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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Friday, 23 August 2013

How much game face is too much?

If there were an Oxford dictionary definition, it would read something like; 'noun - used to describe the ability to hide one's true feelings and thoughts behind a face that suggests you are neither affected nor concerned by what is happening.'

Doctors are GREAT at game face. I do sometimes wonder whether, personally and professionally, we've got the balance a bit skewed.

Professionally, some would argue 'Game Face' is crucial. On my oncology job, it would have been curtains if I'd fallen apart with every tough conversation or breaking bad news encounter. Yes, these discussions may have been difficult for me to bear personally, but you've still got to get through your shift so that they and the other patients don't suffer.  Further more, it would almost be selfish to imagine that any news you deliver to a patient or their families is more upsetting to you than it is to them.  Your job is to be empathetic but 'the rock'.  I'm now working on the intensive care unit and the emergency admissions unit, and you can imagine the range of traumatic situations one encounters on a daily basis.

For me, all of this has evolved somewhat since losing my friends. Being in ITU has been especially challenging because my friend was in ITU after the avalanche.  I know exactly what it feels like for those families who come in to an environment with all the beeping machines and almost space-like sterility. Someone comes and tinkers with a machine and then walks off again - what were they doing? What does it mean?
This is Una in a nutshell! From her wall at her flat in Edinburgh.

But almost from the start, I have felt that wearing too much of the mask means you lose why you became a doctor in the first place.  People know when you're not being real. No-one is emotionless - and so I have let the controls go a little and have a bit of banter in the more light hearted moments, and, to an extent, wear a little of my heart on my sleeve in the sadder ones.

My game face has also changed personally. I think Una and Rachel always saw their own worth, in a very humble way, and channelled it to bring joy to others; I feel this strength from them at a time where I have found myself really missing them.  Sometimes we should just be honest and not be embarrassed by ourselves.

To value yourself helps you to see the strength and character of others, and I think game face can get in the way of that.  But I also think it gets in the way of seeing what is true, good and right about people.  And whether it's in your personal life or at work, whatever work you do, how can you respect and value someone truly unless you're real with them, and they're real with you?

It's been a tough few months, and maximal game face is the only thing that's saved me in bleak moments.  The other thing is being around 'good people' and you know how I know they're good? Because there's no game face, and we're all honest. Boom. It's tough to define what a 'good person' or a 'good doctor' is, but I'd suggest that's somewhere to start.  So come on everyone, retract that game face a little and you may just be surprised....

Wednesday, 7 August 2013

Changeover day!

I am totally shattered, but like all junior doctors up and down the country, it's the first Wednesday of August which can mean only one thing - changeover day!

This time last year, I was a bright eyed, newly qualified doc who got really freaked out when someone called out 'Doctor!' and I realised that it was me they were looking at to solve the problem they had.  One year on, I still get a bit freaked out about the fact I'm a doctor, but I hope a little more calm and finesse has entered my game.

But if you get a slightly baggy-eyed Karin coming towards you in hospital, it's probably because I'm not that bright-eyed version of Karin I was twelve months ago. I was on call three times last week, as well as working the other two days. I was at work all weekend. I worked a normal if horrifically busy Monday before doing another 12 and a bit hours on call today. Then.... I moved house, along with all my other doctor buddies. I've been living out of a rucksack for 3 weeks in between house rents, and today moved out proper into my new digs. But that was nothing compared to my friends who finished their shifts and are moving locations completely overnight - the house I was moving out of had two of us moving out and two people moving in, three of us doing so at 11 at night. Most of us have to be at our new jobs between 7-8am tomorrow morning.

But this isn't meant to be a whine.  It was just quite surreal to work for so long, get home late, eat dinner and then say - 'Right - let's move house!'.

I've scribbled in a couple of places about tips for junior doctors, advice on the first day etc.... My top three tips:
1) Eat lunch. And drink water. This is not optional. You can check bloods while eating if necessary.

2) Ask for help. There are no stupid questions for at least 2 months, and actually not even after that. I ask lots of stupid questions, but I'd rather look stupid and know for next time.

3) Make friends, have some laughs and generally get a team going with your fellow doctors, nurses, pharmacists, ward clerks etc. It's the joy of the job and it will make everyone's job easier and more fun.

For me, it was emotional to the last working on the cancer ward. I got my first personalised card; I nearly cried when I was given it!  It is so true that while you don't do the job to get any thanks, and certainly not on a cancer ward where the courage of everyone around you (patients, family, staff) is just overwhelming, it is just so special to think that you might have actually done your job well and had such a personal connection with a person and their family.

Everything I'm about to say is a cliche, but really, the last few months of working on that ward, in combination with losing my friends in January, have made me feel more full of love for life than I could have imagined.  So my actual biggest tip for new doctors? Try and focus on how bloody lucky we are to do a job that has the scope to make some kind of difference to someone's life.