tag:blogger.com,1999:blog-4643535418434065942026-01-23T04:36:54.828+00:00A worm's-eye view from the UK's most junior doctor.The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.comBlogger25125tag:blogger.com,1999:blog-464353541843406594.post-8265655396428241982007-10-27T19:07:00.000+01:002007-10-27T19:35:52.712+01:00

I am a vein hunter. A tracker of blood, a tribesman of the tributaries of the heart, a pursuer of the pleasures of deoxygenated blood.Every day, I'm asked to find small veins in elderly people. They tend to be invisible, barely palpable, and wriggly. Holding them down to get a small needle in is like pinning down Harry Houdini on how he did his tricks, or Gordon Brown on when the next election

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com13tag:blogger.com,1999:blog-464353541843406594.post-80524357533108704702007-10-10T22:14:00.000+01:002007-10-10T22:18:03.063+01:00

Throughout the ages, small pieces of paper have changed the lives of millions of people. Voting slips. Eviction notices. Parking fines.But these pale in comparison to the sheet of paper that rules the NHS with an iron fist. It's the Mao Tse Tung of the written word. The Joseph Stalin of A4. It's known as "The Clinical Incident Form".It's supposed to be a routine thing, a little message to the

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com9tag:blogger.com,1999:blog-464353541843406594.post-9909510881239907522007-10-08T22:20:00.000+01:002007-10-08T22:41:17.149+01:00

http://cambridge.facebook.com/group.php?gid=5202063122Genius

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com1tag:blogger.com,1999:blog-464353541843406594.post-12400207820790331632007-10-08T18:44:00.000+01:002007-10-09T07:01:33.211+01:00

My partnership with the Mountain Goat has been put on hiatus: I've joined a different firm. I now accompany The Big Cheese for his ward rounds. In management circles, this is known as "being headhunted". Or "constructive dismissal".The Big Cheese runs a tight ship, which means that the ward round's conducted at the speed of light. There's barely enough time to collect the registrar and the

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-56871120297166762642007-09-30T13:33:00.000+01:002007-09-30T15:45:50.328+01:00

Introducing myself never used to be difficult. I had a name, I used it, the conversation moved on.Pretending to be a responsible professional makes things much more difficult. I don't know whether to introduce as Dr {Worm}, or rely on a more user-friendly first name.The end result: total tongue-tying. A mumbled conglomerate of first name and surname. This leaves the indelible impression that, far

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com11tag:blogger.com,1999:blog-464353541843406594.post-33679132933324393952007-09-24T21:28:00.000+01:002007-09-28T00:07:11.139+01:00

I've started talking in the plural."We've decided to do this test", I hear myself explaining loudly. "We should try this drug". "We need to get you to pass wind".I'm not entirely sure how this started. Nor am I clear who's included in this fictional group, or why I need their support.My subconscious seems to have assessed my medical knowledge, and found it inadequate. Subconscious Worm decided

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-74692960786633501222007-09-22T14:25:00.000+01:002007-09-22T14:30:24.988+01:00

Rich, a male Filipino nurse, is clearly insane. Despite plenty of evidence to the contrary, he's chosen me, basically a medical student with a staff discount in the canteen, as his personal icon of clinical excellence. A ward-based Dr Quinn Medicine Woman or Karl Kennedy.He's also got a touching faith in our drugs' ability to cure any medical complaint. Sometimes his enthusiasm for the chemical

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-91234654552678446052007-09-18T22:21:00.000+01:002007-09-19T00:18:13.263+01:00

Many people frown on racism. Not the Worm's team. For at least one of our patients, racism is actually a very positive sign. As far as Mr Bradshaw is concerned, the more racist the better.Other patients have their blood pressure and pulse monitored every 4 hours. Mr Bradshaw gets asked how he feels about immigration.He was a devoted racist before he came into hospital. Since he was admitted, any

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-80859611411497180982007-09-14T18:40:00.000+01:002007-09-14T21:13:16.506+01:00

Mr Sumner is not a well man. 97 years old and just 4 days after major surgery, he initially stunned us with the speed of his recovery. Then, ten minutes after lunch, he suddenly slumped back into bed, cold and unresponsive.I broke into a cold sweat of my own - none of my patients have died yet, and this was too close for comfort. I actually felt nauseous. Somehow the rising tide of bile stayed

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com3tag:blogger.com,1999:blog-464353541843406594.post-49466587690867790302007-09-11T21:10:00.000+01:002007-09-11T22:11:12.786+01:00

Our new patient Napoleon is hard to read. More Napoleon Bonaparte than Napoleon Dynamite. Asking him for intimate personal information - like, for example, whether he feels thirsty - is more taxing than you'd think. He gives out these details piecemeal, like a serial killer toying with the police. Finding out when his bowels last opened takes the entire day, and usually ends up with me

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com3tag:blogger.com,1999:blog-464353541843406594.post-49932134827895211872007-09-08T11:15:00.000+01:002007-09-08T11:36:31.192+01:00

Contrary to what you've heard in the papers, there are loads of jobs for doctors. LOADS. I was lucky enough to see the job allocation process in the flesh. In the canteen.Big boss consultant: "So, you're working here next month?"Junior doctor: "No, I'm a locum"Big boss: "No-one passed on the message that we wanted you to apply for the permanent post? You were a shoe-in."Junior: {silence}Big boss:

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com7tag:blogger.com,1999:blog-464353541843406594.post-65593649233905984172007-09-04T21:05:00.000+01:002007-09-03T21:08:53.611+01:00

Covering the wards over the weekend is like travelling to a family wedding in Norfolk. People seem familiar, but they all turn out to be far more bizarre than you'd ever imagined. And the food is disappointing.You meet a lot of patients whose charming eccentricities as smiling faces in the hallway suddenly become downright freaky. Take Alan. A normal pudgy teenager during the week, somewhat

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-35155486942627249502007-09-04T09:00:00.000+01:002007-09-03T21:07:10.756+01:00

I have awarded Jenny a Pain ASBO. She is no longer permitted to complain about pain within a 1-mile radius of the hospital.Before the PASBO, Jenny claimed it was agony each time I took her blood - despite my getting it first time, with a tiny needle, no digging around, in and out in 30 seconds. She found the experience excruciating, despite receiving the "Magic Cream".The "Magic Cream" is a local

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com1tag:blogger.com,1999:blog-464353541843406594.post-55321221450225212812007-08-29T17:48:00.002+01:002007-08-30T17:28:35.761+01:00

No-one's spanked my buttocks. I haven't been forced to eat anything more unsavoury than the usual canteen fare, and my eyebrows remain unshaved.As far as initiation rituals go, this institution has been surprisingly gentle with me.But there's no doubt I'm still the new boy. Some of the nurses, with more years on the wards than I've had in medical school, like to pull rank. Sometimes with good

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com4tag:blogger.com,1999:blog-464353541843406594.post-79036464015671377742007-08-27T11:53:00.001+01:002007-08-28T18:26:02.794+01:00

I like walking round the hospital with the Giant. He's so tall, it's like having your own bodyguard. Almost a one-man entourage. When I gave up rapping to concentrate on the medicine, I thought I'd left my "bling" lifestyle behind, so this is quite a treat.Not everyone takes so well to his enormous height. A small Filipino nurse started screaming at him to "BACK AWAY, BACK AWAY NOW", startling

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com6tag:blogger.com,1999:blog-464353541843406594.post-47127417087120336972007-08-25T10:57:00.000+01:002007-08-25T11:43:44.391+01:00

I see more of our patients than either the Giant or the Mountain Goat. This has some benefits, but also some drawbacks.Take Gerry, for example. He is an enormous young black man, who had part of his bowel removed. Like many of the patients (and staff), he finds the heat of the ward unpleasant. Unlike the rest of us, however, he doesn't consider himself restricted by social convention, and so

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-38122515576447590722007-08-21T18:27:00.000+01:002007-08-21T23:26:57.503+01:00

The Potato, a ward Sister who looks exactly like a potato would if it were human, wanted me off the ward.It was "Patients' Protected Mealtime". This tries to discourage staff and students from unnecessarily bothering patients who are trying to eat.The fact that I was at a desk, quietly reading through a patient's notes, well away from any other human being, apparently didn't make any difference.

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com3tag:blogger.com,1999:blog-464353541843406594.post-12117412457404039372007-08-20T18:33:00.001+01:002007-08-25T18:17:23.643+01:00

A lot of people hate hospitals. I never counted myself one of them, although that could change. Two patients today were quite the opposite: desperate not to go home.Reg is a nice guy. His neighbours come to visit him in hospital, he's polite and he doesn't give the nurses any trouble. He holds court at the centre of Male Bay 2, advising the younger men on life and love, and gently harassing the

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-10912933257914027412007-08-17T19:02:00.001+01:002007-08-18T19:04:47.211+01:00

We're quite worried about one of our patients. Simon had an appendicectomy, but because his appendix burst before the operation and released a lot of pus, his bowel hasn't been working since. His abdomen has swollen, and he's in a lot of pain.I'm not the one to decide whether we should keep going with Simon's conservative treatment or take him back into theatre for another operation. I went off

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com2tag:blogger.com,1999:blog-464353541843406594.post-8584952348788281392007-08-14T23:28:00.001+01:002007-08-25T18:18:11.689+01:00

Small talk is pretty difficult in medicine. It's not like doctors and patients get together to discuss the day's events over a pint. The situation's pretty simple: one of you has information to give, or something unpleasant to do, and the other one wants you to get on with it. Any conversational interlude just delays the inevitable.But is silence really an alternative to awkward chitchat?I went

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com0tag:blogger.com,1999:blog-464353541843406594.post-29032551097267923262007-08-13T19:58:00.000+01:002007-08-14T17:41:38.337+01:00

I don't actually practise much medicine. I'm more like a PA to the general public; organising their appointments, making sure they're in the right place and getting the right scans at the right time. I don't make cups of tea, but neither am I called upon to make fine medical judgments. I write notes dictated by other doctors, and watch enviously as nurses and physiotherapists make decisions of

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com1tag:blogger.com,1999:blog-464353541843406594.post-22227351560198803722007-08-10T09:03:00.000+01:002007-08-20T22:33:22.500+01:00

My mood is veering wildly between momentary highs and swooping lows. The brief pleasure I take in having explained something to a patient's satisfaction, so that they finally understand what their doctors are doing to them, is rapidly overtaken by my despair that I STILL CAN'T GET A CANNULA IN THEIR SMALL WRIGGLING ELDERLY VEINS. It sends me home literally hanging my head in shame. And because

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com0tag:blogger.com,1999:blog-464353541843406594.post-45713153476115215472007-08-08T08:10:00.000+01:002007-08-08T09:02:08.267+01:00

I hate my pager.Only a few days into my job, and this little black box of doom controls my life. It stops me buying the sandwich that I've rushed down 5 flights of stairs for. It stops me talking to patients, because if I quieten it for a moment to finish my sentence the impatient person at the other end just pages me again. And it seems to know when I'm on my way to the toilet.As an implement

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com3tag:blogger.com,1999:blog-464353541843406594.post-34426873043898592462007-08-07T13:10:00.000+01:002007-08-07T14:05:07.961+01:00

Patients with foreign objects stuck in their bottoms - universally - have a great cover story. It's never an awkward admission that something went wrong. Never a wry smile, never an acceptance that certain events led inexorably to their wholly-foreseeable conclusion.Instead? "I fell on it, Doctor".In order to believe this, I would have to believe that:- a surprisingly large number of people

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com0tag:blogger.com,1999:blog-464353541843406594.post-50033269718021353182007-08-07T10:56:00.000+01:002007-08-07T11:43:02.564+01:00

Mrs K was biting her thumb at me. Literally, repeatedly, vehemently, furiously, contemptuously biting her thumb at me.This small Greek lady did not speak English, but thanks to an admirable display of body language, and my cursory acquaintance with a Shakespearean thumb-based dispute, her displeasure was all too clear.I had not expected this. Despite 6 years of medical education at two of the

The Lowly Wormhttp://www.blogger.com/profile/16601619383283316868noreply@blogger.com0