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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.

Saturday, 13 June 2015

What being a doctor teaches you about life

Happy weekend, chaps and chapesses from one EXHAUSTED lady.  This week the humidity and heat went from zero to 100 in one fell swoop, and no amount of fans and AC have made sleep a whole lot easier.  I'm hoping that seeing as I've survived Indian/Malaysian/West African levels of humidity that I'll get used to it.
More lovely sunsets courtesy of East Rock.
In my exhausted state, I have therefore had a lot of time (lying perfectly still in hopes of catching a light breeze...) to exercise my brain instead and do the sort of 'life pondering' I enjoy, strong amongst which is the fact that soon I will be returning to my other job as a doctor.  Now that I have a rota and even a list of names of those I'll be working with (one of whom is a great friend of mine - win!), it's starting to seem a little more real.  But a year away from night shifts and 12-day work marathons (which is what I'll start on - whoop!) and ward rounds etc has given me some valuable time to consider what being a doctor has taught me about myself and life. So here it is - life as seen from the hospital applied to the real world:

- Man is not meant to be alone - all junior doctors will have at least one story (usually zillions) of the confused older man or lady admitted because they are 'off legs'.  Acute delirium means they have no idea who they are, who you are, where they are, why they are there and what the hell is going on.  When these patients are alone, it is as if they are lost to us completely, no longer people but instead bodies with organs and problems.  When they have loved ones, family or friends, there, it is as if a key unlocks something familiar and they become something of themselves again.  To me, every time, it is like magic.  So yes, man is not meant to be alone.

- Laughter is Very Important medicine - I feel I don't really need to say much more about this one other than to add that laughing my head off has got me through some of the most miserable days, and that some of my oldest, fittest patients were the ones who lived with joy and a giggle rather than misery and a scowl.

- Sometimes you have to say things you don't want to say, and people have to hear things they don't want to hear.  I mean, this is totally the pits.  I remember the first bit of truly terrible news I had to deliver - a patient who had somehow got the impression their cancer was 'cured' (it was a kind of cancer that can't be cured), and I had to tell them and their extended family late one evening that it had not only returned but spread widely.  They teach you at medical school about delivering bad news, with 'warning shots' and all the rest of it - but telling people things when every part of your gut and heart is screaming 'NOOOO!' is something I find incredibly hard.  Sometimes to care is to say the things no-one wants to hear (including yourself), and being ok with being a little bit hated for it (including by yourself).

To address any under-eating: Totally not my usual 
food vibe, but a cook-out triumph nonetheless!
- Looking after yourself is extremely important.  I set this in the context of a recent heated debate shared with a group of American friends where we were discussing weight and under-eating at times of stress.  I learned during my emaciated London days that when I'm stressed, my body goes into some kind of weird shut-down mode and rejects any kind of food - thus eating (or not eating) is something I take pretty seriously, particularly because, being a thin bean, I haven't got much to spare! When stressed on a night shift or whatever, it is easy to put yourself second to your patients all the time - and every time I feel guilty for saying 'No' (cardiac arrests etc excepting, obviously...) to have just ten minutes to eat some food and drink some tea.  But you can't look after other people unless you spend just a smidgeon of time looking after yourself.

- When you are at your lowest and most miserable is usually when something amazing is going to happen - WHY?!  I don't know (genuinely!)!!  I have come to value the times when I have felt SUPER low - both clinically and in the lab - when I felt totally swamped during my most traumatic on-call night shift, my audit was sapping all of my time with no discernible progress, or I had to throw SO MANY experiments away and hope that Experiment 3000 (that's how many single cells clones I screened) would work.  But then one patient said thank you, the audit ended up winning a prize, and of course I found Gary the Clone!  Which is why I never, EVER give up hope in things or people, especially when I'm feeling low - because only when you stick at something at its most desperate do you give it a chance to convert into something awesome.  Perhaps being at the lowest, worst point is what is needed for the very same things to have a chance of reaching their full potential?
Lake ZOAR! Love that it sounds like something from
Star Wars...
- Never lose faith in people - it takes a lot, and I mean a LOT, for me to dislike someone, including colleagues.  We've all had colleagues we don't get on so well with.  One of my most controversial colleagues did, however, spot, diagnose and manage a patient who rapidly became unwell at a point when our senior colleagues weren't entirely sure what was going on.  She can also be credited with a lot of what I am doing professionally now.
For what it's worth, I don't think there is anyone I actually dislike, apart from the obvious ones (Hitler, Stalin etc), but I think they are somewhat beyond redemption.

- It is far, far better to live driven by love than hate - life experiences as well as my job leave me in perpetual awareness of how short life is.  And my patients never told me about the things they hated - they would tell me about the stuff they loved and the things they missed.  The circumstances that led some patients to be in the Intensive Care Unit I used to work in were often so cruel and so random that it was hard to not question the fairness of life itself.  I've said before that my quick-to-forgive nature is often interpreted as my being a pushover, and how I see it as quite the opposite - and also living in hate makes me mega sad, and I don't like to be sad (who does?!).  And so, even when I say hateful things, it is only ever driven out of love, because I have seen how quickly life, or even just our minds, can be snatched away.

- Everyone makes mistakes.  It's how you forgive yourself, respond to and move forward from mistakes that's important.  And anyone who criticises you for getting stuff wrong is just hiding the stuff they're embarrassed to have messed up (or clearly has no insight into the mistakes they've made, which is infinitely more worrying...).  This is the best Ted Talk I've ever watched - and helps me to forgive myself a little when I think on the mistakes I've made.

- And finally - don't be afraid to give a little of yourself. I was recently reading about the remarkable Paediatrician and Aid Worker, Dr Annie Sparrow, who said 'The more loss you go through, the more you can share with other people'. Or as John Keats would say: 'it seems to me that we should rather be the flower than the Bee - for it is a false notion that more is gained by receiving than giving - no, the receiver and the giver are equal in their benefits'. The only way to survive, I'd suggest, when you live professionally with loss, but also when living with loss, whatever your definition of this is, in life.
In sitting here writing this, moving only to tap on the keyboard, the breeze has totally done its job!  It's almost like the weather knew I was in need of salvation or something - something I am more than happy to send on to others I know who need it right now.  I get overwhelmed sometimes when I think about how much I still have to learn about the world - but feel very lucky that through my job I am given a glimpse into so many aspects of human life and nature.  What else can I do but to try and learn from it?

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