Healthy, wealthy, and tired.
I try to drive to work as little as possible, partly due to my desire to be green, and partly due to my desire to save £200 a month on petrol. In the last few weeks, I have been increasing my stamina at cycling, ready for the big one: cycling the 31 miles to Chesterfield and back, whilst also managing to stay alert, awake and professional at work.
Last week I finally did it, and documented the whole thing on GPS. In homage to my near anonymous friend “Jon”, and his Skinnywheels blog, here it is in all its glory:
To Chesterfield and Back
It’s a reasonable easy ride. I take a direct route on the way there, which takes in the joys of the A61, a national speed limit dual carriageway that runs about 7 miles of the route. I only do it on the way there, because at 6:30am it’s fairly traffic-free. At 4pm, you don’t want to be on a road with lorries doing 70mph and no cycle lane.
The plus sides of the A61 are plentiful:
- a smooth, smooth, non pot-holed road, all the way.
- a solid 3 mile coasting downhill (I managed 31mph with the wind against me!).
- a more direct, and thus shorter, route.
On the way home, I go through Chesterfield city centre, then Unstone and Dronfield, which is safer, avoids all but 2 of the monster evil roundabouts and is a more modulating route, with small ups and downs rather than a 3 mile long rise.
On recent trips, I have cut my 1 hour 15 outward trip to 1 hour 8. I am hopeful of hitting around 55 minutes, which would mean I am faster than driving it in rush hour!
All the livelong night
This weekend, I worked the Freudianly named “graveyard shift” at Chesterfield hospital. Three nights, 9pm until 9am, Friday, Saturday, Sunday.
Whilst a great time to get some real hands-on experience, there is a key problem in working nights. It goes thus:
- Most of us are not naturally nocturnal.
- Most of us have jobs in the day time.
- Night shifts usually only have a day’s grace between day shift and night shift.
- It takes more than one day to completely upend your circadian rhythm.
- Therefore, you always feel completely, exhaustedly, hungover-jetlagged-coma-after-a-trainwreck tired.
There are two methods for attempting this changover. One is to try and stay up as late as possible the night before, sleep all day, and go to work (hopefully) refreshed. I tried this. The result was that I was so tired on the first shift that I started having visual hallucinations about 4am, attempted to wear a commode around 5, and woke up the next morning completely naked in the middle of the M45.
The other method is to sleep normally the night before, stay up all day, and have a two hour nap before the start of the shift. My SHO used this method. The result was that he became so tired that he began to have paranoid delusional beliefs around 3am, attempted to order the demolition of the hospital library about 6, and woke up the next morning on a ferry to Bergen, with a new tattoo. Of the Queen. On his face.
Obviously there’s a bit of exaggeration there, and neither of us actually developed first rank symptoms of schizophrenia, but we were very tired. Aside from this, the weekend was actually fairly enjoyable. There’s a bit less red tape and paperwork on the night shift, and less distractions.
One highlight was a tired A&E clerking on Friday night from another doctor, who had written “Patient is a resident in a residential home” twice in three paragraphs. Some would say that this is not particularly useful information, even when written twice. The doctor had failed to mention that the woman was profoundly deaf, and severely demented. Which would you rather know?
5:30 I put in my 45p, and selected some Prawn Cocktail Walkers. They fell out of the holder, and got stuck halfway down the machine.
5:31 I got annoyed, and tried to shake the machine. A lot. It didn’t work, the crisps remained stuck.
5:32 Rammed the machine again, and another packet of crisps fell out, Cheese and Onion this time. It also got lodged. Right next to my other packet. Nudged it again, to no avail.
5:34 Tried ringing the vending machine company, asking for a refund of my 45p. Oddly enough, no one there when its barely dawn.
5:36 Decided I *needed* crisps, so used my might again. This time a Capri-Sun fell out.
5:39 Having drained the last drop of the Capri-Sun in a contemplative manner, I hit upon an rational plan of action – purchasing the chocolate bar directly above the crisps will cause it to fall, thereby dislodging my crisps!
5:40 The Kit Kat chunky holder turned, and then the chocolate bar twisted out, began to fall and then… got stuck in the mechanism.
5:42 I finished screaming, and decided to whack the machine again.
5:43 Still whacking.
5:44 Another Capri-Sun fell out, but still neither crisp packet nor chocolate bar is released from the vending machine’s iron grip…
5:45 After a final heave, the Kit Kat fell, dislodging both packets, and I left the machine clutching half a newsagent’s in triumph. (Feeling a little guilty at my windfall, I later went to the reception desk in the hospital, who congratulated me on my honesty, but told me to keep the food!)
There ends my summation. At 9:15am Monday I left the hospital after 36 hours of attendance, with mild tooth decay and a mite more experience as recompense. Plus I think I’ll get paid at some point too, but right now I’m more excited about the Capri-Sun.
NB. I am thoroughly committed to being a great doctor, which includes respecting patient confidentiality. All information about patients on my website is anonymised, and often altered drastically so that whilst it still makes a good anecdote, it is unrelated in sex, time, location, age and/or ailment from the original facts.
In the War(d)s
On Wednesday, after five years apparently spent preparing for the experience, I started work as a doctor in Chesterfield hospital. A real doctor. With a stethoscope and everything!
My first job is a four month stint in Cardiology, and my first ever day as a doctor was a 12 hour emergency on call. It was a sharp learning curve, with little prior explanation of even the simplest proceedings.
My first hurdle was the “bleep”. Your bleep is your electronic dog lead; anyone can use it to make you heed to their beck and call. Obviously that’s good if someone has a heart attack, and you are needed for resus. It’s less good if a secretary the other end of the hospital wants your signature on some mildly unnecessary form, whilst you are trying to finish a ward round.
This combined with my non understanding of the system on the Emergency Admissions unit to make me look an absolute idiot in my end of day handover. Day rating: 7/10.
On Thursday, I wasn’t on call, but I did have to conduct the ward round and all the ward jobs all on my own, with my SHO, Registrar and Consultant all on leave or busy. Whilst this was mega intense, and frankly not a lot of fun, I did manage to get everything done, and went home (nearly) on time. My Consultant seemed happy enough, so I’m not too worried, although I would like to have lunch at lunch time more often, rather than eating a sandwich on the toilet at 3:30pm, combining two time occupying jobs into one. During the last hour of my shift, I turned on the CD player in the nurses station: the only CD we had was one of Christmas hits. The tacky music alone made this an 8/10 day.
Friday started out very well. By lunch time – and it says a lot that I was even having lunch – we had finished the ward round, and started on the patient care endless paperwork. And then I discovered I had to attend a compulsory 2 hour introduction, hand washing and blood taking lecture. I got back to the ward, and almost immediately got bleeped to go write a TTO for a patient I’d never met, who needed a slightly complicated bit of warfarin prescribing. I was also approached by rather a large man, looming over me as he asked:
Large man: Are you a doctor then?
Me: Well, yes, just about.
Large man: Can you write me a prescription then?
Me: Err… are you a patient here?
Large man: Yes.
Me: In that case, what for?
Large man: Can you prescribe me a hug?
Needless to say, both of us ended up with a hug. Unfortunately, by the time I had finished on that ward, returned to my own, and finished seeing all the patients, reviewing all the drugs, and filling out all the bits of paper, it was 6:45. I only get paid until 5, but I suspect the NHS aren’t too bothered about that. Despite the lateness, I got a hug off a somewhat threatening man, so the day has to get a 9/10.
So far, the best thing about the ward is all the wonderful nurses, pharmacists, receptionists and porters. Without them, I would actually still be in the hospital, probably gibbering quietly, and completely naked except for drug charts sellotaped all over my body.
Stay safe kids, and remember – don’t get sick in Chesterfield!