Heal Thyself...

As soon as I realized I was up the duff*, I booked an appointment with my family doctor.

I had met this man once before. He was older ("I'll probably retire next year"), focused on telling me about his days in residency, and happy that I would see him "as needed".

Cut to January 2014.

I arrive, grey and shivering with nausea. I fill out my paperwork, pee in a cup and wait in the consultation room.
The door opens.
A cheerful, pudgy teen sweeps in the room.

"OMG, sorry I'm sooo late. I'm Dr D and I'm a first year family med resident and I'll be looking after you today!"
"um..."
"So, like, you're pregnant, right? How far along?"
"um..."
"Oh, it's like your first visit! So we don't know for sure. So, like, I'm going to give you some forms to fill out and...Oh! It says here you're a resident!"
 "Yep. Family med. Doing fellowship in ER."
"Whoah! So cool! So, like, maybe you can help me - do I need to order the Rhesus titres today? Or can I leave that for the next visit?"
...
...
...
"Nope. Shut it down."

Consciously, I know I'm being unfair. She's finished medical school, she's a doctor, she can't be 19 and everyone has to learn somewhere.

However.

I was losing weight, unable to work and unable to handle a giggling, baby-talking little sprite who kept congratulating me on a pregnancy that was destroying me.

I've got a new family doctor. An old dude who used to deliver babies, has seen it all, and who knows what blood tests to order in each trimester.

This brings me to my next moral quandary; will I let a resident deliver my baby?
The short answer is no.

The long answer is; I have delivered about 40 babies, under varying circumstances, with varying outcomes. I would not want me or one of my colleagues to deliver my baby.

I want to give birth with someone who has caught 600 babies. Someone who will not think my birth process is, like, so amazing. Someone who will treat it as a run-of-the-mill, un-magical, totally routine experience. That way, if anything unusual happens, they can react to it.

I know, it's not fair to those learners out there, desperate to get their fingers in my cervix. It's hypocritical, considering how many chances I've been given over the years.

But I'm comfortable with it. If I wanted someone to revel in the magic of birth with me, I'd pop the sprog out on Pender.

*Aussie slang is the best. More to come.

Goldfish: 1 Sam: 0

Today is the first day of my medical leave. I am officially too unwell to work.

Little Pickle (the spawn) is feeding me a cocktail of progesterone, estrogen and beta-HCG that somehow conspires to leave me nauseated, lightheaded and dizzy.

I think if I was still in family medicine, I could keep working. The regular, gentle hours, the slower pace and the flexibility of the days would all contribute to a puke-friendly environment.

This is in contrast to, say, ER. Where last night my patient revealed the thick yellow pus coursing from his foreskin, and I had to leave so I could throw up in the bin. His wife chastised me for making him feel bad.

Last weekend I was interviewing a psych patient who was being belligerent. He was yelling at me and the cops and kept saying, "Doc, doc! I just need you to tell me I can have a smoke!" I was trying to reason with him when I felt the dizziness rise. I had to get on the floor with my head between my knees so I didn't pass out. The cops were not happy with me.

Why do I tell these stories of weakness and failure?

Why not mention the awesome catch I made yesterday, when I discovered a hidden skull fracture under a deep laceration? Or tell the hilarious tale of the young woman who hadn't pooped in 11 days? (She's ok. We have stuff for that.)

Because I am riddled with guilt and confusion. I haven't been off work since 2005. I feel as though I have no purpose if I'm not working, or studying, or practicing something to make me a better doctor. So I write down the stories where my body couldn't keep up with demands of work to remind me: I can't do it right now.

Muy depressingo.

I suppose the blog will take a turn from now on. I can't bring myself to commit to the vicious, backstabbing world of mommy-blogs, but maybe I can continue to study and do fun facts and tips. Like managing an aortic dissection! Fun for the whole family!

TTC

You know you're working in a small town when the trauma team is activated for "a Bancroft".

In summer, a Bancroft is an ATV collision. In winter, it's a snowmobile crash. I was trauma team captain on Saturday, and we had a Bancroft of epic proportions. Chest tubes were placed, blood drained from lungs (600mL looks pretty impressive on the floor of the ER), eyeballs pushed back into place. All in all, an exciting and successful night. Nobody died.

That night I also worked an evening shift. (Trauma team sometimes doesn't get called in, so they try to maximize our working hours in a 24hour period.) During this shift, I chatted with the ambos as they brought in patients. You get to know them pretty well during our ride-arounds, and they start to recognize you. "Sam! We've got a Sydenham special for you right here!".

The police are also becoming familiar. This is both wonderful (Sam, I'm just gonna stay in the room cos this guy has already attacked two officers and we heard you're pregnant) and terrible. When I see Officer X, I know there's a troubled psych patient coming in. He has the kindest demeanour and most experience, so they call him out when someone is really frothing.

I don't know what it will be like to come back to a big city hospital. At St Mike's, we had regulars, but no sense of community. Too much turnover between police, paramedics, residents and patients prevents you from building relationships. Yes, you'll see more pathology and more exciting cases, but you may never get the high five from the officer when you convince your patient to take his meds. You won't get the heads up from the ambo that the patient has bedbugs, so you should be wearing a gown. You won't get a page that simply says, "Bancroft ETA 15mins".

I'm gonna miss this place.