Musings of an invisible person

Saaaam Maaaartin!!! Ok, so only someone from my school will get that. I am a medical student at GKT (and previously Cambridge) and this is my rather odd blog. Odd because you are probably the only person reading it yet I still pour into many things I don't tell good friends....

[saaaam-maaaartin]

Why do realisations always happen post-midnight?

Long time no post. There’s probably no one even reading this but hey. This basically acts as my rant space. I could write it on paper and then burn it or something symbolic but instead, I’m leaving it here for people to stumble upon.

So, back to the reason I’m rambling (I’m procrastinating from rambling on the internet in the early hours, that’s a new one). I watched The Big Sick, it’s a film. A legit film, not some weird viral thing. and it kinda made me realise how actually I crave human contact. Dogs are a pretty damn good substitute but in London that’s not really practical and human cuddles are the shit. The trouble is I’m terrible at approaching someone and really struggle asking someone out. I was set a challenge to get a no and I have failed completely (the logic of the challenge is that if you get a yes, it’s a win and if you get a no, you complete the challenge and so it’s also a win). I don’t know why but I just can’t do it. I was kinda pushed into my first relationship, my second she asked me out and the third kinda happened by accident. These women were great and the relationships were good but I didn’t initiate them and for some reason, I can’t bring myself to. I guess I have tried a couple of times (yes, a couple of times ever. I can actually only think of two examples) but either they didn’t realise, didn’t hear or pretended that way in an attempt to be kinder. What it means is that I ended my last relationship in 2015 and haven’t really had anything since. Kinda a problem if human contact and cuddles mean a lot to you. Not that I realised that for most of that time though.

I’m rambling. The thing is I want someone in my life. Yes, that person can’t be just anyone but also I’m not naive enough to think there could only be one possible person out there for me. I like the idea of being set up on a blind date (or a few) by a friend. maybe something will happen, maybe it won’t but I think I need to get out there somehow. Meet people and maybe, just maybe, I’ll meet someone, someone who I would like to spend more time with and someone who would like to spend more time with me

[saaaam-maaaartin]

A dark cloud looms

Life is tough in medicine right now. There is chronic underfunding, chronic low morale, chronic understaffing and a lack of will to do anything about it. This has been well established and is nothing new. Now a new dark cloud looms. One which could see doctors put in a lose-lose position. Take Dr. Bawa-Garba, a paediatric registrar who was put in the impossible situation of covering for another registrar (in addition to her own workload), with no senior support, on her first day back after maternity leave, with no trust induction and a massive IT system failure. Anyone can see that’s not safe but what can you do? Walk out and refuse to work? All that does is leave you two registrars down and in an even more unsafe position. So no, you get on with the job and you work incessantly with no breaks for food, drink or the toilet and you do your best. You sacrifice yourself for your patients. You might think that Dr. Bawa-Garba was commended for working so well in such challenging circumstances. You’d be wrong. A boy who was correctly treated by Dr. Bawa-Garba died. The hospital investigation found there to be no single cause but instead highlighted a raft of changes to be made by the organisation. Dr. Bawa-Garba has been hung out to dry. She has been charged, and found guilty, of manslaughter by gross negligence, her initial 1 year suspension was compounded by HEE removing her training number. This unregulated body with no accountability or appeal procedure effectively set her career back 6+ years. The GMC then pursued her through the courts resulting in her being struck off the medical register. Her career has been obliterated. Why? Because she went above and beyond in challenging circumstances. This could be any registrar in the country. This could be me in a few years. This makes me want to leave the country more than Jeremy *unt. The thought of having my medical career taken from me through no fault of my own on any given day is so scary and terrifying that I will consider emigrating to avoid it. And that’s before you at a criminal conviction with possible prison time. Now look at all the problems the NHS faces at the moment. Does this help any of them or does this make them ten times worse? Read about Dr. Bawa-Garba and support her because by doing so you are supporting every doctor in the NHS and by extension every patient and ultimately that means you.

[saaaam-maaaartin]

Conflicted.

So on the one hand, I don’t do emotions. Not for me at least. I get that other people have them and I can rationalise them. I have the closest to what I think is emotion when I know I should. I think this is like when you spend a lot of time with someone and you start to copy their mannerisms. On the other hand, I want to leave people better than when I met them. This can be helping them, teaching them, making them a better person, causing them joy etc. Now sometimes this has to be on balance. (I mean, come on! Even I’m not that arrogant to believe that I only do good.) The trouble is without emotions how do you form a deep relationship? I can form friendships but when everything is rational how do you keep that going when something puts a strain on that friendship? Move apart, that friendship now ios more effort than benefit for either of you so it naturally declines. This ebb and flow can make it feel like I kind of float through the world like a leaf on the wind. Maybe settling here or there for a bit but ultimately not making an impact and not being noticed when I move on. If someone gets emotional with me I can sometimes find it hard to rationalise. What did I do wrong? Would it really have been better if I’d taken that path instead of this one? Why can’t they see I took the most rational path? Of course I don’t want to hurt them. I want to leave them better than when I met them and it hurts me if I can’t do that. Is this a hero/saviour complex? Maybe. But when did anyone say you need to stop doing your utmost to help me?

So the question then becomes, how long can I stay in someone’s life? How deep can I get before I have to move on to prevent causing more pain? Is that really a life I can live? Is that a life I want to live?

Reason 157 for me to do medicine (but not GP) I can meet someone, get to know them better than a lot of people, help them and send them on their way. Nothing ongoing. Nothing lasting. No depth. A good impact with minimal pain when it’s over. Is this what my future looks like? 

[saaaam-maaaartin]

I need sleep

I need sleep so I will return to tackle the omnishambles that is KCL in the morning. Night interwebs

[saaaam-maaaartin]

A conversation...

I had a conversation recently where someone questioned how old I was given that I’m already so cynical and despondent about my profession and it’s still 2 and half years before I join it. I know it’s a joke but it highlights a real problem. If I have gone from being so enthusiastic to so cynical in 4.5 years what will happen in the next 4.5? Medical students are planning to leave the country in droves. Electives are now being seen as a way to scout out where you are going to emigrate to. I think medicine is a privilege but privilege doesn’t make it safe, doesn’t pay the bills and doesn’t ameliorate being overworked and undervalued. Why would stay here if we can get those things somewhere else?

[saaaam-maaaartin]

If you think being a healthcare professional is easy...

Healthcare professionals are the occupation group with the highest Standardised Mortality Rate in men and second highest in women. Fuck.

http://bjp.rcpsych.org/content/193/1/73

[saaaam-maaaartin]

Reflections on some recent comments

The NHS is fucked. before I expand let me lay down a few facts.

1. If the NHS fails it will be privatised under a Tory government

2. If the NHS is privatised doctors (and almost certainly other healthcare professionals) will be better off. We will get more pay, more holiday, and the best damn health insurance money can buy.

3. Are we mad? Why don’t we step aside and let Jeremy *unt privatise the NHS? Simply because there is one group who will be so much worse off that it would be irresponsible to do so. Who is this one group? The fat cats? Fat cats would make profit on health. The MPs? MPs will almost all have private healthcare already and if they don’t they’ll vote through that they are to have the best insurance. No. That one group is patients. Yes, that’s right. Patients. ALL of you, at your most vulnerable, in your time of need. That’s who will be worse off and we are fighting for you. Remember that when you say doctors are greedy and earn too much already. (not to forget that I will spend 7 years at university and probably at least the same again as a “junior” doctor. To get to wages which rival what some of my friends who went into finance start on after 3 years I will spend 14)

The idea of 7-day, 12 hours a day GP care for all is unrealistic. For a start, the vast majority of appointments are for the retired or small infants. People who can attend during a work day. It simply isn’t needed. When you ask patients if they would like this service they say yes. What they aren’t being told is that this means they will never see the same GP twice. The practices being shown off as a brilliant example of how this can be achieved are a group of 18 practices. Yup. You read that right. 18 practices. Not only will you not see the same GP but it probably won’t even be the same practice! Practices could have double figures of GPs working there, let’s assume an average of 5, not unreasonable. That’s 90 GPs. How is that for continuity of care? If you were offered that choice which would you pick?

Watch the BBC show Hospital. It shows that on a daily basis operations are being canceled with operating theatres empty save for staff twiddling thumbs and getting angry. Why? Someone took away the coffee in the break room? There’s so many of them there’s nothing to do? No, It’s because the hospital can’t discharge anyone because there is not enough social care. If we sent them home they’d be back in a week if they made it in... Where’s the efficiency in that?

From Dr Rant on Facebook “Dear Teresa May. By some unfathomable logic, you have decided that the solution to the A+E crisis is to 'force' GPs to work 12 hours per day, seven days per week as standard operating hours. Assuming that GPs aren't already working at levels way beyond capacity, please tell me how this will solve the problem. The people lying on trolleys in corridors need admitting to a hospital bed under a specialist medical or surgical team. Their problem will not be solved by spending 10 minutes with a GP.” Followed up with a comment of “ If your problem can be solved by 10 minutes with a GP you should be chased out of A&E with a water pistol. There's my policy: free water pistols for doctors. Vote for me”

And another, ”Dear Conservative Party. General Practice is falling apart. The workload is increasingly onerous, the pay is less than our hospital contemporaries, and 1 in 3 GP surgeries has a vacancy for a GP job which they are unable to fill. And you know all those "5,000" GPs you were going to train by 2020? Well, following the junior doctor strike YOU created, no one wants to become a GP anymore. The UK has fewer doctors, fewer beds, and spends less of its GDP on healthcare than most of Europe. These are the reasons that have led to the current NHS crisis NOT GP opening hours. Morale was already at rock-bottom before Teresa May's statement. The Doctors' forums and twitter feeds are now full of talks of strikes and resignations. Your plan for the destruction of the NHS is almost complete...”

I’ll put the discussion I had recently in the next post

[saaaam-maaaartin]

It’s been a while...

So I 've got a lot to get off my chest right now. It’s coming. Get ready. Multiple posts tonight. Better get writing then...

[sepulchritude]

my fav trope is like, nonhuman characters not understanding human needs/customs but still being super supportive of their human companion

“look what I found while exploring this planet’s surface!” “kilrak please I’m trying to sleep” “ah yes your human circadian rhythm. *stage whispering* I am supposed to be quiet during this time in your rhythm, yes?”

“the book I purchased on ragnok V says humans require physical touch when upset. therefore, I shall engage in a ‘hug’ with you.” *supremely awkward five-armed hug ensues*

*human sneezes* “OH MY GOD SIL'EEN GET THE MEDIC OUR HUMAN IS DYING”

“this pamphlet I received recently says that humans require companions and packmates in the form of small earth creatures. you should have told me this before we departed earth, but it is no worry. we will have to stop at the next trade planet to get you one of these ‘cats’ or ‘dogs’.”

[agentquinn]

imagine the aliens really purchasing a kitten for one of their rough and world-weary scifi badass human companions and watching in helpless wonderment what ensues 

“she’s been cuddling that small animal for the past fifteen minutes just going ‘kitty, kitty’. did we - did we break our human?”

a more seasoned alien puts one of their tentacles around the younger one as the rest of the team gathers to watch their human make kissy noises. 

“no, kilrak,” the alien says. “we did good.” 

[frowningfox]

“Human-Steve! I have heard that today is the anniversary of your hatching! According to my human culture pamphlet, it is customary to set a sugary pastry on fire while chanting your species’ growth incantation and presenting sacrifices wrapped in shiny paper. I am afraid to ask, in case this ritual is sacred and this request therefor insensitive… but may I be allowed to participate? It sounds much more fascinating than molting.”

[anexperimentallife]

“Human Steve, I have read about your ritual dance called ‘The Hokey Pokey,’ performed mostly at mate-bonding celebrations after the guests reach an elevated level of intoxication. But Human Steve, how do I know WHICH left foot to put in, put out, and shake all about? I do not… Human Steve, why are you laughing?”

[captainarwenpond221b-deactivate]

“Human-Steve, you are… you are eating, but it is not one of your ritual fueling times. Are you dying? Is everything alright? Have you not been receiving enough sustenance? Do I need to get you better things to eat? Human-Steve, why are you trying to hide that food?”

[rinneavicula]

“Human-Steve, my research has informed me of a grave oversight in your care that I, as your companion, have made! Thus, I have gathered collections of fictional human literature to read aloud at the time of your bed. Which is more to your liking: “The Care and Keeping of Cacti” or “1001 Crossword Puzzles?” Human-Steve? Human-Steve, I am serious.“

[saaaam-maaaartin]

You

I don’t really believe in love at first sight but recently I was the closest I’ve ever been. I wasn’t looking for anyone. I didn’t think I deserved anyone, let alone you. It was only when you made a joke about me asking your (exam) number that I thought you might actually be into me. Even then I didn’t really think it could be true. Why would anyone show interest in me? Since then I have told you more than anyone. More than I had imagined telling anyone. I had to hold back from saying “I think I love you” because I was scared about moving too fast and scaring you off. I had absolutely no issues with telling your sister how I felt about you because why should I? I was proud of it. I dealt with you cancelling plans I had spent days organising because you had bigger things on. I was happiest in your company. When we kissed I spent the rest of the day smiling. I don’t know what’s happened but you’ve been on edge, finding offense and generally not seeming yourself. I want to help but it seems the only way to help is to walk away. That hurts. I feel sick. I feel worse than I have in relation to the end of any relationship even though they lasted over a year and this barely started. I feel more than I have felt in the last year/18 months. If you felt about me like I do about you I cannot imagine what I have said or done to make you decide to do this. At difficult times I’ve wanted you closer not further away. I will try not to wait. I will try to move on but at the moment I can’t. I’m sorry. I’m so sorry

[saaaam-maaaartin]

Awkward...

So I’ve realised that whilst I struggle to make meaningful relationships (they all seem really superficial for ages and revolve around the same things) once I do I really treasure them and love spending time with those people even though I consider myself introverted. (Yes I get the whole energy thing but when it’s good I get energy from being with those people) The trouble is then I start to get precious about it and worry that I’ll ruin the friendship mainly because we get honest and I perseverate on the things I did wrong. This leads me to pull away and ultimately something happens that sort of allows me to let go of that relationship. something like going to uni, changing schools, changing uni. Something that justifies not hanging out and then I miss those relationships and I’m pretty sure I sabotaged them all. Now I’m struggling to make any and I feel sop lonely. so by caring about people and my relationships with them too much I end up ruining the relationship by trying not to ruin it. Awkward right?

I guess what I’m thinking is people from Bryony, drama people, Pitt people, medic/nat sci group, flat 21. I miss you all. I really miss you. I especially miss those who were really close with me in those times, Krishna, Matt, Sam, Ele. You are all special to me and I hope that I can catch up with you all and repair what I’ve done. I’m sorry I didn’t make the effort I should have done, you are all so worth it!

[saaaam-maaaartin]

Shit

I can't work unless I'm forced. I've been hiding away in the computer room and I've barely been doing anything useful. This is the shittest I've felt for a long time. Hopefully tomorrow's drill night will make things better but I doubt it somehow. I just want to sleep and watch trashy TV and get lost in books

[saaaam-maaaartin]

Well that doesn't help

So one of the main things preventing me from going to the GP is that ongoing psychiatric illness is a bar to serving in the Navy. The fact this this means going untreated for something makes it ok to serve but if I seek treatment I can't is perverse. But that's the way it is. So that means no SSRIs for me... I did contemplete buying them illegally online but the chance of them not being what I ordered/costing too much is not what I want. I struggle to go in to the hospital now. When I do I struggle to do anything, I end up in the computer room most days. I don't like this but the option is seek help and then get fucked by Jeremy **nt, seek help and leave the country or to not seek help and keep the Navy option open. No option seems any good for my mental health. Knowing that is really not good for my mental health.

[saaaam-maaaartin]

Starting to wish I never moved

So a while ago I wrote about not being sure where to apply for clinical school and ultimately deciding to leave Cambridge. At the time I was unsure whether I’d made the correct decision and over time I convinced myself I had. Now I’m at the end of my second term and I want to run back to Cambridge. Outside of URNU I’ve struggled to make friends, the organisation at King’s is destroying me. I am criticised for making the most of exceptional opportunities offered to me. At Cambridge I would have been ridiculed for not taking them. perhaps this is why Cambridge produces fewer GPs than other medical schools. They let you make the most of opportunities and grow into the doctor you want to be rather than pidgeon-holing you. I am being stifled and I don’t think I can take it. I hate it. I wish I could crawl back to Cambridge

[saaaam-maaaartin]

Why should I continue?

Why should I bother continuing? I am asked to work my bollocks off with less holiday than is legally required for a job (doesn’t apply to me as I am paying to be there not being paid) for another two years in order to be allowed to work as a junior doctor. A job that will almost certainly push me to my limits. Not the good push me to my limits but the how much sleep deprivation, dehydration, hunger, exhaustion and crap can I cope with. You know, the ones that makes me risk fucking up. The ones that puts me and my patients at risk. This is my biggest worry, that I will do more harm than good. 

[whenincambridge]

when your mum asks why you haven’t met someone yet

[saaaam-maaaartin]

Good job Kings...

Why do’t you set up a dedicated student support email address, great idea! Once you’ve done that why not just ignore all emails to it, no-one has any problems! Aren’t we great!

Seriously, what the fuck. A week is more than enough to reply to an email address like that. Someone could be emailing about something pretty damn urgent