was on the ITU today and to risk sounding cliche, it was an eye-opener. i suppose that's the point and the very reason we are put on wards, but i hadn't expected for it to have as big an impact on me as it did. we saw a patient with 70% burns, with mutilating but life-saving surgery. he was, literally, up to his eye balls in skin grafts. and we were told when they were changing his dressing yesterday, his lip fell off. as a medical student, you learn to steel your stomach. and in a way, i find it's mind over matter. i've no recollection of this but according to my mother, i was a steady little five year old eagerly helping out when my darling brother sliced his hand open on glass. i spent many saturdays volunteering at a hospice when i was a teen, assisting the nurses and emotionally detaching from patients on palliative care. and then i copped out and went to law, regressing into the most squeamish person on earth. but now i'm back to medicine, i like to think there's not much that fazes me. scapel, incisions, drains, needles, blood, poop - bring it! observed a tracheotomy (incision in the neck to insert a tube for ventilation into the windpipe) too but seeing the burns patient this afternoon was like a scene out of 'the mummy'. every inch was covered in bandages and when the consultant showed us part of his blistered skin, i felt so very sad. the rest of ITU wasn't exactly rainbows and unicorns either. there's a certain gallow humour on the ward, and apparently how long-term patients deal with the passing of another regular. i also saw first hand how "heart sink" administration can be, with patients wanting to die at home unwittingly held at hospital because of discharge bureaucracy.
before applying to university, i was fortunate to shadow an intensivist who warned me that what we see in hospitals is not representative of life outside. if you're an oncologist who only sees people with cancer, then you'd start to think that everyone is getting cancer. so while i recognise that most people aren't in hospital, i'm very conscious not to take health for granted. every day i leave the wards overwhelmed with gratitude that my husband and family are healthy. speaking of husband, my GP tutor told me yesterday that our life experiences shape our attitudes to patients and being married, i feel it more keenly every time someone is their spouse's carer. i can't help but wonder what it would be like if that were us and whether i could cope if i were ever in their position. it really gives weight to the traditional wedding vows, and just this afternoon one patient shared his near-death experience. he described drifting away, then hearing his wife say, "don't you dare leave me alone, you selfish (insert salty language)" and the next thing he knew, he'd woken up in ITU. we all had a good chuckle, but i couldn't help but surmise that people some times hang around for their spouse, and rightly so!
the consultant we were shadowing taught me more about professionalism in one afternoon than years of lectures. what i respect was how he treated fellow consultants and the domestics alike. as we walked through the wards, he would be bantering with the theatre orderly, joking with a domestic about rounds at the local and taking the mickey out of the other consultants. social stratification is something i'm trying to blind myself to and i'm always so encouraged when people at the very top of their professional game treat those at the perceived 'bottom' with the respect they deserve. when i was a pupil, my pupil master was a high profile senior counsel. and one thing i'd observed and really liked about him was how on the way to court, he'd ride shotgun and talk football with the firm's driver. now we'd be on the way to massive trial and i'm sure he'd 1001 things on his mind. cross examination questions, strategy, client management, bench management etc but for those fifteen minutes, he'd banter with the driver.
it's a journey, isn't it. and along the way i'm glad to have positive role models, people who influence my world view and walk the talk.
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