London couldn’t run without doctors. Which is why we asked one of them what it’s like to work in a hospital here. We didn’t want to talk to a top-consultant who only splits their time in a private clinic in the West End. Instead we asked someone near the bottom of the food chain: a junior doctor.
The doctor who spoke to us — and wants to remain anonymous — has now worked at two major hospitals, one in inner London and another on the edge of the city. Across those hospitals they’ve worked in a multitude of disciplines: from A&E to geriatrics.
“A strong sense of impostor syndrome…”
When starting as a junior doctor, one is overcome with a strong sense of impostor syndrome.
You’re flung from medical school into the wilderness of hospital medicine, primed with textbook knowledge but almost completely devoid of practically useful information. You go from being a medical student with no responsibility to the contact point for patients, relatives, senior doctors and other health professionals. This is a feeling which, even after over a year, has not gone away.
“If you don’t put your finger in it, you put your foot in it”
Despite the title, you actually have more contact time with the patients on the ward than senior members of the team, who pop in and out (from seeing patients in clinic, going to meetings, etc). You often find yourself in challenging situations. When a patient starts crying because of a rough rectal exam from a colleague, you’re the one left to comfort them. When the nurses get irate because another one of your colleagues is trying to use ice from the organ donation container to treat a haemorrhoid, you’re the one who has to mediate. Communication skills are key; if you’re no good with them in your personal life, you’ve got to find them from somewhere to survive at work.
As for those rectal exams; I wouldn’t be explaining my day to day job if I didn’t mention them. There is a famous rhetoric that “if you don’t put your finger in it, you put your foot in it”. A senior consultant told me in the “good old days” they didn’t even wear gloves (vomiting emoji). People react in comical ways to what is a strange experience for both patient and doctor. “I’m never staying here again!” and “I hope you’ve cut your fingernails” are two of my favourites.
I remember from my first job, we had a lady who needed a bag on her tummy to collect her poo (called a stoma) because she had her colon removed. She would always wax lyrical about the various consistencies of her poo that day and ask me what had contributed to it. That was when I started to use the phrase “you know your body better than anyone else”.
“He had been pleasuring himself by rubbing his prostate with a piece of rhubarb”
A new job in A&E has brought a wealth of new experiences and is helping me improve substantially as a doctor. I work in a deprived part of London with a lot of knife crime. On my second day I was ambling back from lunch to see a group of armed police officers running from the resuscitation room I was working in that day (where the sickest patients go in A&E). I go in to find a poor man who had been stabbed outside a café nearby, bleeding profusely all over my chair and desk space. “Why don’t we lie down on one of those beds sir?”.
It doesn’t always take a medical degree to get the diagnosis in A&E. A man came with blood in his semen, only later admitting that he had been pleasuring himself by rubbing his prostate with a piece of rhubarb up his bottom. It’s probably that then.
From the dramatic to the comedic to the bizarre… and slightly terrifying. One evening the police came in with a heart in a jar, found at a local bus stop, wrapped in a ribbon. They wanted to know if it was human or not. Turns out it was, and it belonged to a child. The current theory is that it was performed as part of an ancient tribal ritual, and the police are still on the hunt for the perpetrators.
“I have fainted twice as a doctor — once when I was scrubbed into surgery”
We often neglect ourselves running around for our patients. “Doctor, can you see this patient, they haven’t urinated in six hours?”. “Of course” I’ll reply, having not passed urine myself for nine. I have fainted twice as a doctor — once when I was scrubbed into surgery. I lost all my street cred being wheeled on a bed into the recovery bay, to the amusement of my colleagues.
Whoever said kids say the darndest things has never met a confused patient. I’ve been called dishy, a rotten skunk, a lying cow, and “too popular” to pour orange juice into the mouth of a patient who was spitting at members of staff. Then there’s the masturbators. Put it away Gerald.
Being a junior doctor is stressful, chaotic and exhausting, but it’s a massive privilege. I get to see people at their best and their worst. You share lovely human moments with complete strangers at their most vulnerable. You go through so much with your colleagues that the friendships you form are really strong.
Doing it in London is an even bigger privilege. You see a lot of exotic illness in immigrant populations; for example, dealing with malaria is so familiar to me. You’re working with world-renowned experts in their fields, the amount of professor consultants in London hospitals is huge. I love my job and I couldn’t imagine doing anything else, in any other city.