Since I started A&E I have received two thank-you letters. In the previous 16 months of working as a doctor, I had never received one before. This is because one does not receive thank you letters for being a ward paper bitch, and one does for being (perceived as) a good doctor.*
This time, a year ago, I was on vascular surgery. I wrote blood forms, checked the results, wrote them in the notes. I wrote down what the consultant/registrar said on the ward rounds, and I wrote the jobs on a list. I did the jobs on the list, which involved writing out radiology request forms, CT reports, duplex scan results, and when something unexpected happened I saw the patient for a few minutes, talked it over with a senior, and wrote it all down.
Today I spoke to a man and his family, and I explained to them that he had a mass in his brain that was likely to be cancer. I gave them a rough plan for the next few days, how he would be admitted, how there would be further investigations, how he would be seen by further sets of doctors, how a long-term plan would be formed. I saw another, younger man who had fallen from a ladder and injured his back. I arranged imaging, discussed him with orthopaedics, who came down and arranged more imaging. I saw a 7 year-old with an injured hand, listened as she told me how she was hit by a football and then felt dizzy before collapsing in the playground, diagnosed her broken pinky finger and splinted it so she could come back the next day for plastics review. I wrote it all down, but it feels a lot less futile than the busy-paperwork that was the mainstay of being an F1.
Of course, it’s a lot scarier too, when it’s so much easier to make a mistake.
*never tempt fate.