The Littlest Doctor

I heard of this terminology for the first time today. I like it. I think one of the best things we are able to do as a doctor is to help someone die with measures for comfort and dignity when we can’t cure them. But somehow, we can get into situations where what we as medical professionals believe is best for the patient is different from the beliefs of the family.

I think a lot of people don’t realise how violent CPR is. I had the lovely family of a frail, older patient ask if we could do ‘gentle’ CPR. It’s a nice idea, but doesn’t exist unfortunately…

It makes me sad that when a person comes into hospital they risk losing the right for a peaceful death. We have to obtain consent to allow a person to die. For most, the idea of dying peacefully in one’s sleep is how they want to go, and how they want their loved ones to pass away. But when people are actually confronted with giving medical staff permission to stand back if their loved one is found near death is a very difficult decision to make. And caring family members unwittingly expose their loved one to a violent and prolonged death.

When this is the likelihood, I tell people this. I tell them honestly, CPR won’t work and we might hurt more than we help. But sometimes they won’t or can’t listen. They can’t understand. Or some doctors (understandably) don’t want to give families graphic details. But I think they need to understand what they may be insisting we do to their family member.

All I can do is hope she keeps breathing and her heart keeps beating. Because I don’t want to break all her ribs, and watch her suffer and end up bloodied and bruised instead of quietly passing away. If it comes to it, that’s not the dignified ending she deserves.

When I was a medical student I completed an elective in emergency medicine. I met an amazing doctor. I was actually supposed to be supervised by another doctor while I was on elective, but that doctor was on annual leave, so the head of the department took me under his wing. This doctor had been practicing emergency medicine for a very long time… But now, he was older, and not well, and couldn’t work clinically anymore but he lead the department at this large, tertiary hospital. He was so loved by his staff.

He taught me about compassion. He taught me to pity people who self harm, to treat aggressive dementia patients with respect, to have sympathy for people who are addicted to drugs, and not to blame people with mental illness for their disease. It can be frustrating, but whenever I find myself starting to get annoyed with patients I remember him.

But he loved his staff, and said that if someone chooses to be abusive they can pick up their leg and leave of his department!

He stopped working not long after my elective, and sadly passed away earlier this year. I am so grateful I had the chance to meet him. It’s so easy to be influenced by the many bitter, angry and cynical doctors you meet, but his compassion made me a better doctor, and I’ll be forever grateful.

I’m ambitious. I want to do well, in everything, work and personal life. Right now I don’t have a personal life, but I’m hoping that will come in good time. Hoping…

At work, I’m ambitious. Everyone knows I want to do emergency medicine. I’m on a rotation there at the moment, and I want to do well. I think maybe I put myself under too much pressure. I want to do well at work. I want to be on the ball, doing the things that need to be done and generally impressing the bosses, but I feel like I so often fail at that.

I don’t know what to do.

I probably need to stop thinking so much!

No wonder I’m sick of work! I’m having a quiet, fabulous and delightful evening, sitting on my comfy couch wearing a fluffy robe and watching Private Practice, one of my favourite shows. I need a favourite non-medical show… :P

The study isn't going well. After much reflection, I think I know why I'm having so much trouble focussing. I don't know if emergency's for me.

In so many ways I love the work, the acuity, the random patients that come in to the department and figuring out who's actually sick and why... But I'm unhappy at work at the moment. And I don't know if it's me or the job.

There's a lot of bullshit that comes with working in a large emergency department - in any large workplace. It's getting me down. I don't know how I'm doing relative to the other junior doctors, and I'm getting mixed messages from various bosses and I don't know where I stand or what I should be doing.

I feel like I should be better than the other junior docs, because this is what I want. I probably put too much pressure on myself, because I am still so junior after all.

But for the first time ever I don't know if I want emergency. And I don't know if emergency wants me.

So it's difficult to focus on study at the moment.

I piked on dinner tonight so I could stay home and study.

I am so lame.

But quite pleased to have some extra time to study! :P

I'm a doctor. I'm little, both in size and doctoring-status.
And I'm sick of it!
Um, the status, the size I came to accept a long time ago... :/

I'm second year out of medical school, and hoping to specialise in emergency medicine. I work, I study for exams, and I eat out far too much.