In April I took these vows, “I, Medical Marbles, take you, A+E, to be my contractually obliged employer, my constant grindstone, my faithful labour and my job from this day forward. In the presence of my Supervisor, my registrar and peers, I offer you my solemn vow to be your faithful servant, to those who have illness and the worried well, in good times and in bad, during the night and day. I promise to spend time with you unconditionally, forsaking all else, to forget my friends and family, to just laugh and cry with you, and to work with you wholeheartedly for as long as our contract lasts.”
Three days ago I bid a fond farewell to the A+E department (ED if I was one of the cool kids, Casualty if I want to be crucified by the consultants) – 122 days spent on the good ship fun!
It has been one hell of a journey!
It’s hard to summarise a job like this one. On the one hand I feel a little less green, a little more wise, a little better than I was before. But on the other hand I am truly the most gullible person I know, and continue to astonish myself at the stories I fall for and my empathy for society’s most marginalised characters if only they use their manners.
I’ll never forget one man, a face in a department decoratively scattered with drunken head injuries. A series of lovingly hand-tooled porcelain figures: my personal favourite, The Discrete Charm of the Drunk Bourgeoisie.
Whilst carefully trying to replace and suture the half of his forehead which was hanging off from some unexplained, unmemorable incident, he was the most taciturn and good natured patient of my 4 month block. He called me Florence Nightingale, at the time I was hoping it was more along The White Angel lines though looking back probably more Lady of the Lamp – I was shining a bright light in his face for 40 minutes after all. He lay serenely for the duration of my pulling and sewing, this was only punctuated by the odd murmur of thanks for looking after him. I would gladly have cloned him.
One of my funniest moments of this job has got to come from a medical student. A very good student, willing to come in during the night so as not to miss any action, happy to stay late and beyond keen when it came to putting in lines and taking blood. She was standing with me one day when we were waiting for a septic patient to come in. I was asking her what we were going to do, the ABCs of resuscitation: airway, breathing, circulation, the mantra that got us all through med school. That along with the smile and nod technique. We got to ‘C’ and she was listing how we would assess the patient’s response: pulse, blood pressure, capillary refill time, urine output….she was making all the right noises. In an effort to help her remember oxygen saturation (it should possibly be mentioned under ‘B’ but we’d moved on from there) I held up my index finger and gave it a wiggle. She looked at me flabbergast, “a vaginal examination”!
I was warned back in April that this would be one of those jobs that you’d talk about forever. On my last day a text from Surgical Dad echoed this, “don’t forget to savour every moment”. I’ve mentioned before the degree of personal sacrifice you have to make to be a fully-fledged A+E doctor, but once you’re there it is pretty exhilarating to say the least. It’s not for everyone I accept that but in the words of the Goo Goo Dolls, “you bleed just to know you’re alive”.
My relationship is sadly over, it was solemnised on July 31st and the relationship between myself and A+E has been dissolved, the Decree is Absolute.