JuniorDr Blog

is missing quite a vital component. Unfortunately, what with work, rest periods and sleep I haven’t been able to fit in quite as much actual revision as I would have liked – and that was after I sacrificed my bi-weekly gym trips.

 

Now I know nobody relishes revision. There are those that can tolerate it either by:

a) Doing enough work all the way through that the exam is a chance to show that hard work and perseverance pays off – which obviously it does do but it also requires hard work and perseverance in the first place which is quite difficult.

b) Cramming it all into the last week so that it becomes a caffeine-fuelled, sleepless montage straight out of 1980s film (they may even put an early Bon Jovi album onto repeat play to enhance the mood)

c) Being very clever

 

I’m not able to use any of these methods because I am easily distractible, sleepy even with Red Bull and not that blessed with an eidetic memory. So what is left is a confused mix of planning, falling to follow through on the plan and then deciding instead to do it tomorrow.

 

As the exam draws nearer – two days and counting – I would expect myself to be nervous and regretful but I’m not. I feel bad that I let myself down but I secretly always knew that given the choice between work and the delights of slick American TV I would buckle. So I am left with apathy and a sense of the inevitable. I may well pass – exams are getting easier I read in the papers – but I don’t think I deserve too. I don’t think that exams test what makes a good doctor but it would be nice to think that I could be both good and passable.

 

But next time is going to be different. I’m going to disable my Facebook account, remove the batteries from every remote control and start early. Or I could just make a cup of tea instead.

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Doctors entered the new National Health Service in 1948 full of goodwill. The profession was a calling and they believed in comprehensive health provision free for everyone. They worked hard and they earned respect.

Politicians brought in managers, set targets and interfered with care. They pushed for more but gave less. Tolerant doctors, working intensely for their patients, let the problems pass. Each time their goodwill eroded a little more.

This year the goodwill of doctors has ended. The latest round of MTAS has beaten us to the ground. Forced to sell houses, relocate families and face sudden unemployment it was the final insult.

The NHS is slowly dying and we need an independent NHS run by doctors and patients if there's any hope of saving it.

 
What other profession would tolerate this? No accountant, no tube driver, no postman. For us there's no alternative. We have no choice if we wish to continue practising medicine than to stick with the NHS.

There's no morale left. A private health service would most likely improve our lives, but not those of our patients. For doctors it is a compromise that is often difficult to stomach. The NHS is slowly dying and we need an independent NHS run by doctors and patients if there's any hope of saving it.

For now we're paid by the government, we're employed by the government but we work for our patients. Hopefully they have enough goodwill to tolerate us until someone has the courage to make some tough decisions.

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;

The OED makes this definition

cackle, v.

• 1. intr. To make a noise as a hen, especially after laying an egg; also to make a noise as a goose
• 2. a. To be full of noisy and inconsequent talk; to talk glibly, be loquacious, prate, chatter. b. To talk loudly or fussily about a petty achievement, like a hen after laying an egg.

Known for her sarcastic putdowns, Democrat presidential nomination frontrunner Hillary Clinton is changing tack to what commentators have dubbed ‘the Clinton Cackle'.

She's accused of bursting into mirthless laughter to deflect aggressive or uncomfortable questions from reporters or rivals. It works - up to a point. Interviewers are left flummoxed, wondering if they've missed a quickfire Clinton joke.

But the increasing frequency at which she despatches the cackle has left her open to accusations that its deployment isn't only in good humour. 

Right-wing radio hosts routinely play Clinton's 'cackle' on their shows and the BBC's Radio 4 Today programme recently hauled in a political analyst to discuss similar uses of unjustified laughter.

Doesn't sound like it's doing her much good. Anyway, forget eggs, what Clinton is laying down is some solid healthcare policy. The former First Lady is calling for universal coverage, a socialist-type policy, similar to that which she failed to implement in 1993 - 94, when Bill was in charge of the coop. She's widely seen as the candidate who'll put healthcare first, even more important in the light of President Bush's recent veto of a $35 bn expansion of child health coverage.

Furthermore, her 33 point lead in the polls shows Americans are listening to her words and not to her belly laugh.

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complete bastard). He wants some help with a private list tomorrow. He asks me this on a weekly basis and I've finally run out of excuses.

The afternoon clinic drags on and on. Everyone seems to be on the same medications and they all seem to have the same problems. At about four-thirty, as I am talking to Mr Wright who is fifty-seven years old, I excuse myself and leave quickly. I just about make it to the toilet as I throw up half a litre of green bile. I wash my mouth out and go back to the consultation.

I get home at seven and go straight to bed.

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with a spectacularly unhappy ending.

Midway through the movie one of the scenes was set in St Thomas's Hospital in London. Soldiers coming back from the WW1 were being treated and one of the ward sisters said something that most likely hasn't been repeated since -

"Nurse Briony, Go sit with the patient in bed 13"

Sit with a patient? ... not check if he's still alive, pump him full of drugs or answer the alarm after it's been going for 30 minutes ... just sit. And it was probably the best treatment the guy could have had in his state.

Nurses these days don't sit. They barely have a chance to talk to patients. We still use the term 'to care'. But is it still appropriate? These days patients get 'treated' in hospital not 'cared for'.

Maybe we just need to sit sometimes.

Though saying that with today's medical advances the chap would most likely have sworn his head off if someone offered to sit rather that whipping him into surgery.

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