GP vs NCHD
I remember clearly when the novelty of finally being a 'real' doctor wore off, along with my notions of becoming a surgeon. I was finally qualified, notionally at least. My UCG days were behind me. This was the real world for which we had spent so long preparing and I was about 21 hours into my first day at work as a surgical intern (the lowliest of Non-Consultant Hospital Doctors or NCHDs).
I knew about the long shifts, we all did, and I arrived in work prepared for 9 or 10 hours but found out at 5pm that I was on call that night and was still expected to be at work as normal for the day shift the morning after.
So I battled through my steep learning curve of siting IV lines, charting paracetamol for patients who would have got it faster if they had thought to stop in a shop on the way in to hospital, writing notes, taking orders, ordering tests, chasing results, occasional snippets of doing something medically constructive - actually talking to, examining or treating a patient. Getting dinner was clearly off the cards.
I eventually got toast (staple diet of most NCHDs at some stage or other) around midnight and did more jobs bleary-eyed until eventually I climbed the 2 flights of stairs to the on-call room around 3am. My bleep went again on the last flight and I was summoned to theatre to assist in an emergency laparotomy for a possible bowel perforation. Through the fog of exhaustion I carefully explained to the caller that they must be joking and had obviously called the wrong person.
They hadn't and neither were they in the humour to joke about it.
I dragged myself down the 2 flights of stairs, across the carpark to theatre and tried for quite a while to stay awake, feigning interest in learning about what was going on, while being shouted at for not pulling the retractors with enough force to keep the bowel loops visible. Inevitably I fell asleep, leaning in over the patient, and got caught.
My elders finally gave up in their new intern and sent me to bed. On my long trudge across the car park and my second attempt at climbing the stairs for sleep around 5am (managed a blissful 2 uninterrupted hours) I had a eureka moment about my future career.
Don't become a surgeon.
I had a scary vision of the next 10-15 years of training which lay ahead of me in surgery. Endless long days and up all night holding body parts open. Competitive attitudes, angry outbursts, antisocial hours and rosters, powerlessness and the very frustrating helplessness of being employed by the HSE, mixed with huge pressure to do research for the sake of research and to convince loads of people you are better than all of your colleagues to have any chance of landing a job as a consultant in anywhere approaching your chosen city.
Sometimes it's more useful to know what not to be, than what to be. I wanted to be a doctor but I wanted a life too. I was 23 and had kind of hoped that the next few decades would be more fun than the reality I had just experienced.
So I followed in the footsteps of my father and his father before him. I chose life. I chose General Practice. And within just 10 years of the Leaving Cert I was fully qualified.
Fast-forward several years and several jobs, it's now 5 years since I set up my own practice and 1 year since Galway Bay Medical Centre had to move to a bigger premises on Dock Road to become 'Docs on The Docks' where I work with a team that make it almost possible to forget that this is a job. Choose a job you love and you will never have to work a day in your life.
I am grateful for my experience on that first day at work though. If it was a 10-hour rather than a 34-hour shift I may not have chosen General Practice. Many colleagues were years further down this path before giving up on it. Leave surgical jobs to the people who have dedicated their lives to surgery. Likewise hospital medicine. But please can we get safe working hours for hospital doctors. It's not fair on patients, doctors, families or society. The patient I fell asleep on survived that perforation and operation despite the junior doctor falling asleep on the job. Luckily the seasoned surgeons (the more senior 'junior' doctors) did their job perfectly.
I fully support the NCHD strike scheduled for next Tuesday 8th October, and would love to think that this crazy issue will finally be resolved. These doctors are only trying to do their job safely and are being prevented from doing so by an organisation that is responsible for the absolute chaos of our Hospitals in the first place. Ask yourself.....
Would you get in a taxi if you knew the driver hadn't slept for 34 hours?
Would you put your child in that same taxi?
Why is it different for our hospital doctors?