage chance that it is something else. But the risk calculator instilled into your brain by practice is telling you that this tiny risk is not worth investigating for. Do you tell the patient all this? No. She is already anxious, you don't want to make her more anxious. So you tell her in your best reassuring manner to try a few simple measures to reduce her stress and that the pain is nothing serious. To safety net you maybe ask her to come back if things don't improve. For the patient to go away happy and to get better, you need to come accross confident. This "bedside manner" that doctors have to have can sometimes feel like an act. You are taking on the anxiety, so that the patient can stop thinking she is ill. But the general public often seem not to understand that the art of diagnosis is, by it's very nature, a sophisticated type of educated guessing. In many cases there will be some uncertainty. But if your educated guess later proves to be wrong, the patient may forever think you are a bad doctor, even if 9 out of 10 colleagues would have done the same thing.
Then there is the question of knowledge. The volume of medical knowledge is vast. It covers all diseases from prematurity to senility, and from every system of the human body. It is almost impossible for one person to know it all. Especially with some of the questions I get asked in my day to day life, eg "why does my tongue hurt when I drink pineapple juice?" or "is it usual for one twin to be left handed and one twin to be right handed?" But if a patient, or worse, an aquaintance who is asking you medical questions, suddenly finds that you don't know the answer, sometimes they look at you like their world is tumbling around their ears. Because doctors know everything.
Maybe some doctors know everything. Gregory House, for example - he knows everything, and that is very lucky, because he has the most statistically improbable caseload of conditions I've ever seen. I have met a few who seem to remember every footnote from medical school. But the vast majority of doctors know about the conditions we see every day in our chosen field, and for the rest we depend on remembering some of the information, knowing where to find the rest of it, and recognising when to refer to somebody else.
I find it very hard to be under the constant pressure of being expected to be some higher form of human being, who never gets things wrong or doesn't know the answer. It doesn't help that I am naturally rather ditsy, and tend to bump into things a lot. Sometimes I can see people looking at me thinking "well, at least she's not a surgeon!" after I have done something particularly dyspraxic. I am getting better at coming across confident and all-knowing at work, but in my day-to-day life, it's just not me. I'm too honest to pretend I know all the answers all the time. Sometimes I love to be somewhere where nobody knows what I do, and I'm just a girl, just another person on the street. I also regularly fantasise about being a housewife, and not bearing this responsibility that sometimes seems so heavy.
I am well aware that I tend to live my life far too much through other people's eyes, and worry constantly about what others think of me. I think for this reason I feel these pressures more than many of my colleagues. I am also aware that a lot of what I'm describing may well be me projecting my own insecurities onto others, and imagining they are mentally criticising me when in fact they are doing nothing of the kind. I don't think it helped that in my first few years of medical school, my housemates were constantly commenting "I can't believe you are going to be a doctor, you're so dozy/clumsy/I can't believe you're going to skip a lecture!" etc. I know that I am a bit scatty, always have been, and this is something I have to fight daily in order to make sure I practice safely by staying organised. I never go beyond the reach of my competence, and I am honest with patients about this. Maybe if I can deal with my inner critic, I can start to let the rest of the world think what it likes about me.
Tuesday, 11 December 2007
A very merry weekend
After a hideously busy week on the postnatal ward in which I didn't manage to wake up on time one single morning, I had a lovely Christmassy weekend, despite the foul weather. On Friday night mr me had told me we were going out for the evening, which would be my Christmas present. He took me to see the Northern Ballet Theatre performing the Nutcracker, which I loved, and was very seasonal and beautiful, and I have been doing random bits of ballet ever since. It was very special that he went with me as well, since he has about as much interest in ballet as I have in cricket. His parents also came to stay the weekend, so on Saturday we went to get our tree from Whiteley's, a garden centre, which was basically a huge land of Christmas decorations. We spent the evening in decorating the tree, drinking mulled wine and eating popcorn and watching a film. Then on Sunday evening we had our church Christmas party, which was pretty good fun - we had a rip-off X-factor competition, and it is surprising how many talented singers and songwriters are hanging around in our church. It was a lovely weekend and I think I needed it to relax in. I didn't get much work done, but I've done 200 MCQ questions this evening, so I feel a bit more in control of that now.
Saturday, 1 December 2007
Friday, 30 November 2007
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.
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.
Thursday, 29 November 2007
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
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.
Thursday, 8 November 2007
falling in love with a skyline
So I think I've recovered enough from jet-lag, post-holiday stupor and complete inability to choose between which photos to post, to tell you a little bit about my trip to New York. I fell for Manhattan completely. I have the symptoms I used to get with a new infatuation with somebody - everything reminds me of them, a song, a movie, an image. Except that being New York, everything actually does remind me of it, because it is everywhere in movies, songs and imagery. The thing I loved most about it was the way you could be just walking along the street, watching your footing or looking in a shop window, when suddenly you'd look up and see this breathtaking skyline. From every angle and in every light it would look different, but it was beautiful in a way I hadn't really thought a city could be.
I travelled with a friend, C, who I've known the last 5 years at church. She shares with me a slightly irreverent sense of humour (important to have in church friends), and an ability to get excited about simple things. Like pancakes for breakfast, yellow cabs, rude joggers, cool pyjamas, seeing a spot from a film, every time we saw the Empire State Building, getting our makeup done at Bloomingdales, posing for stupid photos, getting dressed up... The list could go on. We were over-excited about everything, and kept making a new plan to fit everything into our days.
We shopped til we almost literally dropped in Macy's, Bloomies, Tiffanys, Victorias Secret, Abercrombie and Fitch, and cool little vintage and boutique-y type shops. We went out to see Les Miserables on Broadway, to 55 Bar in the Village, where we listened to live jazz and pretended we were cool, we saw a bit of the Halloween Parade, and a bit of the marathon going past. We saw a lot of the obvious sights - the Empire State, the Statue of Liberty, Grand Central Station, the Rockefeller Centre, the Brooklyn Bridge and a few of the less obvious ones, like the original Winnie-the-Pooh, the reading room at the New York Public Library, the Strawberry Fields garden for John Lennon, and the Guggenheim.
Some of the most memorable moments were just from seeing people living their normal lives, like stumbling across a kid's ice hockey game, overhearing couples arguing or walkers swearing at joggers in an uninhibited New York way, chatting to taxi drivers, watching a wheelchair athlete repair his bent wheel in the middle of the marathon or watching a family take a photo shoot of their kid on the Alice in Wonderland statue in the park.I can't wait to go back and see the things we didn't manage to do. I'd like to go with mr me and see things in a different way. It was lovely to have a girly holiday, and shop without feeling guilty and annoying, and watch Breakfast at Tiffany's and When Harry met Sally as research, and get unreasonably excited about everything. But it's always wonderful to come home.
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