Category: Weekly wonder post

Medicine has long been a journey of wise sage teaching eager student. The medicine men (and women) of ancient times took an apprentice and slowly unveiled the arts of their trade. Even as our profession has been formalised, it relies greatly on the passion and time of seniors to encourage, shape, and water the younger generations. We are not taught how to teach but instead are meant to know, intrinsically, how to communicate our experience and understanding to one another.

As a medical student, it was hard to imagine ever knowing enough to manage a patient and their ills. As an intern, each medication charted initially brought a level of fear. What if this patient for whom paracetamol has just been charted actually has liver failure? What if clexane is contraindicated based on renal function? What if they can’t have metoclopramide because of possible small bowel obstruction or the extrapyramidal side effects of someone with Parkinson’s? Such big considerations for such little effort of filling out the appropriate boxes on the chart. As a registrar, the questions become about bigger picture management and getting a patient safely to discharge. As a consultant, your worries are about juggling inpatient and outpatient concerns, managing your staff (junior doctors, nurses, secretaries, public and private facilities) and the constant demands of training and academia. And at each transition, there are new lessons to be had.

And so it is, at each stage, that the younger generations learn from the older ones. Often the best lessons come from those closest to you in training. The residents teaching the interns how to cannulate, the senior registrars teaching the junior registrars how to operate or intubate or co-ordinate dialysis or manage hyperparathyroidism. The senior consultants teach the juniors how to develop a practice and hire staff and manage their diverse demands. One wonders how the very first medicine (wo)man managed their multitude of tasks.

And so, to help you in understanding the world around you, here are some articles about learning, travel and our planet.

Maybe our practice shouldn’t be just about medications and operations. Perhaps we should be prescribing fruits and vegetables too. And, interestingly, mushrooms (no, not that kind) and nature.

If you are lacking in creativity, perhaps you need to pack your bags and head on a trip. Travelling teaches us lessons we mightn’t otherwise gain.

Until next time, enjoy the little things.

You, like everyone else in this industry, have probably been a part of conversations about physician fatigue and hospital safety in the recent weeks. There has been growing pressure in our system. This critical mass of media has started some rather interesting conversations amongst colleagues.  Of particular interest, for the first time in a very long time, some consultants have started opening up about their own experiences.

I wonder now, as a very junior trainee, how often consultants are able to hark back to their days of training and have frank discussions about the difficulties they faced, or if these conversations are often tinted with the rose-colour of retrospection. How easy was it being the only person on call, in days before mobile phones and e-orders and everyone having two cars in their household? How easy was it to check up on sick patients before the era of external EMR access? What did they do when UpToDate and all of the internet were not available within seconds to answer questions about forgotten facts or unknown pathologies?

Our seniors have been there to guide us and to train us – sometimes with kindness, sometimes with hard love. How often do we make time to reflect and appreciate their human experience?

We have probably all read the articles about our colleague Dr Kadota and how she struggled with unrelenting working conditions in her job last year. Many of my surgical colleagues have paused reading her story, not because these hours seem particularly outlandish, but because (aside from the long stretches of on-call) many have worked similarly long back-to-back days. And, in our little posses discussing work-sleep balance, it becomes clearer how experiences differ. The age-old saying, “do something you love and you’ll never work a day in your life” is less true than the experienced “work with a team that gels well together, and the day will pass more pleasantly.” A fourteen-hour day with a team that enjoys each others’ company and is productive is far more pleasurable than a four-hour day with a dysfunctional unit. It’s not so much about the quantity but the quality of the experience.

I am hopeful that these conversations continue.

As I progress through the health system, I become more and more responsible for the well-being of my more junior colleagues. I feel the anxiety of the new interns bringing me their referrals. I feel their nervousness not knowing exactly what they are asking for or what they should be telling me. I also feel the personal rejection that emanates from them when I ask for objective data that is unavailable, and remember feeling similarly hurt when I was in their shoes. But now that I’m here, I realise that these questions are fact-finding missions that bear no ill against the caller. The more information gathered over the phone, the easier it is to give advice, but the lack of information does not make me angry. It is just is what it is. I am never quite sure if gentle advice is taken in good faith or as a personal attack. And, from seeing altercations between colleagues before, I know that the intended sentiment can be lost between two people not knowing each other very well and not always reflecting on the other person’s stress, workload, or personal struggles.

And so it is that we must learn to forgive ourselves and others, and to recognise that a perceived altercation is not always an intended insult. It may not even be perceived as negative by the other soul.

And so, this week, instead of proffering articles, I am interested to hear your experiences at work and how we can make each other’s lives easier.

The new clinical year is upon us and the Doctors are Human summer hiatus is breaking. Welcome to the first WonderPost of 2019.

For the newest among us, welcome to the fold. Hopefully you had a chance to read the post on starting internship. I sincerely hope you’ve enjoyed your first proper week of work. You will find your feet in no time.

In the midst of all of the media coverage of the plastics registrar who resigned after insufferable working hours and conditions, it might be hard for both the new and old among us to feel enthusiasm for work. While there are plenty of workplace issues that need resolving, I’m hoping we can also all find positives in our work days. There are the great interactions with our colleagues (other doctors, nurses, physiotherapists, dieticians etc), there are the brief moments for a coffee, new tidbits of learning, new experiences, and kind patients. There are the times when you can’t find what you’re looking for and some wonderful person helps you out. There are the moments when you ask a boss for help and they come through. There are those occasional on-call shifts where you actually get to sleep for a solid stretch of time. By all means fight for your rights and claim your overtime. Also remember the good parts, because nothing in life is all good or all bad. On the same topic, I came across this article about how our system is broken. It’s not one of us. It’s all of us and none of us.

To help distract you from everything else in the world, here are some interesting things I’ve found in the world around us.

In particularly old news, here is an article about the young Princess Elizabeth before she became Queen. Isn’t it fascinating what the news looked like all those years ago (and how little the things we care to hear change)?

Many years ago, a friend told me about the history of cannabis and how it came to be illegal. I had been gobsmacked, because until that time I had naively believed things that were illegal were so because they were bad. History is not so simple.

If you’re the sort of person who obsessively carries your KeepCup and constantly worries about your environmental impact, this article will help you separate some fact from fiction.

The patriarchy isn’t necessarily good for men either. Here’s a guy going deep on feminism, the patriarchy, and why we all need to work harder to challenge societal perceptions.

And finally, before making any big-ticket purchases, here’s an analysis on how to spend your money in a way that supports your happiness.

Let us know how you’re travelling. We’re so excited to be back.