Elective Mummy

Elective Mummy Blog Week Four: Some patients will give you dilemmas, some will give you advice...

by Elective Mummy on 26 Jul 2017

WEEK 4

It’s confirmed... they're red bird mites. Pete from pest control came around and spent all of ten minutes spraying the room, and ten hours answering questions such as “what’s the worst thing you’ve ever seen?”. I heard delightful tales of rats running across kitchen worktops, and homes literally crawling with beetles from those bags of wheat that you can heat in the microwave!

I’m starting to feel like a resident GP at the surgery now, with my own patients returning for reviews. My concern is trying to remember the little details (not in the notes) that show that I recall our last meeting, so they feel like they're in safe, familiar hands. I’ve found myself staring (probably a bit intently) at people, thinking, “Is this the one who artificially inseminates turkeys, or the one who works in the pet shop and has an allergy to guinea pig poo?”. I read an ‘IFL science’ article today which had the reassuring title “Being Forgetful May Mean Your Brain Is Actually Working Properly”. Phew. I daren’t read the articles about ‘baby brain’ - a neurologist I know nicknames the phenomenon “reproductive dementia”.

I had my first unconcerned patient with concerning observations this week. It was unnerving. I’ve been steadily gaining confidence in explaining risk factors and investigations to anxious patients, but had no idea how to navigate a consult with an indifferent one! They wouldn’t engage with any investigations or risk modification whatsoever. I have to admit that there was a tumbleweed moment at one point where we just stared blankly at each other. It felt contrary to my duty of care to let this patient leave without an agreed plan of action. What if really, they were terrified and wanted help, but had a phobia of intervention?! Wasn’t it my job to unpick this? I observed the GP reiterate the options available, before the patient got up and left. My instinct was to run after them and shout, “PLEASE LET ME HELP YOU!”. I felt as though I’d failed them, but hoped that they would come back.

After hearing that more than one of the patients we referred under the two-week rule in previous weeks had been diagnosed unexpectedly with malignancy, I felt inclined to refer almost everyone I saw this week! Sebaceous cysts were looking remarkably lymphoma-like and bone fractures like osteosarcoma! I imagine this to be one of the hardest ongoing challenges in GP – when to refer and when not to. I'm sure I’d be getting a regular rollicking from the budget holders.

My heart-warming case of the week was a patient with a broken wrist, who had been struggling to take care of their grandchildren (children of the daughter they had lost) for the previous week. They hadn’t wanted to bother the doctor.They wanted to know all the ins and outs of my training, my aspirations and all about my children. Their parting advice was to make my career fit around my children and not the other way around. You take note of such words from certain people. Going “LTFT”:https://www.healthcareers.nhs.uk/i-am/working-health/information-doctors/less-full-time-training-doctors means I’ll finish my training about five years before retirement! Does it really matter though?

My baby turned one this week, and he also took his first steps! My big boy wiped his bottom for the first time. We also returned to London where I partied for two days with all my best friends. It felt SO good at the time, but not so good during the six-hour drive home on Sunday evening, with a nursery rhyme CD on repeat and perpetual screaming and whining from the back seat.

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