has just passed his MRCS part A! Another dinky step on the way to being a real surgeon. There was a 70% fail rate this time around so I'm very proud of him. There is something bubbly in the fridge waiting for him when he comes home (if you're going to be a surgeon, may as well start getting used to to the good life now.) I won't be there as I'm on call again today - May is another month of us missing each other with overlapping nights, long days, and alternating weekends. We only know the other person is there by the dwindling and then replaced bottles of wine in the kitchen. (If you're going to be a surgeon, may as well start getting used to never seeing anyone except for patients' insides now.)
In other news, I have finally unpacked the tent from our Lake District trip. Yes, a month down the line. !!! It was surprisingly un-rancid, though as I was fully expecting a whole new branch of the evolutionary tree to have sprung up in the miasma that was inside, I guess it would have been hard to do worse. It's now on the balcony, poisoning the herbs with its wicked fumes. I don't mean wicked like the cool kids mean wicked, either.
I've had a very pleasant bank holiday on call for surgery, which has been bliss in a bucket (as far as on call can ever be bliss in a bucket.) Instead of being on-call for >200 patients on medicine, I am on-call for 60 patients on surgery. Instead of wanting to cry a bare 3 hours into a long weekend, I had a cup of tea on Saturday. And one on Sunday. And two on Monday. Two cups of tea on a bank holiday Monday on call. I was checking bloods at the time, but the fact remains that I was consuming a refreshing beverage whilst doing so. Hell hath frozen over.
If medical on-call is like hitting yourself in the face repeatedly with a hammer, surgical on-call is like stubbing your toe on the table. If medical on-call is like being slowly eviscerated by a pack of hyenas (and it is, oh it is), surgical on-call is like having a tummy-ache after eating too much pudding. If medical on-call is like wishing you'd never been born, surgical on-call is like...well anyway you get the idea. Surgical on-call >>>>> medical on-call. Fact. The only bad thing about surgical on-call is the stupendous ward round every morning around every surgical patient, but even that is small potatoes to someone who knows how to handle a Filofax. And I know. I know how to handle my Filofax - perhaps my only true skill in life.
Poor Tim on the other hand has started medicine on the bank holiday and I have to admit to slight schadenfreude because he has had only surgical days before this. MEDICINE! I didn't want medicine to break him, you understand, I just wanted it to shake him up a little. I am a bad person. I know this. But Tim is just so cheery all the time and never stressed and I just wanted to know that medicine can utterly chew up anyone's - anyone, even perfect Tim! - soul and vomit the sad masticated remains into a spitoon of pure horror.
I don't know if I've made it clear, but in case not: I hate medical on-call.
Fact.
So on Monday night when Tim breezed in, I was slightly disappointed he didn't look like me after a medical on-call i.e. death warmed up.
"How was your first medical on-call?" I asked sympathetically, dying to hear all about how awful it was.
"Oh, it was all right. There were two cardiac arrests."
"Two arrests!" That's really bad. "Was it horrifically busy?"
"Oh yeah," said Tim cheerfully. "Awful. Stupid amounts of work. Impossible to do. Definitely dying inside. But it was fine, really."
"But wasn't it horrible" I pressed. I really wanted to know. "Didn't you get called every 20 seconds about things? And then patients weren't getting their antibiotics for days because you literally couldn't get to them to put a drip in, and every time you thought you could sit down, someone else would ring you, and everyone was so sick and it was just endless and you wouldn't eat anything all day and you wanted to cry all the time?"
"Well, yes it was like that, and I had 10 pages of jobs, but I just didn't even look at most of them because I didn't have time. And the good thing about arrests is that when you're at them, you know, you can't do anything else, because nothing else is as important as someone whose heart isn't beating. So really everything else has to wait. And you can only do one thing at once. There wasn't time to do most of my jobs, so I didn't do them."
"Oh I see," I said. "You reached despair early on in the game." I felt smug.
"Well, you know, I just thought, I'm only one person, and this is impossible, so it's not my fault."
"Yes," I said. "But even though it is impossible, don't you feel overwhelmingly guilty, exhausted, and horrified all at the same time, every second, and indescribably shitty about yourself as a person?"
Tim considered for a moment.
"Not really," he said. "I feel great. I just gave the 10 pages to the night person and said, "good luck", and then I went home."
Tim has a surgical heart though (unlike me: I have a melty melty medical heart, clearly*) and is famous in his District General for his 'surgical phone manner', which his friends have explained to me means never saying anything superfluous on the phone, where 'superfluous' includes 'please' or 'thank you', and hanging up unexpectedly when he thinks the conversation is over. So his general ruthlessness is all in keeping with that. And his mental attitude is very healthful really - why stress over something you can't change - and is totally the opposite of my entire personality, which is all about stressing over things I can't change. No wonder he had a great time.
*It's all right though, because ophthalmology defines in its Person Specification (i.e. the list of attributes applicants need to have to be successful) empathy and communication skills as number 1. Surgery doesn't even have it on its list (no joke.) Perhaps I can just cite the above conversation as evidence during my interview (melty melty heart melts.)
In any case, I was comforted by winning an essay prize from the Institute of Medical Ethics, confirmed by a very lovely email including the words, "I hope to get a cheque to you very soon", which is one of my favourite sentences, second only to, "the cheque is already in the post". New Zealand is moving on, slowly, slowly (the visa application form is hilarious, including the questions, "have you ever been involved in genocide?" "are you a terrorist?" and other delights), and I have bought a copy of Brides magazine in a moment of madness. Just the idea of planning a wedding makes me feel vertiginous (i.e. nauseated and unhappy) so I think when we come back from Africa we're just going to plan it all and do it in 2 weeks and I've made Tim promise he's going to do half the planning when the time comes. It's early, but we have had to have this conversation now, because he hates planning so much. He hates it, as much as I hate a medical weekend, but he's brought it on himself by wanting a "nice" wedding, whatever the poop that means.
Typical conversation
Tim: "I feel like we should have lots of flowers. Flowers are really nice."
Me: "Fine, but you will have to choose them."
Tim: (visibly blanching) "Why?"
Me: "I don't care about having flowers. So if you want them then you should sort them out."
Tim: "Maybe we shouldn't have flowers."
Me: "Fine, that will bring the budget down."
Tim: (after short silence, small voice) "But I really like flowers."
Me: "Well you'll have to sort it out then!"
Tim: "How do I even do that?"
Me: "You'll probably have to look through some magazine or something closer to the time and pick something."
Tim: (visibly blanching) "Look through magazines? I hate looking through magazines."
Me: "Well then we won't have any flowers."
Tim: "But I really like flowers."
Me: "Well if you want them, you'll have to sort them!"
Tim: "But I don't want to, because it's so boring."
Me: "Then we won't have any. Have we had this conversation before?"
Tim: "But I really like flowers!"
Me: "OH MY GOD."
And on that note, it's time for my surgery on-call! Another time my beauties xxx
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