It’s been a shite day. All sorts of bad news within our department: bad exams, bad job interviews, bad things afoot among the patients. Bah. And now all the upstairs lights have gone out, I suspect the fuse is to blame, but am too cross to attempt changing it at this time of night. My mojo has gone bleurgh.

The only positive news is that we went shopping for fabric for my Matron of Honour Best Woman Dress (MOH sounds ghastly, I think), and got some rather lovely stuff. In the negative, it’s taking miles of the stuff to cover me, in fact, as much as it would take to upholster a three-piece suite. The healthy eating plan has failed. I am a fat lump.

Bah.

I did something tonight that I have never done before. I fell foul of the “reply to all” gaff. Our rota organiser tends to send at least two copies of the call schedule, sometimes three (depending on how many mistakes are in the earlier ones), and I just got the July rota (Version 2.0) tonight. Aha! I thought. Time to approach the thorny question of: may I have all the Christmas and New Year holidays off, thus shafting all my dear colleagues over the festive season? So I sent a carefully-worded, and, fortunately, edited and re-edited, email. Just after hitting “send”, I realised that some unknown Gmail effect had sent it to everyone in the Department. I mean, it was fine, it just wasn’t what you’d necessarily send to everybody; also, it looks wile stupid to do something like that. So far, I’ve had one text message and one email, both quietly hooting at my idiocy. It is all because I was at a meeting last night, at which I assumed the rôle of Official Geek.

In other news: there isn’t any. Well, I am still not unpacked, still tired and on call tomorrow. However, on the positive side, I haven’t seen Batman for almost six weeks, but he’ll be over on Saturday (just until Sunday). Toodle pip.

Sometimes, I just hate my job. For example:

Tuesday: patient is on other surgeon’s list, but for my boss to operate upon. My boss denies all knowledge of patient, I have never heard of them, and the surgeon whose list they are on thinks that they belong to my boss. Our list finishes early and Head Nurse sends all theatre nurses to other places. Then my boss decides he does know about patient, so sends me to try to get list re-started. Phone anaesthetist as first priority, who makes a t*t out of me and says that it would help if I had come in the night before and sorted it out. I would have, had I known anything about them.

Today: We have two cases on a morning list. One is infected and so theatre must be scrubbed out after this case, but is the only one I can do without Boss. Boss late, so I don’t start the infected case, as he’d have to wait too long to do the other case. He arrives and bollocks me that I didn’t do said case, and tells me I should have more initiative. Choke back waves of self-loathing for general crapness, then later explain that I would have started, except that it would have delayed the start of the other case and he might not have got it done. He says this was right. Still feel slug-like. Go to clinic and do not understand what Other Boss is asking me, so appear rather stupid. Get home (after an hour in traffic) and remember did not see another random patient, so have to get back into car and return to work. Am stupid and sluglike.

Anyway. In other news, a band has been found and booked. I wish I were in a band: it pays much better than my sluglike existence. My cough was improving, until today, when I have either pulled a muscle or punctured a lung, as every cough sends a faint-inducing stabbing sensation through your own dear Blade. The patients were being sympathetic this afternoon, which is clearly a bad thing. And finally, it has been three weeks since I saw Batman, so I am off to Gotham on Saturday afternoon, following a session of frock-trying. I can’t wait.

I had a lovely weekend in Gotham, with my delicious Batman. We went skating, and to a concert, and puttered around the shops and met his friends. It’s all so dreamy. Came home on Sunday night, work on Monday. 106 patients on the Monday clinic, 5 doctors and at least 73 people arrived simultaneously. It wasn’t fun. Then we were late starting the theatre list, late finishing, and late arriving at the evening teaching session. After teaching, we went out for dinner and I ferried some people home. Got home at midnight to find:

1. Quotation to fix the neighbour’s swanky car. £747.88 for a dent that is, seriously, the size of my thumb.

2. Invoice for annual subscription to College of Surgeons. £300. Due on 31 January, which is fortunate.

3. One of the fancy shades on my expensive hall light had decided to spontaneously leap to the floor. Small metal ring wot was supposed to hold it on had suffered some kind of metal fatigue or something. Very bizarre. Shade unbroken but here’s betting that it’s going to cost a bomb to get a new thing to hold it on.

Sunday: arrive home around 2 pm. Sleep until evening. Get up. Go for some organised religion, then eat sandwich, talk to sister for short time and go back to bed. Sleep all night.

Monday: awake feeling rather fine. Go to work, do enormous clinic. Headache begins around noon. At 2 pm am eating half a sandwich in changing room, whilst patient is already asleep in theatre.  By 3 pm, headache is so bad that it has brought Flashing Lights and Overwhelming Nausea along to keep itself company. Am sent home as am about to vomit in the wound. Drive home (with hindsight: not clever idea), after sincerely beseeching The Deity Above to get me home without accident. Get into bed. Am too nauseated to take painkiller. Lie there for approximately four minutes, then have to run to bathroom. Am lavishly, enormously, technicoloured-ly sick. It goes into my hair. Do not care. Take painkiller, antacid and go back to bed. Fall asleep. Batman phones two hours later. Talk briefly then head too sore to continue, so take another painkiller and sleep until 8.45pm. Get up, eat scrambled egg and go back to bed. Sleep all night.

Tuesday: am cured. Think it was a migrane. Work on facking thesis corrections and wonder why EndNote is now being such a pain in the bottom. Go to work in afternoon, which is fine.

Wednesday: despite booking annual leave months ago, have had to work today, as too many other people are off. It is twelve years today since my wonderful, beloved Dad died. We always take the day off and spend it quietly at home, except that I have been Quite Far Away for the last two years. I did not want to work today; it made it seem too much like any other day.  Of course, it is not. I will tell you about him sometime. Have to excuse myself from ward round at 9 am so that I can find a corner in which to be quiet for a few minutes, as he died just after 9. Feel rubbish for acting like it is a normal day, for smiling and being pleasant and pretending to care about rotas and shifts and all the crap that has nothing to do with the job but is the only current topic of conversation among the junior medical staff. Day is enlightened by some extremely nice patients, who are the point of it all.

I am a little blue around the edges tonight. Goodnight.

No, there’s nothing wrong with me, not that a month off work wouldn’t cure. I apologise sincerely, especially to Manuel, for the recent break in blogging. It was because I have found a cure for my Hindernet addiction, and it is this: spend so much time in front of a computer that you simply cannot bear to even switch it on ever again. Combined with this were the post-exam Deep Blue Funk, that comes when an all-consuming torture is almost, but not quite, over; also the fact that Some Of My Bosses Are Assholes.

Last week was crap. It sucked. It’s work. I feel like I go to work and spend the whole day fighting my corner, or else expecting that the next step will be the one when I fall into the hidden pit of crocodiles.  And you know what? Whatever. It’s got so that I don’t care any more, which is a shame.

Between all that, trying to organise some leave to head back to Labland to sort out some problems, trying to finish the corrections, trying to go to work every day and just keep my shit together…it is possible that I need to stop and calm down. I talked to my fantastic Boss, whose advice was kind and reasonable and very helpful, and I am doing as Batman says and focusing on one thing at a time. I am even going to take the weekend off. Is this what burnout feels like?

In other news, my car has been manifesting a warning light on numerous occasions, but is fortunately still within warranty, so is currently on its seventh holiday to the garage. Unusually, it’s staying in the car hospital tonight (it’s been daycase surgery up until now), and I’m in a courtesy car. It’s cute and smells of new car, but is a 1.2 L petrol, instead of my 1.9 L diesel. I love my car. It’s practical, and not terribly exciting, and it goes forever on a tank of diesel. Just like me. Well, two of the above, anyway. It might sound a bit tractorlike, but I love love love it. The temporary car, on the other hand, stalls. Well, it does when one is used to driving an un-stall-able diesel. So I’ve been puttering around all afternoon, revving it like crazy lady, then taking off with screech of rubber. Hence the title of the blog post. Also, it sounds like an electric beard-trimmer.  I hope my car gets better soon.

What a week. I’m bloody glad it’s over. Between meetings with people, practice with Prof. for the thesis defence (yesterday, dreadful), last-minute changes to the rota (call last night to help out a sicky colleague), and utter humiliation at teaching session (today), not to mention a big row with PJ and a gentle reprimand from one of the consultants…well, I’ve just about had Enough.

Good things that happened: 1. Foxy boots 2. Lovely card from fantastic cousin. (Thank you, H.) 3. Enormous support from the sister and Batman, despite my type A++++ personality and general unpleasant behaviour when under stress.

I feel sick, dizzy and like I might just have a seizure or something at any moment. I also have that odd feeling of complete separation from life, as if I am merely observing myself walking around and doing stuff. Therefore, I am going home to Mammy to be looked after for the weekend, before I crack up completely. It’ll be OK. I will be OK. I just need to hang onto my shit for six more days and it’ll hopefully all be over. OK. Deep breath. I can do this.

Sometimes there are patients who really get to you. This weekend I’m on call, and it’s been bad. The combination of a young person and a horrendous injury has left the whole team deeply distressed. It could have been worse, we say, striving for sense when there is none, looking for a way to convince ourselves that the patient will be able to cope: no-one died, no-one has a head injury; they will get better and likely live a near-normal life. Freak accident, we all know it; as one of the surgeons said last night: there, but for the grace of God, go I. We all do things that are fun but silly, but hindsight is twenty-twenty. It’s not often that I stand in theatre, holding back tears. In fact, I don’t ever remember it happening before. It’s not often that I go in to see a patient after surgery, and they say, “Blade!” and hold up their arms to be hugged. It was a night when I was glad not to be a consultant, as they had the impossible task of making decisions and telling relatives the worst of news, whilst we juniors waited in theatre. One moment will never leave me: I was on one side of the operating table, and I lifted my eyes from the patient, to see the two grave consultants standing across the table, in front of a theatre full of people, all silent and transfixed by the person on the table.

But that’s the job, and it’s important not to become emotional at the time, as it interferes with decision-making. Afterwards, when the surgery is done and we wait for the patient to heal, we also must come to terms with what has happened and what we had to do. For us, we have no pain, no wounds, no suffering to deal with; it seems wrong to mention how we feel, in the same breath as speaking of the patient. There is no comparison. We can have no real understanding. But we must seek within ourselves the strength to care enough but not too much, to comfort and console, to listen and to speak. And we must do so whilst we are searching for equilibrium again. There is no question that the correct decisions were made last night, and that is how we will live with it, learn from it and get up in the morning and operate again. But whilst most patients become part of the general memory, there are the few who are specifically remembered in detail. This is one of those patients. They will be all right, and so will we, in time.

Tell me this: if you were, for example, a secretary in the Glorious NHS, and you were booking a registrar-only* clinic, would you:

(a) book patients at regular intervals over the course of the morning; or

(b) book 21 patients between 10 am and 11.15 am, four or five patients in each 15-min booking slot?

See, those among you who give a shit might go for option (a). The real NHS secretary will go for (b). I’d have been ripping if she wasn’t so bloody nice. Must have been some kind of a brain fart she was having that day. Anyway, I was alone, it was a childrens’ clinic, and I was seeing the 10.45s at 11.50, with much apologising. Just as well that most people are nice. I read in a magazine a couple of years ago, that if attending for an appointment, allow half a day and bring a good book. I was rather irritated, but it’s right. Everybody gets cross, every time you step out of the consulting room, thirty heads swivel and thirty pairs of baleful eyes bore holes through you. People genuinely think we don’t care that they have to wait, when, in fact, we hate keeping people sitting around in overheated waiting rooms. And not just because it makes them cranky, either. It’s not much fun trying to see people in under four minutes. I happen to care that people get seen, sorted and are happy with the explanations. Call me an old sentimental idealist, if you like.

Anyway. I have a bloody interview on Monday, the RITA. Record of Intraining Assessment, an annual roasting by the senior Consultants and the Postgraduate Dean (who happens not to like surgeons, and we don’t like him much either. Think love-hate without any love.). I’ve got to have my surgical logbook up to date, which it is in a manner of speaking, in that all the sticky labels of all the patients I’ve operated on are gummed into a wee notebook. Of course, though, it has to be inputted to the computerised logbook, which is as much fun as giving birth without any anaesthetic, whilst simultaneously being slapped around the face with a wet fish (I’m guessing. My Obs & Gynae placement as a medical student was harrowing. Who knew that new babies were so ugly?). I’ve also got to compile some portfolio crap about all the wonderful things that I am and do and think. To put the tin bloody headgear on it, I have another meeting on Monday morning, which is going to be the rat’s ass preamble to the B*a*t*rd of All Meetings on the 24th. I love my job. Really.

Meanwhile, back at the ranch, Batman’s been making sterling efforts to ice-pick through the hard, cold exterior. How could my knees not go weak for a man who says, “I was out with X last night. He’s a real geek. You’d have loved him.” Also, during a rather romantic phonecall, Batman managed to talk about mobile phone interfaces and computer code. He’s dead smart and when he talks geek, he knows I am powerless to resist.

* All new referrals are supposed to be seen by a consultant. When consultant is off, the new patients are supposed to be cut from the clinic, leaving only reviews. Registrars, who are allegedly training to be surgeons, see the review patients, because seeing reviews who have already had surgery and are now healed, or who got better all by themselves, is so f*cking educational. One learns so much seeing people who are better than one would if one got to sit in with the consultant and see the new, undiagnosed and interesting patients. Sarcastic, moi? Perish ze thought.

Here’s a Helpful Hint: if you feel a little peaky tonight, this would be a good time to take two aspirin and suffer it out ’til morning. See, today is changeover day. On the first Wednesday of August and February, all junior medical staff (i.e. below Consultant grade) switch jobs. August Changeover is the worst day to be sick, because it’s not only change but all the newly-qualified are sent out to work. It’s no secret that there is a peak in the death rate in August, and a smaller peak in February. There’s a reason for this: nobody has any clue what is going on. I was thinking today about my first day at work. I’d been inducted and certified and rubber-stamped, and I hadn’t a bloody notion. I remember being asked to prescribe paracetamol, and the nurse standing over me to tell me what to write. It was awful in a way that I can’t adequately explain, except that it’s complete and utter terror, mixed with abject misery. I used to hate changing jobs, moving hospitals, having to go through all the paperwork of starting a new job every six months, learning names and where to go, blah, blah, blah. So having finally got a registrar job, and staying within the same specialty, is just wonderful. No new abbreviations or protocols or we-don’t-do-it-like-that-here, no at-sea feeling; I came to work this morning and was able to do something other than hover uselessly. It might still be a pain in the backside, but at least it’s the same pain.

In other news, the sister has started a new job, and we are now working in the same hospital. It’s great, and I am so excited. Didn’t manage to bump into her, but equally, I didn’t want her new colleagues to think that her sister is a great big creepy stalker. Which I am.