JuniorDr Blog

abdominal pains all night. I feel his abdomen. It's a little hard but not peritonitic. I tell Shankar not to worry and to give him an enema.

I get home late and make a few calls. I open a bottle of Merlot and have a large glass. My cell goes and I answer it. It's my ex. We broke up several months ago but have been seeing each other on and off for a few weeks. He wants to know if I'm free tonight. I think it over and decide to put it off till the weekend. I really should stop before one of us (probably me) gets hurt.

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view this is just detail and is irrelevant; resuscitation is a medical treatment and therefore should be administered or withheld by a doctor. The input of nurses into this decision should be welcomed, but not deemed pivotal.

There are two ways to look at this: philosophically and pragmatically. Is it right for nurses to take on more of the duties of doctors? It's analogous to community support officers, who are not trained police officers but still do many of the things that the police force do. In a practical sense, it's true that nurses spend more time with patients than do doctors but this notion that they therefore have a 'better idea' of patients' 'attitudes towards death' is vague and subjective and hence inadequate grounds on which to base the decision to resuscitate.

As an aside, I'm not sure what nurses have to pay in terms of indemnity insurance per annum but I'd guess they're inadequately covered for the increasingly high level decisions they're being asked to make.

What's more important is that better information must be made available to patients and family regarding the issues surrounding resuscitation, i.e. which doctor makes the decision, and what the quality of life will be like for patients resuscitated in the last weeks of their life.

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I'm getting the hang of this and have now completed my thirtieth stent insertion. It's got to the point where Douglas, one of my bosses, spends the morning next door drinking coffee whilst I get on with the list. I notice that he always has one eye on the monitors though.

At around five I head back to the angio suite to help out John. He does the entire list himself and only wants me to talk to him for a couple of hours. He starts to talk about his wife and the problems they're having in the bedroom department. I was feeling better but the sickness is coming on again.

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 'what's the colour of blood?' 'That's correct, see you later..'"

 So thank God I passed. And it goes without saying that after this blog (hmm, it's getting addictive like they said it would) I'll be drinking with colleagues in the bar downstairs to celebrate, as the questions were a lot harder than the old pharmacology professor's. But that's probably because I'm not tall and blonde.

For those of you unfamiliar with how a PhD works, I'll explain. At the end of your first year you submit a report which is essentially a mini-thesis, containing the introduction, methods, results and discussion of your project thus far. This forms one part of the assessment. The second part is the transfer viva, in which you are asked to present your data and your plans for future experiments. Then comes the most crucial part, the questions, which are mainly about experimental strategy and stats but you're often presented with hypothetical situations that test your ability to think laterally, something that scientists are much better at than doctors. The whole viva takes about an hour and if you're successful, you've technically b(l)agged yourself an MPhil.

"What does ‘p is less than 0.05' actually mean, and don't just say ‘it means it's significant'"

"Why is it a bad idea to perform multiple t-tests across a range of data?"

My thoughts one year in are that a PhD is harder than medicine. The main difference, other than spending the whole time cooped up in the lab, is that you have to think in a very different manner, a manner that's much smarter than simply having a good memory, which can be enough to propel many lucky students through med school. But the fact that you have to think on your feet is one of the attractions of a PhD. Everything in medicine is so well-defined, there are NICE guidelines for everything and handbooks updated twice a year to which you can refer. In science of course you have the literature to fall back on, but most of the time it's about thinking of new ideas and ways to test them, which I think is more difficult.

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