by Adam Kay
Saturday, 10 January 2009
It was Pete and Mary’s wedding today. None of us could believe that two doctors would both be able to get their big day off work. One of my friends only got the afternoon of her wedding day off. She had to do the morning clinic in full hair and make-up so as to make it to the church on time.
The really amazing thing is that they have managed to stay together at all. The hospital system isn’t great for anyone’s love life. Pete and Mary got their first jobs in different parts of the country. This meant they spent the next five years working 120 miles apart. Pete had to move to a different house to be near his job and pop back home when the rota let him. Which it mostly didn’t.
The best man at the wedding was also a doctor. He gave a brilliant speech, saying Pete and Mary’s relationship was like dating an astronaut who works on the International Space Station. He had to do the speech between the starter and the main course and then dash off for a night shift.
Thursday, 29 January 2009
I had to wait for about a minute during a c-section until Heart FM had moved on to the next song. Cutting Crew might be the perfect band name for during an operation, but I refuse to deliver a baby to the chorus of ‘I just died in your arms tonight’.
Saturday, 7 February 2009
I missed the first half of a musical called Les Mis thanks to a difficult birth which kept me at work late. I had no idea what was going on in the second half. It didn’t help that the good guy and the bad guy had very similar names.
I went to the pub with Ron and the others after the show. Watching the first half didn’t seem to have helped anyone else understand it either.
Sunday, 8 February 2009
Simon rang me to say he had cut his wrists last night after a fight with his new girlfriend. He ended up in hospital, though he was back at home now and feeling OK.
He asked if I was angry with him, and I said of course not. I was actually very angry that he hadn’t called me first so I could try and calm him down. Surely he owed me that much? I felt bad that I hadn’t done enough or been able to stop him doing it. And then I felt bad about being so angry with him.
We talked for an hour or so. I told him again that he could call me any time, day or night. We’ve had the same chat many times in the last few years. I’m sad that things seem no better now than when he put that first cry for help on Facebook.
But maybe that’s the wrong way to look at it. It’s not like fixing a broken leg. Simon’s feelings aren’t easy to cure, but he is learning how best to manage them. I should be pleased he’s gone this long without something worse happening.
Tuesday, 17 February 2009
The emergency buzzer goes off and causes panic. As well as the usual number of people rushing in, there is dust and rubble everywhere. If this was an episode of Casualty, there would be half an ambulance smashed into the room with us, but no. It turns out the midwife pulled the cord so hard she has taken down most of the ceiling.
Wednesday, 4 March 2009
It should not be a rare event for me to leave work on time, but today I manage it. I am going out for dinner with my grandma. After we have eaten our starters she leans over, licks her finger and wipes a bit of food off my cheek. Then she licks her finger again. I realize too late that it was actually a patient’s blood. I decide not to say anything.
Saturday, 7 March 2009
‘Doctor Adam! You delivered my baby!’ cries the woman behind the cheese counter in the supermarket. I have no memory of her at all but I guess she must be right. She knows my name, after all. I ask about ‘the little one’, because I can’t remember if she had a boy or a girl. It was a boy and he’s doing well. She asks me all sorts of questions about things we must have talked about while she was in labour. I feel bad that she can remember so much more about me than I can about her. But I guess that while it was one of the biggest days of her life, I might have delivered six other babies on that shift.
‘I’ll put it through as Cheddar,’ the woman whispers to me as she weighs my goat’s cheese. It will save me a couple of quid. You don’t often get a bonus in this job so it’s quite exciting. I smile at her.
‘That’s not Cheddar,’ says her boss, as he walks past. There goes my bonus.
Friday, 3 April 2009
I’m having a drink with Ron. He has decided it’s time to move on to a better job. Sometimes I think about moving on myself, but it’s hard to know how. There are plenty of different banks for Ron to work in, but only one NHS.
Ron says I must have many skills that could be put to good use in a different job. People who have never worked as doctors always say this. Our training is very specific. I know how to solve some problems, but not all of them. I’m not sure I would be very good at managing a branch of Ryman, for example. What other job could I find that would involve pulling babies and Kinder Eggs out of people?
Monday, 4 May 2009
Another busy day on labour ward. I go to help out with a difficult birth, but when I get there things seem to be going well. I hand over to the midwife and wait at the back of the room just in case they need me. We can soon see the top of the baby’s head.
The dad is down there watching. He is very excited and tells his wife how well she is doing. The midwife tells the mum to stop pushing so she can help the baby out slowly. If she stays calm, she won’t need stitches.
As the baby’s head appears, the dad screams, ‘Oh my God! Where is its face?’ Mum also screams and the baby’s head shoots out. I explain to them that babies are normally born face down.
The baby’s face looks perfect, even though there is now blood all over it. I put on some gloves and prepare to sew the mum back up.
Thursday, 25 June 2009
I am down in A&E around 11 p.m. and looking at Twitter while waiting for the next patient. A big news story is breaking. ‘Oh my God,’ I say. ‘Michael Jackson’s dead!’ One of the nurses sighs and stands up. ‘Which room is he in?’
Tuesday, 28 July 2009
I am booking a couple in for a c-section and they ask if they are able to choose the date. They are British Chinese, and I know that in the Chinese calendar some days are lucky and some are unlucky. I say we will do our best to give them a choice. They ask me to check for the first or second of September.
‘Are these lucky dates?’ I ask. I should get some kind of medal for being so understanding and sensitive.
‘No,’ the husband says. ‘September babies go into a different school year and do better in their exams.’
Monday, 10 August 2009
Yes, madam, you will shit during labour. Yes, it is normal. No, there is nothing I can do to stop it. Although if you had asked me yesterday, I would have said that the massive curry you ate to ‘bring on labour’ was probably not a good idea.
Wednesday, 18 November 2009
I go to visit Ron’s dad in hospital. He looks terrible. He has lost even more weight and is all skin and bone. I can see how hard his body is fighting the cancer, but it has no chance.
‘I wish people didn’t have to see me like this,’ he says. ‘It’s going to cost a fortune for them to make me look nice for the funeral.’
The doctors are doing all they can to make him comfortable. Ron’s dad used to work as an engineer and is amazed by all the machines around him. ‘This would not have been possible twenty years ago,’ he says, and we talk about how lucky we are to live in the modern world.
‘Do you think they will be able to cure cancer twenty years from now?’ he asks. I can’t work out whether it would be best to say yes or no. ‘I only know about vaginas, I’m afraid,’ I say, and he laughs.
Then he says, ‘Why do we always say that people have lost their battle with cancer? We never say that cancer won the battle against them.’ He keeps making jokes, just like he always has. I had been nervous about seeing Ron’s dad, but I find I am really enjoying it.
It is kind of him to act like this. It makes things easier for his friends and family, of cour
se. But it also means everyone will remember him as he always was.
Thursday, 10 December 2009
Today I delivered a baby for a mum I saw in the clinic a while ago, when I first started working at this hospital. At the time she was worried she might not ever be able to have children and now here we are. I feel like holding the baby up above my head and singing ‘Circle of Life’.
While I sew her up I ask how the treatment I had arranged for her had gone. It turns out she got pregnant without any help the week after she was in my clinic. I’m still calling it a win.
Thursday, 17 December 2009
Sadly, mothers and babies die every year in this country as a result of violence at home. Every doctor has a duty to look out for it. This can be difficult as controlling husbands often go to the clinic with their wives, which stops them from speaking out.
Our hospital has a plan to help women get help if they need it. In the ladies’ toilet there is a sign that says: ‘If you want to talk about violence at home, put a red sticker on the front of your notes.’ There are sheets of red stickers in every toilet.
Today, a woman has put a few red stickers on the front of her notes. It is the first time I have had to deal with this. I find it difficult as her husband and two-year-old child have both come with her. I try but fail to get the husband to leave the room. In the end I call in a midwife to help me and eventually we are able to speak to the woman on her own.
We talk to her gently, but it doesn’t seem to help. She seems scared and confused. After ten minutes we realize what has happened. The red stickers were put on the notes by her two-year-old when they went to the toilet together.
Friday, 8 January 2010
More than once I have thought about leaving this job. Some days things go wrong, patients complain or the rota changes at the last minute and it all makes me feel like I’ve had enough. But I always think how lucky I am to play such a big part in people’s lives.
Today, I went to my old school to give some career advice to the pupils. I had to sit behind a table, and dozens of other employers sat behind their own tables. They all had lots of leaflets and sweets. One company was even giving out doughnuts. I had nothing. When the gangly teenagers asked what it’s like to be a doctor, I felt I had to tell them the truth. The hours are terrible, the pay is terrible, you don’t get much praise and sometimes you actually feel unsafe. But there is no better job in the world.
It’s hard to explain how special it feels to help a couple get pregnant after years of trying and nearly giving up hope. Labour ward is madly busy: rushing from room to room helping any baby who gets sick or gets stuck. But the parents will never forget you.
I can see the appeal of other careers that pay shitloads of cash, but there is no feeling like knowing you have just saved a life. You go home late and tired and covered in blood, but feel like you have played a useful part in the world.
I said this speech about thirty times. It was like therapy for me. I felt happy as I left the school hall, partly because I took a free doughnut. I’m even looking forward to getting back onto labour ward.
Sunday, 14 February 2010
It is the first Valentine’s Day I have spent with H in four years. I joke that going out with a doctor is a bit like having a birthday on the 29th of February.
We have a lovely dinner at a Thai restaurant. At the end of the meal, the waiter brings over a beautiful wooden box with two sweets in the shape of hearts. I eat mine whole. It turns out it was actually a candle.
Tuesday, 16 February 2010
A husband and wife are in tears when I tell them that the woman will need a c-section. The husband is very keen to be the first person to touch the baby and he won’t stop going on about it. There is not much time to wonder why. Does he need to break a magic spell or give the baby some kind of special powers?
He asks if he can be the one to lift the baby out. I know for a fact that he would either faint, vomit or both if he saw inside his wife. It is never a pretty sight.
It also takes most doctors quite a lot of practice before they can take a baby out by the head. Unless the husband wants to go and try scooping melons out of a swamp with one hand for practice, it might be best if he leaves the job to us. We don’t even have time to get him dressed up in a gown and gloves. Gloves! That gives me an idea.
‘How about if we pass the baby straight to you?’ I say. ‘We will all be wearing gloves so you will still be the first person to touch her.’ He agrees. Problem solved!
Saturday, 27 March 2010
I spend the evening with a few old friends from medical school. It is nice to catch up, even though we had to set a new date about seven times before we could all make it.
After dinner we end up in the medical school bar, for old times’ sake. For some reason we start playing drinking games. The only game we can remember is ‘I have never’. It turns into a kind of therapy. All six of us have cried because of work. Five of us have cried while at work. All of us have felt unsafe during a shift. Three of us have had relationships end because of work. All of us have missed important family events.
On the plus side, three of us have had sex with nurses and one of us has done this at work. So it’s not all bad.
Monday, 19 April 2010
One of the senior doctors, Dr Brown, has taken two weeks off because her dog has died. People are laughing about it in the labour ward coffee room. To my surprise, I find myself telling them not to give her a hard time.
Dr Brown hated me from the moment we met. Once I asked her if I could leave work on time for a birthday dinner with H. Dr Brown said no, and told me I would find it easier to get a new partner than a new job. A few years ago she told me I could not speak to patients about their diet unless I lost some weight myself. She has told me off for all kinds of small things and shouted at me in front of patients.
And yet I am still telling people not to be unkind about her. Why make fun of someone for being upset? We should feel sorry for her. Her pet clearly meant a lot to her and death is sad for everyone.
The others say they suppose I’m right and I walk off feeling like a saint. Two weeks off for a dead dog, though. She must be fucking mad.
Saturday, 5 June 2010
I am so tired these days that I often wake up and have no idea where I am. Today I hear a loud knock and open my eyes. An old man is tapping on the window with his umbrella and asking if I am OK. I seem to have fallen asleep in my car while waiting at a red light.
I almost fell asleep earlier while sitting on a stool, waiting for a patient. We are always told not to use empty hospital rooms to get some sleep during night shifts. But that big ball of fire in the sky always makes it rather hard to sleep during the day. And it is not easy to keep switching from sleeping at night and working in the day to the other way round again.
We are told that we are here to work and not sleep, so we have to stay awake for all of our shift. But surely doctors can do a better job if they have a quick nap when things are quiet? If the boss or his wife needed an emergency operation at 7 a.m., I bet they would not want it done by someone who had been forced to stay awake all night.
It’s strange being this tired. You’re not all there. I worry that I can’t react fast enough. It’s like I have had three pints in the pub. And yet if I turned up at work drunk, they would probably send me home.
I left work at 9.30 this morning. It took me an hour to write up my notes because I could not find the words. It was like trying to write them in French. I wonder if the police will take my tiredness as an excuse when, one of these days, I fall asleep at the wheel and run someone over as I drive home.
Friday, 11 June 2010
I tell a pregnant woman that she has to give up smoking. She looks at me like I’ve just said, ‘I want to kill your cat.’ She refuses to go to a class that would help her to quit. I explain how bad smoking is for her baby, but she doesn’t seem to care. She tells me all her friends smoked when they were pregnant and their kids are fine.
I’m tired and just want to go home. I look at the clock. It is half past six. Clinic was meant to end an hour ago, and she is far from the last patient on my list. I snap.
‘If you don’t stop smoking when you’re pregnant, then nothing will ever stop you and you will die of lung disease!’ I know I should not have said this and tell her I’m sorry. But, strangely, it seems to help. She asks me to tell her more about the classes. It’s good to know that death threats can work on patients sometimes.
On her way out she jokes, ‘Maybe I’ll start taking drugs instead!’ I laugh and decide not to say that this would probably be safer for the baby than smoking.
Tuesday, 27 July 2010
Ron tried to dump me as a friend today. He doesn’t know why he bothers trying to keep in touch with me. It’s clear our lives have taken different paths since we were at school together.
He says I use my job as an excuse all the time. I missed his stag do and the first half of his wedding because of work. I missed his dad’s funeral because of work. And then his daughter’s christening. He knows my job is busy, but how hard can it be to swap a shift for something you really want to do?
I put my hand on my heart and swear to Ron that I love him. He’s one of my best friends and I would never lie to him. I know I’ve been a rubbish friend, but I have still seen a lot more of him than almost anyone else I know. The job is just very busy: it doesn’t stop.