I fell asleep on the sun longer but I could sense
@DrMarkLander
was looking at me, I thought maybe he was gazing at me thinking about how much he loved me but it turns out he was filming my stonking JVP for educational purposes
Did anyone else’s mum used to make them walk on the inside of the pavement &her on the roadside when you were a little kid, so that if a car went out of control & mounted the pavement it would hit her & she could hopefully shield you from impact? Or was my mum just really badass?
Got the news: surgery was successful, I am officially in remission from cancer
Thought I would go crazy with champagne + celebrations on hearing this, but instead I suddenly feel profoundly tired - exhausted actually - and have an overwhelming urge to sleep for a very long time.
Desperately desperately desperately understaffed due to the NHS Covid app telling Covid-negative, asymptomatic, double-vaxxed doctors to go into isolation for up to 10 days at a time.
This cannot go on.
Staff are going off sick with Covid faster than I can update the rota, so I have had to issue a message along the lines of ‘I am no longer able to state with any accuracy who will be working any day this week - whoever turns up is who you’ve got for that particular shift’
My 1st oncall as a house officer I was called to a patient in pain, who was already taking codeine. What to do?! I was so nervous I called the oncall pharmacist AT HOME for help. She didn’t shout, hang up or laugh; she kindly talked me through the analgesic ladder.
Pharmacists❤️
Night from hell.
Exploring new limits of pain.
All these years I’ve been prescribing oramorph as a ‘strong painkiller’, not realising it does ABSOLUTELY NOTHING.
If you are a consultant and you can hear the FY1 getting an absolute bollocking over the phone from someone for any reason, you really ought to take the phone off them and say ‘hello this is the consultant, how can I help?’, rather than just giving them a sympathetic grimace
I wrote BEN across my chest so pts/staff know who I am under the PPE.
We write job titles as well for easy identification,so I amended to BEN (DR)
Writing upside down on your own chest is tricky..✍️
It looks like I wrote BENDER on my chest in large letters then did a ward round
Shout out to the patients in hospital beds - oxygen masks clamped to their faces, lungs full of Covid, fevers of 39 degrees - who, when asked how they are feeling this morning, look up with a weak smile and pant ‘oh, not too bad doctor’.
Greater heroes than any of us 💙
Junior docs are not children in school, who have nothing else to do out of hours but play and watch TV. They are adults with responsibilities, families of their own, mortgages, plans, lives.
Be careful about assuming they can change work schedules & cancel leave with zero notice
Don’t know about you, but we found every single staff member with covid has been *still* LFT positive on day 6/7, so are still isolating for the full 10 days, rather than returning on day 8.
So I really can’t see anyone being LFT negative on day 5 & able to come back 🤷
Please shut the borders. We, the NHS, is begging you.
Or keep them open but make the hotel quarantine mandatory. We don’t have to do this 3rd wave.
Please please please don’t just stand by and let it hit us.
Do the people in the audience at a lecture who nod their head occasionally at the lecturer when they hear something they like understand the POWER they have?
It’s the most motivating & reassuring thing to see from the podium. Our hearts burst with love & gratitude when we see it
If we ever get to the point in the British healthcare system where I have to give the patient the treatment they can afford, rather than the treatment they actually need, then I’m off, I’m out, I’m leaving.
#NHSPrivatisation
I’ve been on Med Twitter long enough to learn that many female doctors (esp if minority ethnic) introduce themselves as ‘Dr (surname)’ because if they don’t, they get ignored, talked over or assumed to be non-medical staff.
So let’s stop forcing first-name only policies at work
I’ve gone from intrigued➡️amazed➡️worried about the total absence of non-Covid gen medicine in the last 2 weeks. Where are the bread and butter cases of acute med? The NSTEMIs, IBD flares, decomp’d CCF, overdoses, sepsis, PEs...
Where are they? Has anyone seen them? Are they ok??
The last 2 weeks = an experiment in how low you can take NHS staffing without terrible things happening. Like a game of Staff Jenga.
Things have not been a disaster because everyone is working their butts off, missing breaks, doing the work of 3 ppl.
Amazing - but unsustainable
Last clinical shift finished ✅
Nearly every acute admission was Covid, except the ones that were Flu A
Please keep me healthy and virus-free for my surgery this weekend 🙏
When I was a jr dr the ward physio suspected a pt had a hip fracture.I was dubious abt doing the hip X-ray she wanted as I couldn’t believe a whole bunch of drs including the consultant wouldve missed it.But I did.Fracture.
She didn’t gloat, just gave a satisfied nod.
Physios 💙
Was just escorted into a side room on the ward to find an army of junior doctors with cards &presents.
It’s been tough since I got ‘the diagnosis’ but this gesture has floored me. God knows how many of them chipped in to buy £500 vouchers.
@DrMiriDZ
I know you organised this🙏
This is how a dermatologist once explained the different topical steroids to me, and this is now how I teach other people.
Hope you find it useful
(I appreciate this doesn’t exactly capture the nuances, it’s just a general aide memoir...)
Just had my pre-assessment clinic + met my amazing cancer nurse specialist. She was super reassuring and told me I am worrying way too much (“doctors are the worst for worrying”), and gently suggested I stop researching surgical complications + poor cancer outcome stats on PubMed
I love it when pts love their GPs.
“My GP is Dr Ahmed. Do you know him? Ooh, he’s wonderful, he’s looked after me for years. He made me come in. I didn’t want to come! But he said ‘Doris, you MUST go to A&E with that chest of yours’. He’s lovely. You must know him? Dr Ahmed?”
Couldn’t find a large scrub top so I wriggled into a medium and hoped it wouldn’t be too tight. 20 panicked minutes later I was being cut out of it by a nurse with a pair of sterile scissors.
I mentioned to my husband a few months ago how much I adored reading the Enid Blyton Mallory Towers books when I was a kid
Look what was waiting for me under the tree 💚
Jan 2019, the UK governmt published its vision for antibiotic resistance to be contained by 2040, including urgent need to
-reduce unnecessary antibiotics
-reduce UK antibiotics use in humans by 15% by 2024
to prevent catastrophic antibiotic failure for future generations
Today:
Trying to mentally reframe my cancer surgery and 6-week recovery time as a fun extended sabbatical off work, filled with TV, reading, daily lie-ins and chilling in the garden, but my brain just isn’t buying it
Oh dear I’m the boring fart who thinks that we shouldn’t be posting of X-rays of patients on social media, no matter what the poor souls have put into their bottoms. We are undoing our promise to treat without judgement or condemnation if we show patients we’re laughing at them
I often see IV clarithromycin prescribed for severe pneumonia.
Didya know :
-oral clari has same bioavailability at IV? IV is not ‘stronger’
-pts often say IV clari is painful
-IV clari takes aaages for nurses to draw up
You only need to give it IV if the patient can’t swallow👍
Follow up question - does anyone else’s mum *to this day* reflexively put her arm out to save you in the passenger seat if she brakes suddenly whilst driving, because she ‘remembers when there didn’t used to be seatbelts in cars’?
Cancer diagnosis: Jan 2022
Surgery: April 2022
Remission: June 2022
Scars irreversibly discoloured on a beach holiday: July 2022
Finally achieved pre-op body weight: Nov 2022
Finally achieved pre-op fitness level: not yet 😔
As a baby dr in the Lakes in a tiny hospital a pt went into VT arrest @ 4am. I KNEW the ALS algorithm but my brain was mushy w/nerves.Instead of removing me the CCU nurse cheerleaded me through:
‘Compressions Ben! Good, now stop - pulse? Defibrillate, and compressions!”
Nurses🧡
Junior: “Why do patients drop their BP when we start them on CPAP?”
Me: “because the CPAP steals pressure from the BP”
Junior: “Oh. Because I figured is was due to increased thoracic pressure leading to reduced cardiac preload-“
Me: “BECAUSE PEEP STEALS PRESSURE FROM THE BP”
Please please please stop debating with Covid-deniers on here, they have passed through the far end of reasoning, they cannot be debated with, we have to draw a line here
Presents for all of the 17 Med regs, SHOs & FY1 doctors working on Xmas day.
Happy to do this small gesture of thanks, but I must admit there was a point whilst wrapping the 11th gift when I thought that it might be quite nice to be a surgical consultant with only 2 jr docs...🤪
Do I have any theatre folk followers on here? Can they confirm that audience behaviour in UK has become awful in recent years? Really common for people to chat at normal volume all the way thru a show, openly film performances, play on their phones, call out responses to actors
Pain much more tolerable. Walking around, having showers, putting on my own TED stockings.
(Kiwi physio came into the room on day 1 and said ‘show me your TEDS’ and there was a bit of incomprehensible back and forth until I realised she wasn’t saying ‘show me your tits’)
Bloody hell, they have their own entire table at Waterstones.
How long until specialty training applications will offer 8 points for “have you published a bestselling medical memoir?”
#COVID19
has hit me like a ton of bricks. I had rather romantic ideas of self-isolation — reading, doing puzzles, playing piano, watching box sets — but the reality is lying on the couch with hot water bottles &severe myalgia. Honestly couldn’t even get up if the sofa was on fire
ME: being rota coordinator is killing me. I spent hours on it. No one appreciates it. Everyone hates me. What’s the point? Its so complex. It’s burning me out. I hate it. I go blind staring at spreadsheets all day.
THEM: well give it to someone else
ME: nooooo, they’d mess it up
Dear every single healthcare worker & scientist on the planet:
Richard Madeley & Denise Welch are on to us! Our worldwide plot to subdue humanity with a fake pandemic is unravelling.
Let’s all meet at mine later to hatch our next dastardly plot for domination.
MWA HA HA!!
-BL
A GP I’ve never met took a few mins out of her insanely busy day to find out my email address +send me a thank you note on behalf of a patient I saw recently in ED.
Lovely gesture+such an amazing boost for me in a week at work that made me think ‘am I actually doing any *good*?’
Said it before on here: GPs amaze me
What’s coming through the door? A woman w painful periods? 89yo man w depression? A 2-week old baby w/a runny nose? Teenager w/neck lump? Could it be cancer?
No blood results/imaging
They have to be an expert in everything, an expert in risk
Everyone thinks could be a GP. Even father of the year
@hamishblake
reckons it'd be a walk in the park: just coughs, colds and referrals.
Happy to have you sit in my room and give it a go?
I'm tired of privileged folks thinking their experience of health system is it.
Tips for gently waking up in-patients on the morning ward round without giving them a fright?
17 years of rounds, but no matter how soft my voice, how non-threatening my body language, how gentle my hand on their arm, they always open their eyes & then jump out of their skin 😱
Just found out that by working as a consultant for the last year - on an 11 PA job with no private work - I have somehow put too much money into my pension (like I have any say or control over this) + now must pay a tax bill as punishment.
I have to pay bills to go to work now?
That’s all folks!
Last workout for 6 WEEKS, The Operation is this weekend ✂️🩸
I’ve worked out regularly for 10 yrs
I dread to think of what physical, mental +aesthetic state I will be in when I return. I will prob find it very hard to restart & will struggle with motivation
Sick leave is boring. I want to put the same energy into recovery that I do for an exam or a really busy shift: just buckle down, work hard + *get it done*. But all you can do is sit around +patiently wait for your broken body to put itself back together again, maddeningly slowly
I wish I wish I wish I had seen Adam Lambert sing Mad About the Boy whilst two male dancers did a romantic dance on primetime telly when I was a kid, or even as a nervous and conflicted gay teen. It would have meant so much just to see.
#Strictly2022
This morning
@DrMarkLander
locked himself in the spare room for a v important Teams call. (My job was cat-wrangler to make sure they didn’t scratch/yowl at the bedroom door)
He emerged 40 mins beaming ear to ear &is now substantive consultant in Acute Medicine
@WestMidHospital
🥂
We have 15 trainee doctors working in Acute Medicine on Christmas Day/night
Today I have the half-fun, half-chore task of buying them all a little present for them to open on their shift
Doesn’t make up for the pain of working on Christmas, but just a little gesture of thanks
In a turn up for the books I have developed surgical emphysema all over my body. My soft tissues are all crackly, from shin to chin. It’s quite sore, especially around my neck and rib cage.
Seen it so many times on patients but very odd to have myself.
Today one of the new FY1s came up to where I was sitting at the computer - shoulders hunched, teeth gritted, forehead vein pulsating, chuntering to myself - put a small box of Jaffa cakes next to me & said kindly ‘I’m just going to leave these here...’
🙏
The med reg spotted S1Q3T3 in the wild today in a SOB patient & we all clustered around in amazement & wonder.
How we postured & preened in front of the medical students! How we nodded wisely &stroked our beards!
CTPA was negative for PE, making us feel a right bunch of charlies.
I knew the consultant geriatricians at UCLH were brilliant, but did not expect this amazing gift of fresh Italian delicacies as a get well soon present from them.
I continued to be overwhelmed by the kindness of my colleagues
Be careful when you describe a patient as ‘quite tachy’ within their earshot as they can get quite offended because it sounds like you’re slagging off their dress sense
If you felt like a mediocre med student who seemed to understand things after everyone else, or if you struggled with grades & exams, you will be really good at medical education.
Because you’ll be able to explain things in a way that you wished they had been explained to you.
Library is coming along
Here is a little performance on the new piano
Can ya guess it?
It was the first dance at our wedding (not me playing it on the piano on the day though obvs)
(Again, I have artfully concealed my surgically ravaged belly)
Having dinner with doctor friends from Iceland who are visiting the UK to sit their PACES exam.
They are terrified of getting a patient w/sickle cell disease in the exam because ‘there is only one patient with sickle cell in the whole of Iceland & they’re tired of being examined’
I just used my expensive and lengthy medical training to diagnose atropine poisoning as the cause of death Murder She Wrote, TWO WHOLE SCENES before Jessica Fletcher guessed it
Hot meals 24 hours a day now available at UCLH
I actually love these wasabi microwave meals. Normally around £9 in the supermarket, only £3.99 for NHS staff.
3 years ago today that I first went on my yearly trip to Palestine to do some
#MedEd
with their amazing doctors.
Should be there right now, but hey ho.
Here’s Gaza City, the medical school, and my lovely hotel room ⤵️
I’m not a parent so maybe I’m missing something.
But when fathers say they are ‘helping’ by doing nappies/feed/childcare, who do they think they are helping? Isn’t this just parenting?
When the 15 med regs/SHOs/FY1s working on Christmas Day this year come into work and find these presents waiting for them, they are going to be GLAD they get to work on Christmas!!
Ok maybe not but it might cheer them a little.
“And what did you do when you awoke with your central crushing chest pain, clamminess and sense of impending doom?”
“Well first I went downstairs and had a cup of tea to see if that would help”
⬆️Is this a British thing or an international thing?
I’ve only lived in a house for 36 hours but I finally understand the rage when people walk past items on the stairs that have clearly been placed there in order to be taken up by the next ascending person
We keep requesting CTPAs for our patients with Covid - more and more everyday, more than we have ever requested before - and the radiology dept keep doing them and reporting them in record time, never missing a beat, I am really impressed
This is a big deal.
Highly trained staff at a huge heart attack centre have downed tools in protest of finding out their pay will be slashed with 2 weeks’ notice.
Is this the 1st domino falling? Junior doctors & nurses are balloting about strikes very soon. Others not far behind
‘You cannot be an insulin-dependent diabetic & be homeless. You have nowhere to store your insulin.’ They either pretty much live in AMUs/EDs in a perpetual hyperglycaemic emergency or they die.
I knew this but hearing it said out loud in this session is still shocking
#SAMLondon
Officially going to 60% LTFT later this year. Not an easy decision. But after 17 years full time NHS service - which I have enjoyed & during which I built a career I am proud of - it is time to take a little step back.
Plus, despite being told how well I look, I’m still healing.
🐱 “Heyyy, sorry I’m late, did I miss anything? Lemme just jump up here - whoops! was that your piano lid? - Anyway, I was gonna pose like this? With my little right paw at an angle like this? How does this look - it looks cute right?”
Of all the Covid insanities and lies, the ‘hospitals are empty’ is the one I really wish would just die. It is *offensive* to me, a hospital doctor, to keep being told that I am, effectively, a liar.
Need to draft an email to all my 35 junior doctors in Acute Medicine to tell them:
- I’m back from the dead
- I see their hard work
- I’m proud of them
- I’m sorry for what we’re all about to go through
- I’ll train them as best I can during this, but things will be tough
Can’t believe emergency and acute medicine managed to get through 2 waves of Covid presentations only to get annihilated by a wave of post-AstraZeneca presentations
Staggered home after work, opened the fridge and found this.
Husband has gone to his parents for a couple of days and I don’t know how to cook.
Do these ingredients make anything? Please help, I’m culinarily illiterate.