ADOitis

Dragged myself out of bed on Friday morning cursing the admin stuffup that was seeing me work on my rostered day off and having to rearrange my errands to another time.

I felt particuarly seedy due to my persistant cold (which certain friends hate) and to make matters worse had to walk the half hour trek to work cos my car was being fixed.

My reg decided to rock up early and the other reg was in Dubbo doing a clinic so I had to cover her patients too. Then went straight to a Urology meeting before doing a professorial ard round with the big boss and then another consultant ward round.

By the time I finished all that it was 10:30 and I hadn't yet written in any of the notes (during the surgical rounds I prefer to wait till after the round to then go and write neatly in the notes so I can actually get time to write everything).

Now all I wanted after 31/2 hours of rounding was to just sit and quickly write in my patient's notes. But the nursing staff (and in particular the NUM) came flying at me demanding to know what was going on with each one of their patients.

1) If you WANT to know what's happening with your patients, why don't you show up when we do our round and find out for yourselves, rather than show up an hour late EVERY day and expcet me to tell you in a private one-on-one debrief.

2) If you aren't able to meet the above mentioned expectation, allow the poor intern time to compose his thoughts and sort his stuff out before harassing him and saying extremely dumb things like "Doctor, you seem a bit stressed today?" (to which I replied "Well it's my day off today, how do you THINK I feel?")

3) If you ask "Did Prof say Ms Blah can start self catheterising?" and I reply "Um I dont think he said anything about it today" plese don't stick in your little jab to insult me by saying "Well were you even ON the ward round?" cos this will only make me despise you even more.

I've realised that work can bring out the worst in me. I lose my patience very quickly and realise that I need to be gentle with the other staff even when they are extremely incompetent.

However, when suffering from ADOitis (as my reg so eloquently diagnosed me) I just lost the plot. Like not as in throwing hissy fits and running aorund waving my arms like a lunatic... but more like just skulking around the wards with a peeved look in my eye. Most of the nursing staff avoided me after they got the idea.

Thankfully ADOitis was cured with a 2/7 dose of Weekendamicin which resolved all symptoms and made the patient feel a lot better.

Weekendamicin was synergised by a steady infusion of Yum Cha today with my Asian buddies (followed by beers at the pub with the boys whilst the girls went shopping). Nothing like some unpronoucable food and chickens feet to lift one's mood (well maybe not the chicken feet).

New life

Today was another day in the Zoo.

However it kinda sucked cos after they rostered us for a day off tomorrow, they informed us at 1pm today that we couldnt take the day off and all had to show up tomorrow even though we'd made plans for th eday off. Stupid admin! They can't even run a hospital!

Anyways, the day started with a quick ward round followed by some discharges and then off to theatre to play with sharp objects.

My boss let me help out with his theatre so there we all were, the boss, the reg and their intern (ie ME!) all with our hands inside someone's abdominal cavity, up to our elbows in blood. We were lopping off bits of kidneys (partial nephrectomies) and I learnt a very valuable lesson from this.

Now when boys are babies, most mothers will wanr you of the danger of standing directlyl in front of them when changing a nappy because inevitably you will get shot with urine.

Well when carving out chunks of cancerous renal tissue, one should really clamp the renal artery first and stand well back when actually chopping.

As the boss cut thru the purple-looking kidney I was hit with a jet of blood that looked like a little boy peeing at me. Here I was all scrubbed up intently gazing into the sterile field when I was suddenly soaked in fresh blood from a recently nicked artery. Thankfully I had my eye vizor on!

"We've got a bleeder" remarked the boss, ever so dryly. Thankyou Captain Obvious for that wonderful piece of insight!

But still, it was fun cos at the end I got to help the reg close up and she let me go nuts with the staple gun (whcih I'm sure most med students have used but seeing as I never showed up during med school to theatre it was a new toy for me)

Then I had to go and admit a lady who tomorrow is donating her kidney to her sick daughter (who is currently next door in the kiddies hospital). It's very touching to see a mother's love for her daughter when she is willing to give her own kidney to save her daughter from a life time of sickness. That kind of self sacrifice is all too rare in general these days.

For once I didn't mind staying back an extra hour to fix her up and get her ready for surgery.

Which brings me to my last point for today. As I was walking out of the hospital I got an SMS from my Aunty saying that my cousin had just given birth next door in the private hospital, so I promptly turned around and went to visit the mother and child.

My cousin and I aren't really close or anything, but it was nice to catch up with her and chat about life in general. The baby was really cute and only 30 hours old with a full head of hair. After a long day of operating it was really nice to go and see a brand new baby.

A new person untouched by the burden of chronic disease. A new life just about to begin.

All the Small Things

It's the small things in life that make the 'shuffle on this mortal coil'* bearable.

Like when you have 2 days off during the week due to the public holiday and hospital wide ADO falling in the same week.

Like when you wake up on the public holiday to find that your flatamte has cooked you bacon, eggs, toast and sausages for breakfast for no reason in particular.

Like when you catch up with old friends playing Playstation and playign some random game where you have to crash cars in intersections to score points.

Like when you are looking forward to steak and chips at the university bar after work.

These small things lighten the load and inject some light into the otherwise dull monotony of life as a surgical intern.

Not every day is an episode of Grey's Anatomy (although Dr E and I were checking out hot chicks in the nearby Kid's hospital Cafe at lunch today)

Not everyday feels like you've made any difference.

But sometimes things just go well and your pager doesn't beep too much.

In these moments, one needs to breath and inhale the air before the smoke that permeates around chokes you.

On that random note, I'm gonna go home, eat steak, watch Mc Leod's Daughters on TV and then play Star Wars on my computer.

Zhinger, is this post too long for you?

* Some random Shakespearean way of describing our lives.

Eat...sleep... pancreas!

Today was food day. After working on a surgical rotation for 3 weeks now I think I'm shedding weight at a rather fast rate. The constant walk between the ward and theatres/clinics is about 500m and so I make this trip about 10 times a day and am burning off all that adipose tissue I put on whilst doing psych in Whoop Whoop.

But today was time to put it all back on. We had the weekly meeting with the bosses where the drug companies feed us hot bagels with bacon and eggs and fruit and muffins and juice and theres always tonnes left over. After stuffing my face before the bosses arrived (always good to eat when they are not around so you don't get asked a question by them with a mouthful of food) we had one of those highly specialty-specific presentaions about some new urine test to detect bladder cancers (with a 4/5 false positive rate! it's as bad as PSA!)

We then had a professorial ward round with the head of the department and we bowed and scrapped and laid down palm branches for him and blew trumpets as he walked onto the ward (well not quite... but pretty close to how it went) He charmed all his patients with his refined genteel British accent and joked with them about fire hoses (referring to their bladder function).

Then he nicked off to go chair some meeting about incontinence and told us all (med student, intern and registrar alike) go home and read up about bladder physiology. During my time on the wards I have noticed we have these posters about incontinence which advertise a rather useful government service. Another shining example of the government's effective public health prevention campaigns. A truly ingenius initiative, tailor made to the web-savy patient.

It's www.toiletmap.gov.au

That's right! The Federal Govt went to the trouble of documenting the location of every public toilet in the nation. Never again do we have to get caught out looking for a loo. Therefore since we have such a map, let us draw near to the bowl with confidence... and let us not give up micturating together as some are in the habit of doing.

"Australians all let us rejoice for we are young and pee"

My registrar made good on his promise today and bought me lunch which was very nice for a surgical reg to do. It's kinda as close as they'll get to saying "well done!" so I took it as a compliment. As we were chatting he was telling me about his internship many eons ago and about some advice he was given by his surgical registrar all those years ago.

"Always eat when you can... always sleep when you can... and NEVER mess with the pancreas"

Such wisdom is never unappreciated... esp the pancreas bit!

I decided that since my reg had been nice to me, I would be nice to my med student to thank her for helping me with so much of my work. She's literally saved me hours of discharge summaries and preadmissions so it was the least I could do. So we actually left the hospital building and walked up the road to have coffee. I realised that there actually IS sunshine during the day. That life exists outside of the Zoo during the day.

Having eaten so much food and wasted most of the morning I decided to do some real work and went back to the ward. Got to remove a nephrostomy tube all by myself (registrar just said "cut it and pull really quickly!" - thanks for the great supervision there! haha) and afterwards the patient gave me the biggest reward of the day. She told me I was a great doctor and that she believed I was in the right profession. She knew my old 3rd year clinical tutor and said that if he taught me, I must be one of the best (ok, now I'm starting to blush). She said that she knew that doctors must get a lot of complaining patients but that she wanted me to know that she would always be thankful for us, for they way we help people and the way we treat people with respect. She told me that whenever I had a bad day I was to remeber her words and she hoped that in some way this woudl keep me balanced.

It was like a divine intervention or something. After dealing with my awful NESB patient all week (who is still acting like a pork chop and causing me grief and sleep loss due to nightmares), I was so humbled by this lady's kindness to me. All I had done was take time to listen to her and not pull her nephrostomy tube too painfully and she knew exactly what I was feeling.

I walked out of that room humbled. Somehow amidst all the rubbish I had to deal with, that simple honest gesture of thanks had made it all worthwhile.

It made things right again in this crazy world.

Nurses, Nutcases and Nocturnal-Surgery

Today I was walking back form lunch when I bumped into an old highschool friend I hadn't seen in years. We were really good friends in high school and she even dated my best mate for a bit. Anyways, when we were in high school we used to talk about our dreams for the future and whilst I wanted to be a doctor, she wanted to be a nurse. We always joked that one day we would start up a clinic together and she could work for me. Well it seems 7 years later we've both achieved what we initially hoped for. She's now a nurse at The Zoo and I'm now a docotor at the Zoo. It's kinda cool to think that your high school 'aspirations' can actually come true. She hasn't changed a bit and definitely puts the pharmacy chick to shame (sorry Big D).

At the moment I am being stalked by one of my patient's families. He is a NESB* who keeps coming back to ED complaining of urinary retention even thoguh we've explained to him it's due to his straining from constipation. So everyday we have this huge discussion with him about why he's not peeing and what to do to and yet somehow he doesnt get it. His family (all 17 billion of them) keep asking the same questions and demanding to speak personally with the consultant (they're public patients! they dont GET to see him!) amd generally making my life hell.
Today his daughter in law grilled me nonstop and kept ranting and raving for 20 minutes whilst I got earbashed by her and then my reg finally caleld her back to 'keep her informed'. Then 20 minutes later I was accosted by a different daughter who was extremely passive aggressive and enquiring as to whether I had been to medical school at all (and yet she hersefl was an expert cos she was a 'natural remedy' practitioner - pff!)

I find myself slinking around my own ward tryign to avoid them as much as possible. They make my life hell and for no good reason. Argh!

Other than that, work has improved the last few days. Have managed to go to theatre a fair bit and fly around in my blue scrubs looking like a real doctor. Did an overtime last night and cruised through and even managed to assist with an appendicectomy (was on call for theatres) and make it out relatively on time. My reg said I'm doing okay and he's offering to shout me lunch tomorrow (which I think is a good sign?)

One of my mates from med school says I prob care too much... I think he's right. I just can't dissosciate myself and 'switch off'... I've tried to supress my altruism but somehow I DO feel responsible for them. It's one thing to not care, but it's another thing to get over invovled...


*Non-English Speaking Background - a particular breed of patient that are just horrible to deal with due to huge extended famillies and poor communication/'cultural' issues.

So Dark...

Today I discharged 4 of my patients... and one of them was a 'terminal discharge'

What an awful way to say your patient died.

It makes it sound like they've gone to the train station or something.

Yes, Mr Blah didn't make it throough the weekend. Apparently his wound started oozing heaps of stuff (it wasn't his potassium!) and his poor health just couldn't cope with it all. This is the first patient with whom I've had ongoing care whose died on me. And although I shouldn't, I start playing the 'What If?" game...

What if I had checked his potassium earlier and given him supplements early?

What if he hadn't come out of ICU so quickly?

What if he hadn't had the operation at all?

In the end I know it's not my fault, but somehow I feel like we lost... we tried to beat death and this time death won.

And to make it worse, today we were finally dicharging one of our patients who has been in for a record 75 days. After multiple pulmonary emboli and bleeding diathesise he was ready to go home on light anticoagulation (INR 1.9) We had his meds ready, his transport booked and his bags packed. He was waiting for his ride to take him out of hospital when he started peeing blood everywhere.

Not a good sign!

Apparently even sub-therapeutic blood thinning didn't agree with this guy and so now he's bleeding away and we gotta keep him in whilst we try to work out how to get the right balance with his blood to prevent clots but ensure he doesnt bleed out on us.

He decided to do all this to us just as I was about to go home at 4:55pm. And then another patient decided to as lots of questions I couldn't answer about his condition (I'm an intern, not a specialist!) and before I knew it the nurses were asking me to sort out all these other problems.

Now I usually dont mind staying back a little bit... but it really annoys me when I work really hard all day so I can get out on time and then like clockwork all my patients crash late afternoon and make me stay back late... I really hate this job! At leats in a paperpushing job you can get your work done early and go home early... not so in the Zoo

Working tomorrow night which means a 17 hour day at the Zoo and then another 7am start the day after.

I think work is making me depressed. I wake up feeling sick just thinking about the day ahead. I find myself doing anything I can to get away as soon as possible.

Surely there's gotta be more to life than this? This is not the way things should be!

Sigh!

The Adventures of Super Scrubs

Once upon a time, there lived a doctor named J who worked in a magical castle/Zoo and who had 2 older ugly step-sisters/registrars. Now unlike most fairy stories, these step-registrars were generally ok to their poor younger colleague but would make him do all the menial cleaning-type tasks such as ordering tests and consults whilst they got all the fun chopping people up in theatre.

Now usually in regular-type fairytales the downtrodden protagonist wished that they too could do whatever it was that the older oppressive-type people did (like go to the ball or do surgery) but Dr J had neither aspirations for either going to the ball or slicing and dicing with scalpels.

But one day the fairygodmother/consultant said "You should go to theatre young man! And wear these silly gumboots and blue pyjamas like the rest of us!"

So the fairygodsurgeon waved his magic scalpel around and voila! Dr J had a quiet day and made it into theatre to watch a magic camera get stuck into some old guys prostate. But his funwas not to end there. That very afternoon another surgeon type figure was performing an entire list of paediatric circumcisions in the adjoining Kiddies Hospital. So Dr J all dressed up (minus the gumboots cos he thought they just looked plain out ridiculous) spent his Thursday afternoon watching little boys get their hoodies snipped off. And as if this wasn't the tip of the iceberg, he was then allowed to scrub in and assist in an adult circumcision with the step-registrar.

Poor Dr J had never seen so much blood pouring from such a magical organ and began to feel quite nausetious and squirmish. He kept being told by the step-registrar (who was a female and prbably not aware of the social etiquette for such body parts) to "Squeeze it harder" whilst she slashed it open and fried it with her magic cautery wand.

Eventually he finished, however the step-registrar wanted him to stay scrubbed so he would assist with an orchidectomy (removal of the tesiticle) for someone with a 10cm tumour (to which a nursing unit manager replied "Isn't that the normal size?").

Having just semi-emasculated several males, he was in no mood to chop someone's source of testosterone off, and just at that moment his magical pager beeped loudly. It was the evil King of Pathology summoning him to the phone but alas he could not answer because he was in a sterile green dress so the nurse answered the phone for him and yelled to all in the theatre "Oh hey J, it's pathology apparently Mr Blah has a potasssium of 2.7!"

At that point the step-registrar relaesed her control over the intern and allowed him to go attend to his dying patients on the ward and herself summoned the other step-reg to assist her in her evil schemes.

So Dr J returned to the ward where he belonged and they all lived happily ever after (except for poor Mr Blah whose health was of questionable state and may not have survived the long weekend. Only tomorrow's team list will tell. Stay tuned!)

Dr J's Movie Reviews

Match Point

Went to see this Woody Allen film with Dr D and Dr K the other night in the city and mistakenly thought this was gonna be a chick flick. Instead it turned out to be a rather ugly film about relationships and lies and deceit and lust. Not exactly light popcorn fare, but it was a very interesting movie.

You walked out of the movie feeling extremely uncomfortable and ugly. And yet that is what the director wanted you to feel. You were supposed to see the mess that lies and broken relationships caused. It was awful.. but artistically awful.

Made me realise just how awful we can be as poeple towards each other... we try to dress things up and pretend like we're nice people, but underneath all of our facades lies the potential for us to be truly horrible people.

Perhaps Love

On a much lighter note, durign my Friday overtime I managed to have enough time to squeeze in a DVD and watched the Asian hit movie-musical of the year in 2005 entitled "Perhaps Love". It was an awesome movie that intertwined the stories of 3 seperate love triangles involving the same people into one beautiful story. It also helped that the actress was really charming and had a real presence on the stage. Luved listening to the mainlander Mandarin in it (much more articulate than Taiwanese) and am def considering buying it once I find a store that sells it.

I must say that it wasn't as good as Sekia no Cushin de, Ai wo Sakebu, (my favourite Jap drama/movie about the sweet girl Aki who falls in love with Saku and then develops leukaemia and dies a slow sad death) but it was still very very good and the production quality was similar to Moulin Rouge.

Blood will have blood...

"I am in blood stepped so far, that should I wade no more, returning were as tedious as go o'er"*

"Whoever sheds the blood of man, by man shall his blood be shed"**

Blood.

It's a interesting substance. Made up of clotting factors, platelets, white cells, antibodies and the ever famous red blood cell.

It's something I deal with every day and yet it's something pretty amazing.

On Good Friday I was working the geri's ward and happened to be in a rush and forgot to grab some allergy free latex gloves to perform a cannulation. Now if I was actually any good at cannulating this wouldn't have been a problem but cos I couldn't cannulate the aorta if it was opened up for me on the OT, I somehow managed to get some old lady's blood all over my hands.

I really doubt a 87yr old granny was at high risk of any blood borne viruses and I had no open wounds, so I declined starting antiviral therapy. But I walked out with my hands covered in blood.

It's a rare sight in medicine.

Normally we wear gloves to protect ourselves both physically and emotionally from the procedure we are performing. We seperate ourselves from the fact that we are spilling poeple's lifeblood all day long in small doses.

Blood is something personal. It's what keeps you alive and gives you your energy/life. And to take someone's blood is to take their life from them.

So I sat there on Good Friday, looking at my blood stained hands and remembering the significance of what I was doing.

Because 2000 years previously another person sat bleeding on that Good Friday. A man whose blood I also carried on my hands (in responsibility).

This man however wasn't getting a cannula put in, he had a spear put in. Roughly into his spleen and by that time his blood had coagulated into fluid and jelly-like substance. This man's blood was taken with consent, not for his own treatment; but for the treatment of my disease.

A disease that was much worse than anything I would face on that Friday shift. In fact, the one true disease that would be the cause of all other 'diseases' in the world. A pathology called sin.

Whilst Good Friday 2006 was spent by me trying to stop people from dying, Good Friday 33 was spent by Jesus actually breaking the power of death itself. Kinda makes my efforts look kinda futile.

You see blood is more than just haemoglobin. It's a symbol of our life itself. The blodo bank knows this when they ask for you to "give the gift of life". Blood is synonymous with life.

And one man's blood brought new life to the world. Not the kind of angstridden life we all trudge thru on this world... but real life... a restored relationship with the one who made life in the first place.

All the medicine in the world can't stop you from dying. It seems to have a 100% strike rate. But one man was seen to have come back after being clinically dead for 3 days... and if he says he knows the secret to beating death... well I reckon it's worth listening to him.

* What I can remember from Macbeth
** Genesis 9:6

A New Slave

Today I finally received my very own med student!

She's a 6.02 model (6th year term 2) and seems to be a quality Asian version, not one of those cheap European brands.

She paged me around midday asking if she could come and help. I told her to join me in preadmissions and next minute there was a knock on the door.

And in walked my friend F!

Of all the med student to gain I got one I already knew quite well. So instead of all the trivial niceties, she was more than happy for me to shove her in another office and get her to do another preadmission for me!

I managed to con her into taking the blood... examining the patients and I just signed off at the end. How great is that?

Afterwards I took her to theatre to meet the reg and consultant and my reg was so nice to me cos he said "Well F, you're a 6th year and should be starting to act like an intern so on the wards you shoudl be helping Dr J with his work so you can get preparred for next year"

Yeah baby!

So now I have a personal slave! Someone to help me whe it's busy and do some crappy jobs for me when I don't want to do them.

With her assitance I did my preadmissions a lot faster and so I made it into the operating theatres today wearing scrubs for the first time this year.

Whenever I don the magic scrubs I feel like I'm someone special. It's like my Superman cape that gives me magic powers (even thoguh they are just shabby pyjama pants - but then again Superman wears his undies on the outside so that's quite the norm for superpowers).

Dressed to impress I stride around the wards like I'm some kinda hot shot surgeon. I even extend my neck and pull my shoulders back so I look the part. When I'm in those sexy blue scrubs I AM a surgical intern. I am one of the elite.. like the comedians on Scrubs or the love-lorn Meredith on Grey's.... I am part of their inner circle... I am one of the interns who the rest of the world wanna know about (evidenced by the numerous TV shows about us... but not garbage collectors)

I bumped into another med student I knew today when I was conducting my aforementioned fashion show and the level of respect I got was superb... I felt like I could hear the theme music of ER playing in the background.

Anyways, today was a lot better than last week. I felt more under control and knew the sytem a lot better. We're even discharging the few remaining patients we have left so tomorrow I should be able to spend a long time in theatre.

Ths is the life!

Dr J's back (alright!)

I must first of all humbly offer my apologies for not having written in over a week.

Betwixt the trip back and the chaotic first week of being a surgical 'tern I have failed to keep my readers updated and neglected my blog.

So I aim to rectify this with one almighty big sum up of the past weeks events and perhaps it wont be too boring.

The trip back from Whoop Whoop was made in a good time landing me home before the stroke of midnight fell. I almost died however when a car travelling in the opposite direction doing 110kmph decided to veer into my lane at the last minute forcing me to swerve and only just missing a head on collision and a date with the orthopaedic surgeons.

The first weekend back in Sydney was a bit chaotic with housewarmings and 21sts and catching up with long lost friends (10 weeks can make you feel like you havent seen your friends in a year or so). I began to wonder whether I was just getting old... cos it really feels liek I'm no longer the 'young' uni student I once was. I'm somehow 'expected?' to be a more mature person... a more boring person? Who knows?

And so ended life as I knew it on that last Sunday night... as I kissed goodbye the vestiges of Whoop Whoop and adopted my new role as a surgical intern.

I woke early and got ready for my first day at 'big school'. I ironed my shirt with care and constructed my neck tie with a precise Windsor knot so as to make a good first impression. I arrived early and even got the updated team list ready for my reg's.

And then it began...

My first reg (who has the same name as my best friend from med school - but incidently is nothing like him) strode into the ward and conducted a Blitzkreig raid of his patients, pauing only briefly to fnd out where the next patient was.

It was fast, it was furious... it was over in 5 minutes!

I hadn't even written my name in the notes before we had moved onto the next patient and by the end of it I had no idea what was happening with any of the ward.

Then the female reg waltzed in and conducted a similar military style operation ward round before bolting to chop some people open.

So I slumped into the nearest chair and looked at my watch. It read 7:30am... and for the rest of the day I would be on myown to 'fix' the patients and organise everything from their Xrays to their trip overseas (I kid you not! I had to send one guy to Lord Howe Island!)

After the days in the Dungeon where I was gently led by my friendly registrars, it was a big shock being dumped on my own. Now it wasn't my new bosses faults. They are great doctors, but I'm just not used to doing 'real medicine' yet.

And so began a terrible week of 'teething' as I tried to figure out WHERE the Xrays were (no online radiology yet in the Zoo) and how to find the specialised Urology theatres. My pager beeped more in the first day than it had the entire 10 weeks in Whoop Whoop and by the end of the 2nd day I was becoming quickly sleep deprived.

Highlight of the week would have to be getting my first catheter into someone's bladder. The poor guy was so nervous so I didn't tell him it was my first time too and I grabbed his willy and threaded the tube into his bladder until out flowed the golden liquid into the pan. I must say I've never been more excited to see urine in my life (and by the sounds of it neither had he, cos he drained 950mLs)

One day I was asked by my reg to organise a medical consult for one of our delirious patients. The guy was pretty sick and we couldnt find anythign wrong with him so we asked cos we were pretty worried. SO I call up the reg on call and he tells me to call the other team. SO i call the other team and they ask me to call the original guy... I keep getting bounced between the two registrars so in the end I went to see my reg in theatre and ask him for help. He told me to document who I spoke to and when and then he calls their boss directly on his mobile phone to ask for a consult. Very soon after we had an angry reg calling back to give us the consult we were after... it's so unnecessary but sadly a way of life in the Zoo.

Then on Thursday at 5pm as I was about to leave I was called by peri-op to admit a patient who was having a rad cystectomy the next day. However this old guy had been worked up by the old intern and declared as 'fit for surgery' but when anaesthetics took one look at him they said "no way Jose!" But then I found out my boss had cleared his entire day to chop open this guy so if he wasn't going to go ahead my boss' entire day was ruined. So the poor tern (ie me) had to beg the anaesthetist to go ahead with the operation even though I agreed the guy prob shouldnt be operated on. The anaesthetist said "If I feel he's a bad candidate, I'll just cancel him.. I dont care!"

I left hospital at 7pm feeling like a failure for not having convinced the anaesthetist to put our patient under, and I was fearing the fury of my boss the next day.

I turned up early on Friday to make sure that I could beg for mercy form the reg before the boss found out. But as I preparred my final speech, I saw the anaesthetist sitting at the desk, looking very unhappy writing in the notes of my patient. Apparently my boss had called him and said, "I dont care, I wanna operate on this guy... just do it!" And instantly the waters parted, the heavens opened and my patient was on the table to be chopped open. (as an aside, the surgery went well and he's now in ICU recovering)

I feel like being back in the Zoo is:

a) very disorientating - I keep getting lost in the rabbit warren known as Radiology, I can't work out how to order certain tests or how to find my way to the RMO room in less than 10 minutes.

b) stressful - the nurses here are more stupid (everyone agrees), the profile of the patients is 'sicker', their relatives are more anal, the regs are more scary and you don't see the other RMOs as much

c) tiring - I'm working much longer hours and really don't think the surgical starts of 7am are suited to my body clock. Walking all aorund the Zoo is either gonna make me fit or give me premature arthritis.

d) depressing - not seeing the sun most days makes you fell like the days don't exist and you only ever see darkness when your outside. Not talking to your regs most of the day makes you feel isolated amongst the thousands of staff here.

However, on Friday afternoon, just as I was about to go home I rounded with my reg's one last time... and both of them, seperately commented on how they thought I was doing a really good job so far. It was a small compliment... but given how rough the week was, it meant more than they will ever realise. I went from hating my job to feeling worth something. I fel tlike I could face a whole other week of this based upon their small feedback. Is this normal? Or am I just losing the plot?

On another note, the love life of a intern is again, never smooth sailing. Met this really nice girl during the last few weeks and I started to think "Wow... she's pretty cool!"... we had a few long chats and she even laughed at my jokes (always a good sign!) however my shortlived liking came crashing down when I found out she had a boyfriend. Why are all the good ones not available? Sigh.

Again I reiterate the motto of my flatmates. "Girls are evil, throw rocks at them"

Fini.