I often have deep thoughts about how some people would react and behave in the current South African medical scene. How Would you cope?
While the world sleeps completely unaware and peacefully, you’re in the midst of a busy night shift. Admitting, resucuitating, discharging and suffering. The angst of making sure everything is done to the best of your ability. The world wakes up, has a hot shower, a good breakfast and continues on with their lives.
Then the classic post-call handover round comes to mind. Standing infront of a freshly groomed and caffeinated team, my teeth fluffy with plaque, ink marks on my arms, socks soaked in sweat, knees buckling from endless stair missions, just managing to keep it together with but a fine line of hope. Post call hope. Hope of a hot shower, a toilet that doesn’t need me to squat, a meal and a pillow for my head.
I’ve lived through these moments with such a fragile spirit.. surviving on zero hours of sleep in stressful situations. Nothing is normal about it. It’s mentally draining, physically taxing and if patients have died in front of you, it’s plain traumatic.
When I come across arrogant GPs and medical professionals, I wonder how they would handle the stress of a full NICU/PICU/ER/Casualty.
When I come across difficult consultants, I always wonder what kind of registrar they were. Did they manage to do their 20 ventilation gases while admitting 5 new patients and also have every other aspect of the call handled to perfection?
How would they have handled someone micro managing their every move, treating them like they’re incompetent but also expecting them to work like they need no one. It’s mind-boggling.
I must admit, I’ve had good luck thus far and haven’t been in contact with too many bad-behaving seniors. But many of my colleagues have.
I remember having a conversation about ‘post call round trauma’ with close friends. The vividness with which they described it, made it feel all too real to me.
A difficult colleague, post call kept interrupting my friend while trying to present her patients,after a busy obstetric call. “You should have done the Caesarean section earlier, maybe then the baby wouldn’t have died”
How? She thought. The patient arrived with a fetal bradycardia. How on earth was I supposed to find her earlier? Am I supposed to control time? She knew it was illogical but the comment was so hurtful.
She felt so defeated, she said that comment was worse than the call and outcome in itself.
A nit-picking colleague who couldn’t contain her bad behaviour made my friend feel so small, incompetent and invalid, she almost abandoned the handover and leave mid-round. A paediatric doctor berating my friend because she did not get an x-ray during the night. Is she supposed to fetch the radiographer and make him do the xray? After all, the department can’t afford afterhours radiographers. What was she to do?
I myself, have been in similar situations. The fresh team, dwelling on things I couldn’t do due to time constraints, instead of what I could. Questioning, not to genuinely inquire and start an educational discussion, but questioning to make you doubtful. Instead of kind, reassuring voices, demanding tones laced with arrogance and ill intent. I have come to spot these people early on, I just know who they are because they always reveal themselves.
Things go wrong, no one is perfect, the system is broken. We consoled ourselves by saying this. But the reality is, some people feed of making you feel bad about yourself and in my experience, it’s mainly colleagues who are doctors. They enjoy eroding your confidence to suit their insecurity. A sad but ongoing cycle which takes a great deal of courage to break.
Apparently the paediatric field draws in personalities that are on the OCD spectrum. I think for the most part, that is true. And quite necessary if you think about it. Neonates and children are non- verbal beings. They have no way of communicating with anyone. They’re so primitive and new to this world, they just have basic ideas of what pain and comfort is.
An ode to the most basic human form, our primitive selves.
But, OCD doesn’t mean cruel, insensitive or intentionally hurtful.
I hope we can all treat the post call team with kindness, remembering that something you say to someone in that state, has further reaching consequences than you will ever know.
Don’t do unto others, what has been done to you. Be the gentle one, be the kind one. No one wakes up in the morning and wants things to go wrong with patient care, but life happens. The least we can do, is support each other through it.
Amazing as always Sabeehah
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