Everyone has their favourite teacher: someone who inspired you to do the things that you do or to do them even better. Working in the medical profession is no different. And I certainly have mine. I’ll refer to him as Mr. M, in order to preserve at least some form of privacy, even though I’m sure there are plenty of trainees who have worked for him that will have spread his name far and wide.
Doing a surgical job as a foundation trainee is your most difficult one. The patients you’re entrusted are often the sickest in the hospital, and as the foundation doctor, your surgical seniors will expect you to be in charge of all of the annoying, nitty-bitty aspects of their medical care in-between their operations. Anaemia? “Up to you pal”. Low blood sugar? “Can’t talk now, we’re in the operating theatre”. Difficult families? “Please leave a message after the tone”. If a surgical job is the first one you have after finishing medical school, then you can be confident your baptism will contain a surplus of napalm.
This is where I found myself at the start of August and it wasn’t made any easier by the fact that I didn’t really have any interest in surgery as a career. My first few weeks progressed without any major hiccups but it certainly was stressful and the boyish enthusiasm all new doctors are pumped full of was what kept me going. To be fair to my surgical colleagues, they were all fantastic and incredibly supportive. But it wasn’t until I met Mr. M in my second month on the job that a new benchmark for me was set.
And What’s More… He Was a Good Friend
Polite, smiley, full of respect for all the team. Immediately, it was clear from meeting him how much he respected all those he worked with, as well as his patients. Pulling up a chair to chat to a family member by the bedside, instead of towering over them, seems like a pretty simple thing to do, and yet it had such a noticeable impact.
He seemed to have such a clear understanding of the traps and pitfalls that people in my position were exposed to: I remember one Monday turning up and finding out that my registrar was on annual leave for that week and the consultant was off sick. Now it’s not uncommon to be in situations such as this, but I got the feeling that the other consultant probably wasn’t going to be back any time soon. At that stage, you don’t have the authority to decide when anyone is ready to go home, let alone when they need to have an organ ripped out like a sacrificial Aztec. So I decided to give Mr M a call, to see if he could lend a hand. Obviously, I apologised immediately that an infidel such as myself was bothering him unnecessarily, but before I could explain the situation, he said down the phone: “Don’t worry. All is under control. I have been watching you from afar…” It may have just been the phone reception, but his voice definitely had a hint of Obi-Wan about it.
By far my favourite memory of his was during a weekend shift: the registrar received a call informing us that a patient may be arriving later in the afternoon for an emergency procedure. I stated very off the cuff that I would be interested in being a part of it, genuinely not expecting anything to come of it. Contrary to my expectations, Mr. M leans on the side of the nurses station, crosses his arms and says “Well, if they do come in, how about I take your bleep for the rest of the day and you go help out with the operation?” Taking the bleep involves getting hounded every thirty seconds to remind you to prescribe fluids for patients that you probably should have done earlier, so for a consultant to meaningfully say this was, quite literally, mind-blowing (well, not *literally*).
I had always wondered why Mr. M was so in touch with the rest of the team, especially the juniors, and I had my answer later on in that year. He was speaking at the hospital’s monthly forum, which was that time focused on making mistakes in medicine.
He told us how when he was a first-year doctor, he had worked on a fantastic, well-staffed firm and that his consultant had told him that he was the best junior he had ever worked with. The consultant had also picked this moment to tell him that several of the registrars were leaving the hospital and there was not enough money to replace them. “Don’t worry, we’ll be fine. We’re a great team, just me and you”, he was told. Several months later, that same consultant was now telling him that he was the worst junior he’d ever worked with.
It Gets Worse
The other story he told took place when he was a junior registrar and he was helping out a different consultant on a palliative operation to make an elderly patient more comfortable, by removing a part of bowel that was causing an obstruction. They would create a stoma from one end and sew the other one up. The procedure went by without difficulty; yet a few days later, the patient passed away, not unexpectedly.
A few months later, some official-looking men in suits arrived in their doctors office, and asked to speak to the surgeons who had taken part in that procedure. That patient’s wife had made a complaint about a completely different aspect of her husband’s care, which, for reasons that I am not entirely certain of, had led to an autopsy. What had been found was that, during the procedure that Mr. M had assisted in, the wrong ends of the bowel had been sewn up after the piece was removed. The operating theatre was treated like a crime scene and Mr M stated how the corresponding fall-out had lost him his first marriage.
“This kind of mistake is, surprisingly, more easy to make than you might think,” he told us. “From then on, I decided to never shout at anyone for doing anything wrong whilst working in medicine. In fact, the only time I’ve ever shouted whilst in a hospital was when I was scrubbed in for an operation and the nearest person was in the next room – I needed him to help me with an itch.”