Working nights for the past 2 weeks has just me physically and emotionally drained - don't get me wrong, I really love my current intensive care job but nights can really take it out of you. You're the only doctor there overnight (with a poorly slept consultant on the phone) and you attend to all the emergency calls on the wards or the sickies down in Emergency.
Granted, it is a great learning experience, but there are sufficient amounts of what we'd like to call in the profession as 'Oh sh*t!' moments - those moments of abject horror - pupils dilated, breath caught in mouth, heart and mind racing. Or being caught in between the boss' decision and the experience of the nursing staff or the decision of family members.
The sitting down with family, the lending of sympathetic ears and sensitive hearts as you lead them through the critical illness of their loved one, and the often difficult discussion of limiting medical treatment in a sick patient - that is the trickiest part really.
People often feel responsible for the life of their loved ones, and often find it hard to understand why a doctor is saying that it wouldn't be kind to their aged, frail parent to stick all kinds of tubes down their throats and needles into the body to keep them alive.
Such is the dual blessing/curse of modern medicine that sometimes we do not allow the severely ill patient a dignified death - we are pictured as the guardians at death's gate holding all these chalices filled with magic potions, fending death off with a spray here and an incantation there.
It is a privilege of being in medicine to walk with the families during their difficult times, but it can be sometimes as frustrating as it is fulfilling - occasionally their demands can be beyond the realms of reason. But it is the passage of time, and the art and sensitivity of bringing the family around to the understanding that we are limited as doctors despite all our life-giving elixirs, and to allow their loved ones a kinder passage into the eventuality that greets us all in the end.
It is physically and emotionally draining, this job. I remember a good friend in Malaysia who's a doctor, saying that she was just so depleted that she was crying in her car all the way home. I'm letting the tears flow more easily these days.
No shame in that.
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