2007/2008 Update

This is a very underused blog. However it has been an good year so I am in the mood to update.
My last entry was just before I started work! Wow.
The early days of being a junior doctor were indeed pretty tough. Not really intellectually just the sheer work load.

During the "9-5" bits of my job it was all quite routine really. Ward round, urgent jobs (ordering xrays etc, chasing other important reports) , breif break for lunch followed by completing the rest of the jobs (talking to relatives, reviewing the xrays etc ordered in the morning, discharge summaries, writing up IV fluids, re-writing drug charts) then I would finish the day by writing out blood results (and acting on them if necessary) and blood forms for the next day - this is the most tedious job for the junior doctor.

On these shifts I was so well supported with my seniors mostly on hand to help if needed. Although some of my jobs I just had such a huge list of patients that there was so many jobs to do, a lot of which were "Junior doctor" jobs and I was often in the hospital an hour or more after the rest of some of my teams. I very much resented this but I also understand that they did their stint as a junior and it wasn't really fair for them to still being checking blood results and writing blood forms!

It was the on call shifts that were so difficult.

On call consisited of either dealing with the new patients or covering the wards in the evenings or at weekends. New admissions was pretty straight forward - talk to them, examine them, take blood +/- insert drip, order Xrays and get a senior to review. The skill was in doing it quickly. Also at first I was not great at keeping on top of checking results as they came in, also remembering the story after you've spoken to 10 other patients I found a little tricky when we were handing over.

Covering the wards could be an absolute nightmare, especially if you still had a million jobs left from your own patients during the day. The junior doctor was pretty much on their own covering or the little tasks on the wards - 6 of them (the more senior doctors saw people on my request, or if the were asked specifically). Early on I would be so overwhelmed by every task. I would arrive on the ward and be handed a pile of drug charts and a list of other jobs and really have no idea what to do, THEN on top of that suddenly patients would start getting sick - "not passing urine for 5 hours", "low blood pressure", "coffee ground vomit", "chest pain", "seizures", "pain". On top of all the jobs I already didn't really know how to do quickly I would then have a list of people to review and fix!!! Argh!!!

On my first night on call one of my first sickies I called my senior doctor in panic - I bleeped her and she answered immediately - I then didn't even have the flippin notes in front of me and in terror could not remember the story. She told me "not that is what is called being an awful house officer". Two other patients in the room then got a bit ill, none of my interventions seemed to be helping and I felt like I had to stay there until they picked up! I wasted about an hour there while the other jobs were just piling up.

Eventually I left the ward (with a plan to go back) and arrived on another ward with another pile of drug charts and jobs. I WAS SO OVERWHELMED. I realised I had reached my limit so bleeped my senior house officer, she didn't answer, so in the end I bleeped my registrar (more senior). He was one of the nicest doctors I'd worked with. He told me to come and meet him and go through all my jobs. So I went to meet him and obviously immediatley burst into tears....
Oh dear...
Running into an office he sent the senior house officer (who had told me off earlier) to go and look after me, she took me for my first break in 10 hours and forced some chocolate into me (I had not eaten since 12 oclock and it was then 9pm - blood sugar was very low!). She was really very sweet and recalled episodes where she had cried as a house officer.
There were a few more episodes of tears (probably about 4) - usually when feeling pissed off when everyone else had gone home, I was due to leave at 5pm, I still had another hours work to do and no-one was helping me. Other times included when a nurse was very nasty to me (same nurse x 2).

One of the frustrating things about being a house officer was the bleep. I HATE it, I've very much realised that I cannot multitask. Being messaged on a pager every 2 minutes was horrible. If you didn't answer the bleep immediately you would receive more and more messages until you answered it. I was good at answering mine for this reason, but sometimes I would be bleeped 4 times in a row and I would have to write them all down to make sure I had answered each number. Once answering it there are a whole host of frustrating things that can happen (see the Facebook group Bleep etiquette) however I am sure it is much more annoying for the poor people trying to get hold of the overworked junior doctor who can't get to the ward soon enough.

So those are the horrible things. On a brighter note I have worked with so many lovely people. Basingstoke is a lovely hospital. I know so many of the nurses, ward clerks and specialist consultants. I've been sad to leave every job because I was generally well liked (and I liked them) by all the sets of nurses and ward clerks I got to know. I've also had some fab patients, the ones who stay the longest are a real joy to get to know. They are the ones who you see go through the most ups and downs, and a chance to chat with and meet their families.

I am now a first year Senior house officer (SHO) although they do not use that terminology anymore. I am a "Foundation Year 2 doctor" (FY2). I'm working in a general practice and I am really enjoying it. I have NO BLEEP! It's lovely. I spent the whole of last year saying I wanted to be a hospital doctor but 3 months without a bleep has completely converted me! So the current plan it to apply for GP training in January to start August 2009.

Christmas Ball with some of my fellow FY1 doctors

The Summer Ball with some more FY1 friends

So that is being a doctor.
That is not the whole of my life. I am now a married lady! We've managed 4 full months (and 5 years of being together this week!) and I am enjoying being Mrs Hallam.
The wedding was superb, perhaps one day I will type up my thoughts before and after the wedding (I wrote a little diary on the honeymoon).
We were married in Muswell Hill Methodist Church, then had Pimms on the Lawn, a cream tea in a marquee, then a BBQ and Beer in the evening with music a la Juke Box!
Here are some lovely photos:

Hen Night (to see Sing a long Sound of Music)

My Families!

Us
Honeymoon in Corsica
Our house

We have also had some goodnews in the past week. Bex has given birth to another beautiful baby girl - Felicity Joan. Elizabeth who is now 2 and utterly adorable calls her "Itty Jo". Felicity unlike her big sister reached 41 weeks! Becca was absolutely bursting. Fortunately it all happened while we were staying and we were able to see the new arrival 9 hours after Bex had gone into labour. (3 hour labour, then released after 6 hours of being OK!).
We then went off to cousin Katie's wedding! (Not B, R, E and Felicity - they stayed at home.)
She is very little and sweet, although babies are less entertaining than 2 year olds!

Elizabeth the day after Felicity was born

Felicity and Bex in the background

Aww Jon and IttyJo

Alongside the good news we have also had some sad. Aunty Mig mum's sister inlaw passed away a couple of weeks ago. She had been unwell for a while but then was diagnosed with a terminal condition and died pretty much soon after after a very rapid decline. She was a very bubbly lady with a silly sense of humour and a wonderful mum and wife. It is very sad that she went so suddenly, especially when I don't feel I got to know her as a grown up. Here she is looking lovely with mum at my wedding.

Marriage

Very good post re marriage (seen via Liz's clutterbucks blog)

2006/2007 Update

It has been another good year and I thought I'd better update. I'm now an aunt, a fiancee and a doctor! I've also recently been a bridesmaid for my lovely friend Sally.

I have previously posted about becoming and aunt but mini-E is becoming more and more gorgeous. She has two main emotional states crying (usually rational crying as a means to communicate that she is tired/hungry/wet/bored) or giggling. Before Sal's wedding Mini-E managed to silence a room of about twelve 20-30 year olds as we were mesmerised by her cuteness. She's starting to walk around if you hold her hands and help her balance, which is impressive as she is really only 8 months old (born 3 months early).

There she is being lovely at Sally's wedding. Speaking of which Sally asked me to be her bridesmaid... which was very sweet of her and I tried to be a very good bridesmaid, though I don't think I'm great at these things! We had lovely green dresses and flowers made of beads. The main reason for this is that Sally needed to reuse here bouquet as she was getting married 3 times!!! (see their website) Silly girl - she's married an American (Don) so had a UK and American Wedding and also had a separate thing in America to do the legal marriage stuff (it was a little complicated due to visa stuff). They had a great wedding with a cream tea which we might copy :P. It was a brilliant day but very emotionally exhausting as it was very hard to see my little Sally go away to America. Sal has been my friend since she was born. Our parents were at college together and I am older than Sally so I have known her for her whole life - she's also known me longer than any of my other friends. She's pretty special and I was very sad that she's not so easily visitable. Even though in the past there have been gaps between seeing each other. I cried when her car went away which was rather unexpected and embarrassing but I guess it's because I love Sally so much. However on a brighter note Don Rothemich is great and I think they will be very happy... AND I am about to start earning money and can spend all my money flying to Boston to visit Sally and Don!

This year I have also got engaged to my very lovely Jonathan. Jon took me to out for my birthday to see Wicked at Apollo Victoria Theatre (matinee) and we then has a gorgeous meal at JB's restaurant at the Victoria Park Plaza hotel. We then wanted to go for a walk in one of the parks but they are all closed at night. So instead we walked around Hyde Park Corner - and while sitting on Royal Artillery Memorial Jon proposed. It was very romantic and I was surprisingly very scared! For those of you who don't know him he's a computer scientist currently working for a mobile phone company in Farnborough. I met him through a friend when he was doing a PhD in Southampton. We've been going out since November 2003 and I think we're well matched. He's intellegent, funny, kind and gorgeous! :p

My friend Nick Bailey recently took a fantastic photo of the ring. There are more photo's on Facebook.Finally I have finished my degree and they have said I can be a Doctor! Blimey. This year has been tough -I've had placements in Portsmouth -Medicine, Slough - O&G and Paediatrics, Basingstoke - Surgery and Ophthalmology, Isle of Wight - Psychiatry and Southampton - Cardiology. I enjoyed most of them and loved meeting new people. We stayed in Halls of Residence Accommodation throughout the year and so I had new flat mates every 10 weeks! It was hard seeing Jon only at weekends but it meant I prioritised work and play a little better!
I especially enjoyed my team in Basingtoke, also the Isle of Wight and Surgery. Career wise at the moment I would like something more community based, a little more fluffy (less clinical) with elements of Psychology and Sociology as well as medicine, with possibilities for teaching and academia (possibly). I like community paediatrics, mental health, sexual health, and I also like rheumatology and dermatology and maybe general practice. I'm really not sure where I will end up though.

The revision was hard but I work very steadily throughout the year and thanks to onexamination.com I was able to stay reasonably calm at finals. Although I felt that I knew nothing (!!) the online finals questions site meant I put my knowledge into context -and apparently I knew enough to pass my finals. I also had fantastic practical revision session with Leslie and Christelle -see below (and some others earlier on in the year).

I am petrified about starting work... I can handle all the administration, the phone calls, filling in forms, writing notes but I'm petrified about the clinical stuff - assessing ill patients, taking blood, putting cannulas in, etc. I'm just so worried that I won't be able to do it and that everyone will think I'm an awful unsafe doctor. I'm trying to think positively about the things I will enjoy - being helpful and kind to patients, nice old ladies, teaching medical students, being part of a team, becoming competent... hopefully it will be ok..... ARGH...

I start on Wednesday - I'm working in Basingstoke (in the hospital where Greenwing is filmed) and I am doing 2 months of Elderly Care, 2 months of Gastroenterology and then 2 months of Cardiology. Then finishing the year with 6 months surgery. I will update more later. For now here are pictures of me and Jon and graduation and then a photo of Luke & Christelle and Jon & I the 2007 medics grad ball.

Non-Blanching Rash -call 999?

Today I developed a non-blanching rash on my legs. It's a petechial rash (= minute red/purple spot on the surface of the skin as the result of tiny hemorrhages of blood vessels in the skin) one cause of which is Meningoccoal Meningitis and Septicaemia.

So I got a little worried.. but not too much as I feel fine. However after thinking about it I thought that maybe I should be more concerned as Bella had a rash like this once and it turned out that her platelets were almost undetectable which could have led to fatal spontaneous bleeding. It all turned out OK for her but she was admitted to hospital to treat her. Here is my rash, though it looks much fainter here.

After debating whether I should go and see the GP (note NHS direct says that with any non-blanching rash you should phone 999). I called Christelle instead to ask her advice. We decided I should go and see the Nurse instead.

I managed to get an appointment with Judith who is a lovely nurse who took one look at my rash and then went to get the doctor. In comes the doctor and agrees that it is a petechial rash. No one was worried, as I was too well, but they agree I was right to come and get it checked out (don't ever ignore a non-blanching rash). They made sure I didn't have a temperature and dipped my urine and told me to go to A&E if it starts spreading. I also have to go and get some blood tests on Monday. (I think I will let one of my friends do it! Tee hee.)

It's probably just nothing (or a viral illness) but I could have some sort of weird post viral thing as I was a little ill over easter. It could be:

Idiopathic thrombocytopenia (ITP) - which my friend Bella had.
Henoch Schonlein purpura (HSP)
And some other things...

Lets hope it's all ok!

Southampton SCM

Just thought I'd post this article about CU on my blog. They've made a fantastic reference to Southampton's Student Christian Movement Group after chatting to Mel who succeeded me in being this years president of SCM. I'm so proud of her and of the group. It's been really successful this year and it's great to think I was part of setting it up.


http://www.wessexscene.co.uk/article.php?sid=1914

CU in court!
Saturday, 23 December, 2006 Four Christian Unions across the country are set to sue university authorities after they were banned from official lists of societies and had the associated privileges withdrawn. The CU’s are charged with failing to provide equal opportunities by excluding non-Christians and promoting homophobia.

The dispute arose as Christian groups refused to allow non-Christians to address their meetings or sit on ruling committees, or to make themselves more inclusive to homosexual or transgender students. The societies at Birmingham, Edinburgh, Exeter and Herlot-Watt universities will no longer receive funding from their student unions, or be able to use union facilities.

The student unions say the Christian groups are discriminatory and non-inclusive. There have been problems since last year where the Christian Union in Edinburgh was banned from placing copies of the Bible in Halls of Residence following complaints from other students. The Edinburgh CU is also accused of teaching a sex and relationships course that promotes homophobia.

At Exeter, the CU has changed its name to the Evangelical Christian Union.

The groups themselves believe that they are being singled out as a "soft target," and that their religious beliefs are being driven underground, contrary to the principle of free speech.

Pod Bhogal, head of communications at a national umbrella group for Christian Unions, claimed: "The politically correct agenda is being used to shut people up under the guise of tolerance when, in fact, you tolerate anything other than the thing you disagree with." He added that Christian students faced an "unprecedented" struggle. His group represents over 20,000 people.

Southampton University has had no such problems with its Christian Union; however, requests by the Wessex Scene to the Southampton University Christian Union has elicited no response.

Southampton University is also home to the Southampton Christian Movement, which paints itself as a liberal and tolerant Christian society. Their website outlines their mission statement: "We aim to bring together students of all backgrounds, religious and non religious, to explore the Christian faith in an open-minded and non-judgemental environment.

"Our diversity is a gift to be celebrated. We recognise the importance of respect for and openness to other faiths. Thinking through and questioning our faith ensures that it remains alive and dynamic."

At the time of going to press, the universities concerned are all taking or considering taking legal advice. Further developments will be tracked by this newspaper.

Christopher Dean

Ode to Bob

I have finally decided to write about my cat bob. She died a few months ago but I couldn't blog about something so sad straight after the entry about mini-E.

Bob came to live with us when she was a kitten with her sister Scooter who died much sooner (both were killed by nasty London motorists). bob was the best cat in the world - here are the reasons why:

• Bob never bit or scratched. If she was angry she would mew and wriggle away.
• She knew when cuddles were compulsory and needed and would submit to the forced cuddle "OK if I have to" kind of attitude.
• Bob loved to be chased - to initiate this she would walk up to you (being all cute with "stroke me eyes") and then run away quickly with her ears perked backwards - the chaser (usually I or Ben) would then run behind her roaring and she would run downstairs/round the corner and hide till you got close and then run away again. It was fun!
• Bob communicated with eyes (Hannah Whitworth taught me to blink at cats to get them to relax) - Bob used to look at our eyes to see if we were chasing (wide eyes) or wanted cuddles (prolongued blinking).
• You could stoke Bob anywhere without making her angry - she loved her tummy being stroked.
  
• Bob wasn't greedy you could leave a bowl of dried food for her and go away for the weekend and she'd eat when she was hungry but never excessively.
  
• Finally Bob loved walking round the garden with us. Our house is situated in a large Christian Estate including a small woods. Bob used to lead you round the garden - looking very proud to be accompanied by her owners. She used to slow down and wait for you if you were too slow and run to catch up if you overtook her.
  

I miss our cat. Although I don't miss the live/dead animals she bought in the house.

Pharmacology Conference

This Week I went to a pharmacology conference in Oxford. It was an exciting experience (though science conferences aren't that thrilling!). I had previously won a university prize in Clinical Pharmacology which had led to me being asked to present a poster at the British Pharmacological Society Winter Meeting. I made a huge poster (90X120 cm) and had to talk about my BSc project to lots of scientists -which was initimdating. Still I felt very grown up and professional. :)

Interesting to compare siblings religious viewpoint

Like Becca I scored as Emergent/Postmodern.
"You are Emergent/Postmodern in your theology. You feel alienated from older forms of church, you don't think they connect to modern culture very well. No one knows the whole truth about God, and we have much to learn from each other, and so learning takes place in dialogue. Evangelism should take place in relationships rather than through crusades and altar-calls. People are interested in spirituality and want to ask questions, so the church should help them to do this."

Emergent/Postmodern		75%
Classical Liberal		61%
Neo orthodox		50%
Modern Liberal		43%
Roman Catholic		43%
Evangelical Holiness/Wesleyan		39%
Charismatic/Pentecostal		32%
Reformed Evangelical		25%
Fundamentalist		4%

What's your theological worldview?
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