The reality of life as a junior doctor is brought to us by Editorial Board member Vincent Simpson, during a challenging on-call week. Vincent is a diabetes and endocrinology doctor and researcher into the diagnosis of diabetes, based in Exeter.
FRIDAY
07.00: I wake feeling slightly nauseous at the thought of starting my night shift in 13 hours. Night shifts are the most difficult part of the job, mixing physical exhaustion, unwell patients, and reduced support from the wider multidisciplinary team (MDT). Despite that, you will never bond with colleagues more than when working overnight. Bonded through stress and snacks.
'I often joke that marrying a doctor is a terrible idea. We are barely at home, and when we are at home, we are too tired to be present.'
I’m in an irritable mood for the rest of the day, but I arrive at work ready to start at 20.20. I place my stethoscope in my pocket with a faded, unreadable quote from Dr Who on the ID tag: ‘Do what I do. Hold tight and pretend it’s a plan.’ The tag was a gift from my wife after passing PACES (Practical Assessment of Clinical Examination Skills) and becoming a registrar. A motto to help me get through another set of night shifts.
I’m surprised to find only nine people waiting to be seen; maybe tonight will be okay.
Patient A is in his 80s and has been in bed for a week. I get interrupted eight times in an hour trying to help him. Each small question takes me away from concentrating on his problems. I start from scratch each time to avoid making a mistake that could cost him his life and me my license. It takes me an hour to finally see him and treat his pneumonia with antibiotics and intravenous fluids. I hope he survives the night.
SATURDAY
It’s 03.30, and I have been working for seven hours. The only thing I want to do is collapse in bed and sleep, instead I get more coffee.
I wake up a woman in her 90s. She looks frail and is curled up in bed. I feel terrible for waking her up so early in the morning, but I know if I don’t and I miss something, the system won’t be very forgiving of my empathy.
On my way out of the door, I check on patient A. He survived the night and looks a bit brighter in the morning light. I hope he can get back to his family.
10.30: I arrive home and fall into bed, only to be woken five hours later by my daughter’s smiling face saying ‘Pappa!’ I feel hungover from the lack of sleep.
I often joke that marrying a doctor is a terrible idea. We are barely at home, and when we are at home, we are too tired to be present. Currently, those words carry more weight than usual. My wife looks almost as exhausted as I am, single-handedly looking after our daughter all weekend, except she will not get any days off and will be back at work on Monday.
I have been working a few hours when one of the other doctors comes to me for advice about a patient who has had four CT scans in the last year. A quick back-of-the-envelope calculation tells me this is the equivalent of 800 transatlantic flights. She would enjoy the flights more than being stuck in a hospital again.
SUNDAY
'It’s 03.30, and I have been working for seven hours. The only thing I want to do is collapse in bed and sleep, instead I get more coffee.'
01.20: I’m halfway through eating my lunch when my bleep goes off. ‘MET call in Creedy ward.’ I leave my coffee and food to go cold and hope to return to it soon.
07.41: I’m taking a quick toilet break before the handover. My bleep goes off, and it’s another MET call. Why do they always happen when I’m taking a break?
The rest of the day is a blur; before I know it, I’m back at work.
I arrive at the hospital, only to be told to head directly to resus. The day registrar is there with a sick patient, and stays an hour late to ensure treatment is not delayed. I doubt they will be reimbursed in any way or the sacrifice recognised by anyone other than me.
MONDAY
It’s 03.55, and, despite my team’s best efforts, there are still 16 people waiting to be seen. Each person waiting is someone’s loved one, but I have to make sure I listen carefully to the person in front of me so they feel cared for at their most vulnerable. The people waiting will have to wait, I am only human.
I walk home, having handed over nine people who are left to see. I wake at 15.30, glad I don’t have to go in again for another night. I spend the evening watching TV with my wife, trying to concentrate but struggling. I’m glad not all weeks are as tough as this one.
TUESDAY
I wake at 07.20 to find 56 WhatsApp messages about how difficult it is to attend clinics as a trainee doctor. Being constantly rotated every four to six months for eight to ten years does very little for building the relationships with consultants. You need to be able to attend clinic and continue to develop as a doctor. Unsurprisingly, younger doctors’ morale is at an all-time low.
WEDNESDAY
It’s my academic day. The morning starts with PhD students and post-docs presenting some of their work. It is a great opportunity to learn new things that I can apply in the clinic when I see patients. In the afternoon, I work on my PhD proposal. I hope it is successful. A PhD would give me time to focus on developing my academic skills without having to worry about keeping up with clinical work.
THURSDAY
I analyse data in the morning for the Diabetes UK conference, but struggle because of sleep deprivation.
At 13.15, I chair the diabetes MDT before attending the diabetes virtual clinic.
I finish the day with an emergency appointment with a young man with a new diagnosis of diabetes. I have to tell him the bad news that he has type 1 diabetes. Understandably, he struggles to accept it, as it will affect every part of his life. There will be no decision he will make that won’t be affected by his new diagnosis. I hope that the latest technology might offer him some hope…
Donate
