Exhaustion…or how I learned that medicine is a game

Well, that’s me finished my first 8 days of work…I calculated that I’ve worked 86 hours since last friday which is rather a lot if you ask me, and I’m ready for my day off now!

All in all, I’ve really enjoyed it. I’m starting to think it’s some kind of crazy game. Here’s how I see it:

Go to work in the morning – get handover. This determines the difficulty of the game that you start at. Lots of sickies = advanced, nothing to report = beginner.

Level 1: The Ward Round – see all patients before moving onto next level. Complete menial tasks for points, insert venflons for more points, review sick patients for bonus points.

Level 2: Complete ward round jobs. More points to be had by knocking down obstacles such as fluid prescribing, rewriting kardexes and things. Go back three spaces for a tissued venflon.

***Congratulations! You have prescribed meropenem, at £100 a day! Win a free lunch from a drug rep***

Bonus Level 3: Lunch. This is a difficult level to get to and is not reached every day.

Level 4: Get called to see a sick patient. 500 bonus points for not killing them, 100 points for correct investigation and initial management, 100 points for diagnosis. Lose 500 points if you have to send them to HDU. Lose 1000 points if you have to send them to ICU.  Game over if you have to send them to the morgue.

…anyway, you get the picture! Some days you win, some days the hospital beats you. I won a couple of days this week, but other days I lost. A couple of people got really sick, a couple are dying, we had to tell 5 that they have terminal cancer, and on one day my (male) consultant and my (male) registrar between them managed to make 4 ladies cry in the course of one ward round – enter me with tissues and sympathy while my reg and consultant stand there looking awkward and saying ‘there, there’ in a very male way.

So it’s been a rollercoaster, but I’m feeling good. I’m starting to recognise when people are properly ill, I’m not panicking about every little thing, and I’ve stopped freaking out every time I prescribe a scary drug – warfarin and insulin are not exact sciences, I find, and I even managed morphine and benzodiazepines a few times this week!

This weekend I have lots of nice things planned, including taking the medical students out for lunch, seeing a friend from uni, and playing my violin at church. I’m looking forward to it.

But most of all, I’m looking forward to going to bed!