Category Archives: profession

Physician Heal Thyself

Yet another doctor has committed suicide recently. The 3rd in the past year in the UK that I know about. There are probably more. It is so sad. On the face of it, many people might think what do doctors have to be so depressed about? The public still imagine that being a doctor comes with a good job, good income and the respect of the population in general. Those of us in the profession and our loved ones know better. For most doctors, the work is relentless. The NHS is no longer fit for purpose. There are too many patients with less resources to care for them. There is more and more paperwork borne out of the NHS having too many ‘managers’ who analyse medical errors and harm and feel that creating another form to fill in will prevent future incidents. They fail to realise that what is needed is more funding to employ enough staff for the numbers of patients we treat. They fail to realise that they need to invest in their staff and make them feel appreciated and valued for their hard work and for doing more than they are contracted to do. They need to examine the levels of sickness and absenteeism and realise that burnout is real and so is depression. Above all, they need to realise that without preventative measures, doctors will continue to work themselves until they simply can’t.

Although the UK rates highly in a lot of economic and living standards indices, being a rich developed 1st world nation, it doesn’t do so well with mental illness. The positive news is that the UK had made it into the top 20 of the world’s happiest countries in 2017 (it was previously 23rd and is now 19th) for the first time since 2012 when the world happiness report started being published annually.

In March 2017, the Mental Health Foundation commissioned a survey to look into prevalence of mental health in the UK and to identify the factors about individual that make them vulnerable to suffering from a mental illness. It found that 7 out of 10 women, those aged 18-34 and those living alone had a mental illness. Only 1 in 10 of the whole population are happy most of the time. Women are 3 times as likely as men to suffer a mental illness. Stress is a growing problem. Majority of people suffer from either a generalised anxiety disorder, depression or phobia. Self-harm and suicide are not classed as mental disorders but are a response to mental distress usually cause by mental illness that has not been recognised and treated.

With these statistics in mind, it is easy to see why young female doctors are at risk of mental illness. Couple that with the fact that medicine attracts people with a type A personality who are high achievers and do not like to admit they have a ‘weakness’ or that they need help. I have already described working conditions in today’s NHS. No wonder so many young female doctors are struggling and every year, we lose a few to suicide. What I find particularly difficult with this is that when colleagues pay tribute to those who have died, there is always a huge sense of shock. Unfortunately, these women hide their illness so well that often even their closest confidants have no idea how much despair they are in. Their friends often describe them as ‘superwoman’, someone who ‘has it all’, always helping others, taking on incredible amounts and managing to ‘juggle it all’ somehow. They give so much to others that they forget to give their selves.

Caring. Freedom. Generosity. Honesty. Health. Income. Good governance. These are the things that increase happiness and promote mental well-being according to the Mental Health Organisation. I would sum it up as friendship. I think human beings are social creatures (yes, even the introverts) and need to have at least one good nurturing relationship. This is intrinsically linked to self-worth. Many people who have attempted suicide and lived to tell their story say that depression and anxiety eroded their self-worth to such an extent that they felt useless and that the world would be better without them in it. Depression interferes with rational ordered thinking. When it is severe, it is like being in a deep dark hole, full of doubts and lacking in any hope. Far from being selfish, I believe people who contemplate suicide are (in their warped thinking) being selfless and believe in that moment that they are un-burdening those around them.

So is there anything we can do to turn the tide? Most experts agree that by the time a person has planned to commit suicide, it is probably too late to do anything. The depression has taken over and has them fully in its grasp. Where we can make a difference is at a much earlier stage. We need to prevent people with low mood going on to develop depression. We need to be that friend who validates their self-worth. The one who lets them know in words and action that their presence is very much appreciated in your life. We need to talk about mental health more so that someone at the early stages of depression feels able to confide in someone and seek help. If mental illness is so prevalent, why do we not talk about it more? Why are we ashamed to say, ‘I am depressed, I need time off work to get treatment/rest to get better’? Would any of us feel ashamed to call in sick at work if we developed appendicitis, had to have surgery and needed a few days to recover? Just because mental illness is invisible doesn’t make it less valid. I think this ultimately is what will turn the tide. Talking about it, admitting we have a problem and asking for help early, taking time out now to prevent getting to the point where all hope is lost and we feel like we have no other option other than suicide.

If you are reading this post and can identify with the desperation that mental illness can induce, please reach out to somebody. Ask for help and support. If you are in the UK, there are some very good resources. Your GP should be your first port of call. If you are feeling suicidal, call the Samaritans on the free phone 116 123. Mind has help pages online that can be accessed at https://www.mind.org.uk/information-support/types-of-mental-health-problems/suicidal-feelings/helping-yourself-now/#.WX8lFojyvIU as does Turn2Me at https://turn2me.org/?gclid=EAIaIQobChMIvKCtr8Sz1QIVT5PtCh2D7QnCEAAYAiAAEgKyyPD_BwE. The Mental Health Foundation has some great guides for promoting mental wellbeing which can be accessed on https://www.mentalhealth.org.uk/your-mental-health . The app Headspace comes very well recommended for dealing with stress, anxiety and depression.

If you are a medic, there is a wonderful Facebook group called Tea & Empathy for peer support for all those working in healthcare. It was founded after we lost another one of our young doctor colleagues a couple of years ago and is a brilliant space full of supportive caring people. The Wales Deanery has published a booklet specifically aimed at helping medics cope with the stress of the job. You can access it here: https://www.walesdeanery.org/sites/default/files/bakers_dozen_toolkit.pdf.

Finally, I want to say to you all: You matter. You are loved. You are not alone. Be kind to yourself x

 

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The Power of Dreams

My aunty forwarded one of those inspiring videos about life and happiness. One particular message struck me. It said something about having a dream then making it happen. Of course, it is easier said than done. It is not quite that easy to turn a dream into reality but those people who are the happiest are those who had a dream then put their all into making it a reality. I have many dreams. Through hard work and luck, many of my dreams are already a reality. I got into medical school, I graduated. I applied and got into speciality training and I am gaining experience as a paediatrician. I met a man with a big heart, fell in love and married him. We bought our lovely first home, a permanent abode after my many years of moving from flat to flat.  I fell pregnant when we were in good place and the baby has been growing well with the easiest pregnancy. I am getting ready to realise one of my biggest dreams – giving birth and being a mother. So yes, my bucket is overflowing.

This is about my professional dream.  I used to think I would be happy to graduate, specialise as a paediatrician, get a consultant post and settle down to a routine. With the recent political shenanigans and the more I work in the NHS, the more I realise I want more. I want more out of my life and I also want to contribute more than the daily grind. Don’t get me wrong, I know in my current role I do make a difference to lives. There is nothing more satisfying that when I have done a good job and I know that parent or child’s life has been changed for the better, no matter how small that change is. However, many days I look back after a busy day and think was that worth it? Those days which are all about paperwork and administrative tick-boxing exercises that contribute nothing except to some faceless manager’s satisfaction.

The part of the world where my life started (Yola) is lovely in a lot of ways but there is a significant poverty. In terms of economics but also in healthcare terms. Nigeria as a whole fails to cater to the healthcare needs of its population unless you have lots of money to go private. The North-East of Nigeria is one of the poorest when you look at health outcomes. In particular, looking at childhood. The statistics (where there are any) are shocking. Nigeria, for all its wealth, regularly features at the bottom of tables for health outcomes. We are in the bottom 5 for most outcomes including maternal and under 5 morbidity and mortality. For the non-medics reading this, morbidity refers to how much ill-health and disease (sickness there is) there is and mortality refers to how many are dying.

Mothers naturally should come in a low-risk group. Most should be healthy young women doing what is most natural – getting pregnant, growing a baby and then delivering the baby. Young children, although fragile because they are not mature yet biologically are despite all of that resilient on the whole and have bodies that are full of strong healthy organs with endless potential for healing. What we are failing to provide is basic care. Basic antenatal care, trained birthing assistants, hospitals to assist in difficult deliveries and facilities for emergency caesarean sections (surgery) for those women who cannot do it naturally. Infections, on the whole preventable and most totally treatable, cause a lot of the morbidity and mortality in Nigeria. Many of the other things we provide here in the NHS is simple supportive care, allowing patients own bodies to heal themselves in a secure environment.

So here is my dream. I would like to set up a women’s and children’s health centre. Big dream I hear you say. Yes, I am aware. It will be a huge task. I worked at the FMC in Yola for 4 months in 2012. I saw how much need there was and the things that were missing. I know a lot of the patients we couldn’t help were those who lived far away from town and did not come to us until their disease was too advanced for us to be able to do anything. Mothers died in childbirth because they did not have adequate antenatal care so predictable problems were not discovered until it was too late. Preterm babies died because they were born out of hospital in environments not hygienic enough and did not get simple breathing and feeding support and early treatment with antibiotics. Term babies were born too small because their mothers were undernourished and unwell with treatable conditions during pregnancy but were not diagnosed and treated. Very few of the patients we couldn’t help needed fancy expensive medicines or surgery. It was simply too little too late.

On the positive side, those that did come to us in time had better outcomes than those suggested by the statistics I read about on WHO and the likes. Those preterm babies born at FMC Yola thrived and majority survived until discharge. Sure, their progress was slower than here in the NHS because of a lack of basic equipment and provisions like oxygen and breathing support, working incubators, labs, fluid pumps, parenteral nutrition for those too young to feed by mouth or through the stomach. But survive they did because they are little fighters.

So what I dream is to provide all those basic things to the mothers, babies and children free of charge if I can manage to raise funds or at the very least at the smallest prices possible to give those with little the chance to quality healthcare. To go with that, I would like to provide an outreach service to those isolated villages. Run clinics, provide immunisations, antenatal vitamins and nutritional support, teach about prevention of infections and when it is vital to seek early medical help. Central to that idea is to train some of the villagers to provide safe simple birthing assistance, supportive care for new-borns and how to diagnose and treat the most common infections and provide first aid. All little things but added up should cut the numbers of mothers and children suffering unnecessarily and prevent the many preventable deaths.

My grandfather listened to me talking about my dream and was (rather unexpectedly) downbeat about it. He pointed out that it wasn’t as easy as I was making out. Actually, I know it will be difficult to do and as I have never done this before, it is a monumental task. There is so much to do to get this off the ground. However, here is my plan. I will start small and do this project in stages. I will deal with the complications as I get to them. A journey of a thousand miles has to start with that first step. I have taken my first step. I have dared to dream and I have written down my dream in black and white. Now onwards and upwards. Watch this space.

Don’t Sweat the Small Things

Sometimes in life, we allow small things which on their own are not significant to add up and turn into a massive problem. I speak from experience.  I am a creature of habit so I like things to be a certain way. To a degree, I do have obsessive compulsive traits. That is not unusual in a doctor. It takes a certain type of personality to go through medical school and then to work in hospitals and face all the horrors that can come with the territory. When I was living on my own, it was easy to use those OC traits for the good. Everything had its place in the little space I had. No mess was left where it was. Everything was clean and orderly. My personal life was organised to a T. In direct contrast, my professional life despite all my best intentions often felt out of control and at best, it was an organised chaos. Dealing with humans and ill-health is by its nature very unpredictable. You do all you can do and things get worse in some patients. In some patients, you barely have to do anything and everything gets better anyway. Which sometimes makes me question exactly how much we as doctors are able to influence and if it has more to do with patients than us.

Anyway…my lovely ordered life was turned on its head when I met and moved in with my husband. He is the spontaneous type who makes ad-hoc plans and also changes them (or should I say ‘forgets’) without warning. He is so full of energy that he cannot be neat. When he makes a mess, he would rather clean it up later. Later being in a few hours, days, weeks or even months in some extreme cases. I used to get really worked up about these things and ended up cleaning up after him because it was too much of a hassle to nag him into doing it. Then I started to resent having to come home after a long day’s work to organise everything again or use up my precious days off sorting. Now I have swung the other way. I have become an expert at turning a blind eye. I refuse to see the mess and I will generally not tidy up if it is not my mess. So whilst I complain less and I try to let him get to it in his own sweet time, it hasn’t lessened the stress it causes in my mind. I will literally obsess about the mess not being there.

Whilst I generally get on with my fellow doctors and nurses at work, there is inevitably one who is like a thorn in my side. In my most recent rotation, there was one such nurse. I will call her Nadine. She is a senior nurse with a lot of experience – this is usually an asset but in her case, she thought she could tell me how to do my job. I am usually quite laid back and approachable at work but I am certainly no pushover. I can’t be because as a registrar I have to take overall responsibility for patients out of hours. Well, Nadine decided because I was a new registrar that she had to question all my decisions, mostly indirectly. This really riled me because the decisions that I made were either straight forward or those which were more complicated were discussed with the consultant as per usual practice. I found that lack of respect very irritating and at the start of the job, I had to avoid any contact with Nadine until I could detach myself enough not to care. Once I realised by talking to the other nurses that it was not unusual for Nadine to give rotating doctors a hard time, I was able to maintain professionalism by communicating what was essential and just tuning out the negativity. What Nadine (and I) felt in the grand scheme of things was insignificant as long as I did the job I was there to do and I did it well. By the time I left, I think she had gained a grudging working respect for me.

I guess what I am saying is that I have come to realise some facts of life. Main fact being that most of life is not within my control. Fact is that there are many small imperfections and it is not always possible (or maybe even desirable) to make them perfect. I don’t always find it easy to let those little things go but when I do, it is less stressful. As long as I control those things I can control and make life as good as I can within my little bubble, I can live with the little things. Life is hard enough without sweating the small stuff.

Champion the Truth

If you don’t live in the UK, you may have missed the junior doctor contract row that has been brewing for a few years but has escalated over the last couple of months. If you live in the UK and rely on major media outlets to keep you informed, you may think the dispute is about junior doctors asking for more money. I would suggest you turn to social media for more accurate information from doctors, other NHS staff and more importantly their families. Long and short of it is that the dispute is about our Government deciding we junior doctors need to work longer hours whilst our pay is cut and refusing to do the simple arithmetic that would show that if you want more junior doctors working around the clock, you need to recruit more of them because we are already working long hours and we absolutely will not do me as it would put our lives and the lives of patients that we hold so importantly at risk. I mean, how is it fair that the Government has voted to pay its MPs more and they can still claim vast amounts on expenses yet the very same Government says we have no money in the coffers to pay for more junior doctors? Isn’t that ridiculous???

I digress, please read up on Facebook, twitter and blogs writing on the issue. Plenty of truth out there is you care. The baseline is that at least half of the junior doctors who have voiced their opinions have stated either that they have made up their minds to quit the NHS or are at the very least, looking into alternate careers or going abroad. The simple truth is we as a group of junior doctors think the bottom line is that the Tories have vested interest to tear down the NHS and privatise our healthcare and hence line their pockets. There is also strong evidence out there that the current fool we call our Health Secretary has been a champion of NHS privatisation for many years and probably owns share in private health insurance conglomerates like Virgin Health.

This blog is actually about the one good thing that has come from this attack on junior doctors. We now have an online Facebook forum called Junior Doctors Forum which is by invitation only. It has 63,000 members and counting. Not all of them are junior doctors. We have consultants, medical students, nurses, midwives, paramedics and other allied healthcare professionals plus a few lawyers, journalists and even politicians about the forum. What I want to do is big up the passion of those on the forum and champion them sticking to their guns and being honest about how they feel and what this is doing to us as a group. Never has there been so much unity within the profession. Medicine is a very hierarchical and competitive profession and although we all start as one, we generally sub-divide as we become more senior and choose specialisation programmes. Our world then shrinks even further so all we know is related to the one field eventually. Our only contact with the outside specialities is if they are part of the multi-disciplinary team that we need to make sure each patient’s care is optimal with the inclusion of all relevant expertise.

So it is all good news though? No. Unfortunately when you get 63,000 opinionated voices with the top 1% in terms of IQ and ability to rationalise, debate and analyse, you get varying opinions. I am all for freedom of speech and embracing our differences. However, as with all other aspects of life, some are excessively worried about how other people interpret our opinions. An article was published based around a discussion we had on the forum and people are getting all uppity about all coming across professional and un-emotional. Why? If this was about professionalism only, we would all continue our stony silence whilst we get attacked as we give our all for the greater good. This time, we have stood up and shouted NO because not only have they attacked us (we have thick skin because of the nature of being medics who take enormous responsibilities day in, day out) but they are threatening the very fabric of the health of our nation. Their proposals are not only ensuring that many of us want to leave because we choose life and living than putting ourselves in danger from physical and mental exhaustion, they are also meaning that we are now less willing to carry on doing extra unpaid hours for no thanks.

The NHS has been running on the goodwill of its junior doctors for a very long time and things have been in a steady decline for the past decade yet this is the first year that doctors have threatened to strike. We love the NHS and have been carrying its weight to the detriment of our mental, physical and psychosocial health for far too long. This is the straw that will break the camel’s veritable back. It is because we are passionate that we are fighting the proposed changes which may start with junior doctors but we all know will extend to the rest of the hardworking staff the NHS is lucky to have as its employees. How then can anyone ask that we lie about how angry and betrayed we feel? How upset we are that we are being made to reconsider our futures? Whether we can afford to have children and continue to be there for our patients? How the lies of Hunt et al are demoralising us? How we don’t feel it is worth it anymore to carry on in the NHS when all we get for breaking our backs for a pittance (£11/hr 6 years after graduating for me compared to a plumber who can earn up to £50/hr) is abuse and an Etonian ignoramus vilifying us for caring.

Well, I am here to say that no. I will not be unemotional. If I didn’t care for the NHS, I would have quit after my first foundation year when I became a fully licenced medical practitioner. If all I care for was the money, I would be abroad today with a private clinic, dictating my hours and pay. If I didn’t care, I would not be attending protests and spending what little I have left over after my living expenses and medicolegal expenses on supportive merchandise. I care and I am not afraid to show it.

Hunt is only the face of the Tory campaign to break the NHS and leave privatisation as its only viable option. The Tory Government is libellous, dishonest, spineless and un-democratic. If the general public continues to buy the bullshit the Government is peddling, it will be the British public who will pay the price in the next few years. So unless you are all dying with something that will kill you with certainty in the next couple of years, wake up and realise facts. Fact is the NHS as we know it will be no more unless the whole of the British public fights this. Just google how much it’d cost you to pay for your health insurance in the US and imagine the UK going the same. Doctors are in hot demand the world over. We can and will be forced to leave the UK and the NHS is this horror continues and we will be fine. I assure you. So the fact that I am getting emotional is not because I am a greedy lazy overpaid privileged posh kid as Hunt and co would have you believe. It is because I care and I am not afraid to show it. Fact!

Open Letter to David Cameron – Our Silent PM

This was written by the father of a UK doctor. He lives in Sweden but is speaking out to save our NHS. If you share his sentiments. Reblog or share my link. Please.

Sir,
Your silence in the matter of the NHS and Junior doctors is conspicuous and indicates your silent approval of the Health Secretary and his policies.

This is not a matter only between Mr. Jeremy Hunt, the NHS, and junior doctors. In fact, this concerns everyone, from a child yet to be born to the elderly person counting the last breath and every one in between. Therefore your intervention is of vital importance to the national interest.

It is also very painful to see how ruthlessly and insensitively you treat the elite youth of your society. The youth who have chosen to indulge in the service of people of your nation, day and night, ignoring their own comfort and social life. They are the foundation of health and wellbeing of your nation of which, I am sure, you are proud of.

I have seen the plight of junior doctors. They are working day and night, have no control over their week-ends or holidays, when on call they have to be available for up to 48 hours. They cannot think of taking leave irrespective of personal urgency. In spite of all this they are single-mindedly devoted to their duties and responsibilities and have never asked for a pay rise. They are just short of being slave driven. To add ridicule and insult to their calibre, Mr. Jeremy Hunt wants to reduce their pay and increase their working hours (while informing the public he is doing the opposite). All the while he has been projecting them as greedy and an unwilling work-force. You are watching all this silently.

The fact is that junior doctors are tired, fatigued, exhausted, demoralised and yet they stand erect and defend the health system of your nation.

I will spare myself the energy and assume that you know more than I can ever explain. You will be well versed on the internal workings of your own government, therefore, I will draw your attention to a few things which might have escaped your attention. I do not think that this has escaped the attention of Jeremy Hunt because it appears his is a well calculated mission.

First, all signs suggest that you want to privatize the NHS. If that is so, you should come out boldly and declare to the public that you want to do so. Firing the gun from the shoulders of the junior doctors and blaming them is not graceful nor is it worthy of a strong Government. The public who have placed you in the high office have the right to know your plans rather than manipulations. If your Government succeeds, cutting the pay of junior doctors and increasing their working hours, junior doctors will survive in one way or another. However, the entire population of your country will suffer. I do not think that they will forget nor forgive. Therefore, before you dismantle the NHS, it is imperative that you rethink your plans because the health and wellbeing of your country depends on it, and for this, you are directly answerable – even in the future.

Second, the Health Secretary has succeeded in downgrading and vilifying the medical profession as much as possible. Once again, you are a silent witness to this. He has taken away all the motivation and incentive from bright and elite students of your schools and colleges to choose the medical profession. If he is allowed to succeed further, you might find medical colleges left wanting for students. That would create an enormous shortage of qualified and quality doctors in the long run and an ever increasing burden on the health service.

Thirdly, if you and Mr. Jeremy Hunt succeed in privatising the NHS – I can see how this could be the interest of Mr. Jeremy Hunt. Your previous health secretary Mr. Lansley, has recently take a role in a company who is promoting privatisation of The NHS.

If The NHS is short of funds (and we know it is, through systematic underfunding by the government), it is not the fault of junior doctors. On the contrary they have to work even harder without adequate machines, equipment and staff. It is a simple case of mismanagement of finances and mismanagement of administration. Instead of pointing the gun toward the junior doctors – who are the weakest link in the chain of NHS hierarchy – aim your guns at cleaning and pruning the financial management of NHS. Look deeply into it as to why The NHS is in this position.

There are 53000 junior doctors. They are working for at least double that number. Each doctor is giving you output for at least two doctors. Instead of motivating them, patting them on the back, and incentivising them, you want to pull the carpet from under their feet so that all of them tumble down. More worryingly, you are willing to do this on the whims of a few people who may not think beyond their own interests at the cost of the health of your entire nation.

Your junior doctors are dedicated, hardworking and responsible. They are the future specialists, researchers and innovators. They are the backbone of the health system of your country. Give them the respect they deserve. Give them the motivation and sense of worth. Applaud them for having chosen the medical profession.

I have seen them working with dedication and without complaining in spite of all the hardships they face as my son is one of 53000 junior doctors.

This letter is the voice of 106000 parents who are proud of their children and their devotion to the service of people.

Best regards,
Anil Bhatnagar

Be Your Own Yardstick

I will start by admitting that I, like most other people, did not like the way I looked for a long time. More accurately, I had insecurities about some parts of my body, some of which remain to date albeit in a very passive way. So I understand that as humans, we always want what we don’t or can’t have. I have worked very hard not to measure myself against people who bear no resemblance to me. I realised very early on that my genetics are out of my control so wanting to be someone completely different was a futile aspiration.

I have always been skinny or more politically correctly slim. I used to hate the word skinny when I was a teenager because to me, it represented a person who was gawky, awkward, boy-like and unattractive as a young woman. I realise that most girls put on weight around puberty and looking at the stick-thin waifs gracing runways, magazines and Hollywood movies, it is easy to see why they would aspire to be skinny like I was. I was completely oblivious to this as I was quite the tomboy and did not have any time for magazines when I was around puberty. The movies I loved were mostly animation and even if the girls/women portrayed in most Disney movies were on the smaller side, they all had the beautiful curves I adored. My mother has lovely feminine curves and so does my glamorous older sister. Perhaps being African where the culture predominantly celebrates curvaceous women had a bigger influence than I was conscious of too. My celebrity role models were Halle Berry, Julia Roberts, Jennifer Lopez and later Beyoncé and Alicia Keys all of whom have (and celebrate their) curves. All of those things meant that instead of the usual Western ideals of being a size 6, I was self-conscious. I wanted to be bootylicious and packaged in a short petite perfectly proportion frame.

The worse part for me was having to go shopping. Again, another aspect where I differ from the norm. It probably started out because I used to accompany my grandmother to the market in Lagos and she used to take her time visiting stall after stall finding the best quality food for the best price. I would follow impatiently, wishing she would speed up and within an hour, I would develop a painful ‘stitch’ in my side, making me want to sit on the ground (a massive no-no as it was rather murky in Lagos markets).

As I grew older and had to start participating in shopping for my own clothes, it was okay because my mama like me is impatient with shopping and she used to be quite military with it. When I became an adolescent, my mama decided to give me money for clothes shopping and it became my responsibility. The shoes, underwear and bags were easy enough because it was just a matter of looking to see what caught my eye. Clothes on the other hand was a nightmare! I vividly remember days coming back dejectedly after 6 hours on Oxford Street in London and trying on top after top and jeans after jeans and none of them fitting well. I would look in the mirror and see this anorexic figure staring back at me. Some of those days, I would be so demoralised that I would cry. Thankfully, although I haven’t put on much weight over the years, I have acquired some (slight) curves which means that I am now a proud standard size 6 or 8 depending on the shop. I can confidently go out to buy new clothes knowing now I will find things that fit. It is just a matter of finding the style I want for the price I am willing to pay for it.

The lesson I taught myself early on was that there is no use aspiring to become curvaceous like J-Lo overnight. Rationally I knew I was going through puberty and it would take time before I developed curves. Also I had seen pictures of my mama in her 20s (pre-children) and she didn’t have much in the way of curves back then. I also looked around my family and realised that most of the young girls were rather skinny. Fulanis in general are skinny folk anyway (think Masai-like physique, same ancestry). I would tell myself that just because Britain was predominantly British and it catered to the genetic makeup of that population did not make me unattractive. Many of my friends and family told me countless times that they would rather have my body than theirs but I thought they were lying to boost my confidence. I only started to believe them once I grew my curves and became more body-confident and got strangers complimenting the way I looked.

I am still not a massive fan of the mirror and often forget to look at myself in it. I still find some of my features surprising and often when someone mentions something about my facial features, I have to go and look in the mirror to work out what they are talking about. I’ll give you a classic example of my lack of self-awareness. I was 14 years old when my sister and I went into a shop I had never been too. I turned a corner and caught sight of a girl who I thought looked vaguely familiar and I mentioned that to my sister casually. It probably didn’t help that at that age, I was still in denial about my short-sightedness so did not have perfect vision. My sister looked at with a smile like I had made one of my endless jests. I was confused. It dawned on her in seconds that I genuinely had seen myself and did not realise it was me staring back from the mirror. Oh well!

In general, I guess it is a good thing that I am not self-conscious about what others see when they look at me. I care more about presenting a professional look when I am at work and a ‘nice’ look outside of that. All my adult life, I have chosen an extra 5 minutes in bed over putting on makeup in the morning. Thankfully, being sexy or desirable are not issues I care about. My dear husband assures me that I have those characteristics in abundance anyway and it is only in his eyes that it is important I am those. To anyone else, it really doesn’t matter to me what they think of how I look as long as they see that I am a decent and caring girl inside.

My message is simple – I value what sort of a person I am inside more than out and because of that I do not compare my ‘beauty’ to others. I have simply learnt to embrace and even love the body I was blessed with. I see beauty in all body sizes and shapes, colour, height etcetera. As Christina Aguilera says in her song Beautiful and I paraphrase – ‘I am beautiful, no matter what they say. Yes, words can’t bring me down. I am beautiful in every single way. Yes, words can’t bring me down…Oh no! So don’t you bring me down today…And everywhere I go, the sun will always shine.’ Preach! Belief in your beauty, regardless of what people say because there will always be critics but that is their problem, not yours my friend.

Listen to Granddad

My grandad by everyone’s standards is a legend. He has seen and done so much in his lifetime and he continues to do so today at the age of 85. Look him up. Ahmed Joda is his name. I won’t bother to write about his many achievements because so many have done so over his many years of service. I want to write about the man beneath it all. My grandad who I call Baba. We all do, his children and grandchildren alike. Because before I realised what other people thought of him, through my young eyes, all I saw was an ‘old’ man who was my mama’s dear father. My only grandfather. The patriarch of the family who was also the main father figure in my life.

The first thing we all know about Baba is that he is a stickler for punctuality. Now this might not sound significant to you but coming from Nigeria, it so is. Have you ever heard of the concept ‘African time’? Did you know ‘Nigerian time’ constitutes even worse ‘lateness’? So a Nigerian who is always on time is as rare as hen’s teeth. His most precious possession is his watch. He looks at it every few minutes even when he has absolutely nothing to do. It’s like a nervous tick. And God forbid he forgets his watch at home, he will drive us all mad asking for the time every 5 minutes.

When Baba asks you to meet at 5pm, at 5:01pm he will be on the phone asking where you are if you are not there. If you make plans to go somewhere with him, be sure to get there on time because I kid you not, if you are more than a couple of minutes late, he will go without you. Whoever you are and wherever you were meant to go with him. I think I wrote a blog about how he invited his friend from Abuja to come to Yola (9 hour road trip) to join us all on a trip to Gembu (6 hour road trip). We waited for 20 minutes and despite the fact that it was 6am and we would get there by lunchtime, he declined to wait and left without them. Lord knows what they went through to find Gembu because Nigerian roads outside of Abuja and Lagos are poorly signposted especially places like Gembu and they didn’t turn up until the next morning! We in the immediate family are no strangers to his bark of ‘come on!’ which when I was little used to make me cry because it sounded so scary. Over time, I have learnt not to react so emotionally to it but still, when that bark comes because we are more than a minute late to leave for some engagement, my heart skips a beat.

I once asked Baba why being punctual was so important even when no one else (Nigerian) cared and why we had to be the first ones at every event. He explained and although I cannot remember exactly how he phrased it, the message is reflected in the following quote:

‘Know the true value of time; snatch, seize, and enjoy every moment of it. No idleness, no delay, no procrastination; never put off till tomorrow what you can do today.’

Lord Chesterfield

He certainly lives by that rule and as I have said before, he has achieved more than most people would in 3 or 4 lifetimes. Perhaps he is still going so strong at 85 because he is mindful of seizing every moment he has been blessed with. I certainly want to emulate that when I grow up.

So many things I love about Baba but one of them is easily how much he has empowered us all to speak our minds. He has never been of the school that children should be seen and not heard. From a very early age, he would ask our opinions on topics most adults would never broach with children and he would give your answer his undivided attention and take it on board. Many years later, he would repeat your words to you especially if you had learnt from experience that things were not black and white and he would invite you to explain why the change in opinion. This means that in the Joda household, we are all prolific debaters and will put across our arguments without fair of censure as long as we were being honest. Active debate is encourage actively and even the youngest gets heard as long as they want to contribute. I think what keeps Baba so young at heart and full of zest is that he surrounds himself with the young and he sees life through our eyes. That way, his ideas are always in date and he can converse about whatever you choose to discuss.

Somehow, Baba never asked me what I wanted to be when I grew up until I was 13 years old. I brought the topic up because when I was choosing my optional subjects for SS1, my mother expressed surprise that I didn’t want to do Economics. My response was one of surprise too because although I was good with figures and mathematics, I was always more into my science than finance. Turns out Baba thought I would make a great economist. Next time we sat around the dining table, I asked him why he thought I would make a great economist. I can’t remember his reasons but I promptly told him I was going to be a doctor and that there was no way economics would even feature in any options I would take for a career path. He expressed his disappointment that that was the path I had chosen but of course it was up to me. I was going to be the first doctor in the Joda lineage and thought he would appreciate my individuality.

It wasn’t until I was qualified and he sought my opinion on some of his medications that I felt he was proud of the career path I have chosen. So was I right not to listen to Baba? I thought so until the recent NHS upheaval which might mean me changing career tracks this late in the game. He is almost always right my grandad after all. Maybe what he foresaw was that being an economist would be a better quality of life for the grand-daughter who was feisty and named after his beloved wife. Perhaps he knew that my hard work and talents would not shine the brightest as a doctor. Perhaps he even predicted that I would end up working in the NHS whose main shortcoming is its poor economics. Who knows? As of now, I think I chose the right profession. I knew I wanted to be a doctor before I even know what a doctor really does. I love the job itself now, more than I ever thought I would. However, the politics of the NHS now means I am questioning whether my love for the job justifies my continuing on in the career when it means me risking my health, my social wellbeing and happiness and giving up so many of my dreams. Watch this space!

Appreciating the Small Things in Life

I don’t know if I mentioned that I got married last year in April. I must have somewhere. We have made it through the first year baptism and we have grown as a couple so much. Of course it hasn’t been smooth sailing but I would not have expected that being that we are both passionate about what we care about, both rather opinionated and both not the types to shy away from an argument. My post is not to pretend it is all paradise, a fairy tale. Perfection. It is in fact about the opposite. About how it doesn’t have to be perfect but you can be perfectly happy especially if you stop sweating the small stuff and instead start appreciating the little things that make the relationship great.

My husband from time to time gets a little insecure (particularly after a few days of me getting increasingly irate when he is not doing his boring chores) and asks if there is anything I think is good about him. I always react with a bit of disappointment because I know what I am like and when anyone does even the littlest thing that makes me smile or happy or proud, I am the first to say it, usually using the word ‘amazing’. So this here post is to tell you about the little things the husband says and does that makes me go all  mushy inside and makes me forgive him when he does the big things that make me want to cry in anger or in frustration.

I will start with a little thing he does which always sets my day up nicely. He makes me a cup of tea or if I am lucky a sandwich for work. I will admit now I am not usually a morning person so finding that he has made time for me in the morning and so saved me some time makes me go all warm first thing in the morning. It just used to be tea in my travel mug to drink on the way to work or on weekends in a nice mug by my bedside. Today, he presented me with the flask pictured above. Not only has he made me tea, he has gone out and bought a little flask to keep it warm knowing how slowly I drink tea and how it goes cold before I get to the last drop. And the flask is in a colour I love and the writing on it is paying me a compliment. What better way to start the day I ask you? I look outside right now and it is a grey rainy Monday morning but my heart and soul are smiling like the sun is up and shining Yola-style.

The other day, he went out and came home in the early hours to find me in bed. I was curled up on my side, tensed up waiting to see if his hands were cold from being outside. Imagine the relief when he placed his warm hands on the small of my back. Better yet, his hands were covered in oil and he gave me the loveliest backrub I could have asked for. I drifted back to sleep and it was the best night’s sleep I had for over a month. That’s #2 of the small things he does. He gives me impromptu massages, backrubs, foot rub, head massage when I need them the most. When I come home after a 14-hour day at work and collapse in a heap and I am so tired I cannot muster up the energy to take off my shoes or eat dinner. In the same vein, he will also fetch my dinner and a drink and make me eat it all then when I start to doze off with my plate still in my hands, he takes it all away and even carries me up to bed. How could I help but love him?

He pays me compliments all the time. I am quite a low maintenance girl if I say so myself and I have a healthy appreciation of myself. I don’t have any great hang ups and my self-image is good. I do not need compliments but I do appreciate them. Who doesn’t? Like the compliment on the pictured flask, 4 years and counting since we met and I know he thinks I am hot. Let me be honest, I do not see myself as hot. I know some people think I am pretty, my mama and sister certainly say I am beautiful and so do my closest friends but I sort of take it for granted that they see the beauty within as well as without. I know I am not ugly and even strangers have paid the odd compliment to me. Omosede Ighile even called me beautiful many years ago when no one outside my family had ever and I won’t ever forget that compliment because those days, I was a little less self-confident and it meant a great deal. Anyway, I digress. Sorry. Some days I look in the mirror and think ‘niiiiiiice’. Some pictures I think ‘wow wee’ maybe he is right I am hot but mostly I don’t remember to look at myself because honestly I do not care how I look most of the time. He does though and what I think is too skinny to be womanly, he loves. He looks at me like I would expect a guy to look at Shakira, Jennifer Lopez or Halle Berry. He gives me a smile that I know means he thinks I am sexy and you know what, it feels damn good. Because I know with many men, after that initial honeymoon phase, they stop seeing your beauty and it all becomes boring routine. Not for my hubby. He sees my beauty even when I am at my scruffiest, usually post night shifts wreck and he tells me verbally and with his eyes. Aren’t I a lucky girl?

Linked to his complements is that he is proud of me. Not only does he think I am hot, he also thinks my brains are hot. I mean, I can’t pretend not to know I have been blessed academically. It’s all on paper from the time I was like 2. So yeah, I know I am no slouch in the intellectual department. However, being a doctor and surrounded by lots of doctors who are not just intelligent but many are in the genius sphere (unlike me), I do not feel as special as I did say back in primary school when I was the school’s big brain. But when I am around my husband or when I hear him talk about me to his friends, I go back to that happy place where my mama was bursting with pride at her baby’s academic achievements. When my sister used to tell everyone who would listen how much of a Brainiac her little sister was. He is so convinced of my intellectual prowess that he would rather listen to me prattle on about religion, nature, culture, psychology and even art than consult Professor Google or people in those fields. What is best is that despite not being medical in any way, shape or form, he swears I am the best paediatrician ever. Even after I was facing my first ever exam failure (post-grad paediatric specialisation exam, 1B). I laugh but really, I am delighted that someone has so much belief in me that even when I doubt myself, he is there to shake me back into believing and therefore being great again.

Following on from there, he likes to hold hands. Small thing #5. He is so proud to be my husband. He was proudly proclaiming that even before I agreed to be his wife. My sister and I used to try to curb his enthusiasm and point out he wasn’t even my fiancé at the time but he was irrepressible. It was ‘my wife’ this and ‘my wife’ that within the first year of our courtship. Silly man! I got used to it eventually but it took a while. Now he will get upset if I fail to hold his hand or kiss him long enough in public. I know he takes it seriously so I try but I am a shy Fulani girl. Public displays of affection (PDAs) do not come naturally. Particularly when it goes beyond a quick kiss. I still get embarrassed. Not because I am not proud of him but because I have been brought up a certain way and PDAs are a no-no in Yola. The attention it draws is just a little embarrassing for this Fulani girl. But I am working on it.

Last small thing in this post because I will be late for work otherwise. He will dance with me whenever I give the slightest sign that I am in the mood for it. As soon as I start singing a song or I start nodding my head to music, he will duet with me and he will want me to get up and do a dance. Unfortunately for him, I don’t have the energy he does after work (it is physically and mentally draining being a doctor if you are not one). So I will usually bow out after one dance but he will happily dance for me whilst I cheer him on. His energy and enthusiasm, whilst in need to curbing most of the time is an amazing quality and I might not say this to him often, it is what stops it being boring round ours and we are always up to something or the other. Keeps it all fresh and turbulent and exciting. Much better than boring which I have a very low threshold for. Might explain why I am a paediatrician. It’s a lot of things but so very rarely boring.

So there you are dear husband and dear readers. I have told you all today about some of the reasons why I love my husband so much and why despite all the big faults, I love him to bits. Tell me what little things you love about your husband/partner/lover/wife/girlfriend/fiancée too. I would love to hear it!

p.s this paragon of ‘small’ virtues is called George. My Georgey boo 😀

Save Our NHS!

Sharing this from a doctor’s facebook wall with permission because she says it better than I could express through the mounting frustration and despair I feel.

“I would like to tell you what the NHS means to me. It means that as a doctor. I get to think about what my patients need, and what is best for them. I get to think about that, above all else. Because my patients are someone’s daughter, someone’s wife, someone’s mother, someone’s mentor, someone’s shoulder to cry on, someone’s friend. I get to value their life over all else.

I love that. I love that when I’m driving down a busy street at rush hour, and an ambulance with blue lights and sirens wailing, presents itself to this mass of people on the road – people with jobs to get to, meetings to attend, events to arrive at, exams to sit – not one of them stops in the middle of the road and refuses to let the ambulance pass.
Not one of them thinks their schedule is more important than the stranger in the back of the ambulance, fighting for their life. They, the general public, the person on the street, the people of Britain, value a stranger’s life above everything else at that moment. I love that. I love the humanity.

Jeremy Hunt says, he wants us to provide a 24 hour NHS. I think thats fantastic. I am pretty sure I have already worked every hour of every conceivable day to make up the 24/7 ideal. I work bank holidays and public holidays and religious holidays. I work often right up until I need to leave to catch a train to a graduation or a wedding. Sometimes I have an Emergnecy and I work past that. And I send my apologies and I lose my tickets. Because the person I am working on matters. Because I value their life over all else at that moment in time.

I think a 24/7 service is wonderful. It’s the dream. It’s like dubai at night. Or New York always. The service that never sleeps. I mean. I never sleep. Not on call. But, yes, sure, things can be delayed. It takes longer for one doctor to see 80 patients at night, than it does for a team of 4 to see them during the day. It takes longer for one lab technician to process 80 blood samples vs a team of 5 during the day. It takes longer for one radiographer to image 80 patients overnight than a team of 3 during the day.

The hospital is not just made up of doctors. We cannot work without our colleagues. Nurses, phlebotomists, pharmacists, radiographers, porters, health care assistants, scrub nurses, physicians assistants, and anaesthetics techs.
We all work together as a team. At all hours of the day and night. Because we value the life of the person we are seeing.
We would love a 24/7 service. But you cannot achieve it by taking the same doctor, spreading him or her thinner to cover the gaps they are already covering regularly – and then tell them that’s what they ought to have been doing all along so let’s slash your meagre pay by 1/3 for good measure.

To achieve the sort of dreamlike 24/7 service Mr hunt is selling and we all want to buy. The answer is simple. Create more training posts. Hire more doctors. Twice the current amount. Hire more nurses. I’m tired just watching them scramble night after night, running between rooms taking care of double their normal case load. Hire more ancillary workers. If you really wanted a fully functioning service, where 3am on a Sunday looks the same as 10am on a Tuesday, that’s the solution.
Don’t fillet and tenderise your already overstretched team to plug the gaps. And don’t turn the public against them because they have said that it’s not right.

What happens to our value as human beings? As care givers? As people who place others first? Where is the logic, in destroying one of the greatest legacies of modern history? In order to reappropriate the money as bonuses for management consultants who “told us what was wrong”.

I never finished my story about what the NHS means to me. When I’m done with my job. And that isn’t dictated by the clock but by when my patients are all stable. When I’m done I go home to my mother, who is terminally ill. Sometimes she is very unwell. And at those times I return to the hospital. This time not as a doctor, but as patient and family. I cannot begin to explain the relief in knowing that our arrival isn’t heralded by piles of paperwork to determine how much money we have to pay for treatment. They wouldn’t find much. I’m always overdrawn. I once laughed when I lost my wallet, because there wasn’t any point in cancelling my bank cards. They would find nothing in the account. I am 34 years old and a “junior” doctor that has been working for 10 years. But I have nothing worth stealing. That’s because I usually just get paid enough to cover my rent and bills. And when I need to do exams or get a wedding gift or live without relying on a credit card I would pick up extra shifts, working even more weekends and holidays than I normally would, which was already a lot.

Then, like a lot of my colleagues. I volunteer. I volunteer my services to local communities. I voluntarily sit on charitable boards where I help develop plans to help the most vulnerable in society. I travel to refugee camps to help those that unlike me, cannot make ends meet, have been forced out of their homes through no fault of their own, and now have no one to care for them. Very few people value them at all, these proud, resilient, insightful people in camps and on journeys – let alone above all else.

So I am grateful for the NHS. Because as a terminal cancer patient. My mum and I show up at our A&e a lot. And often at the most inconvenient times. 3am. 7pm. Weeknight. Weekday. The tumor doesn’t care. But you know who does? NHS staff. They care. They value her life over all else when she walks through the door – even if she may not have very much life left to live. They always smile. They always listen. They are always patient and kind. They are cheerful most of the time, even as their pagers bleep mercilessly through every conversation they have, alerting them to another patient in need of being valued.

They trundle away regardless of the time, tucking my mum into bed, helping her to the bathroom, taking her blood despite the fact that her veins disappeared under the influence of chemotherapy long ago. Patiently searching for those life giving green threads in her hands and arms. Listening to her chest. Poring over her substantial medical history to make sure they understand everything. Discussing the minutiae that may unveil what the cancer is doing this time and how they can best hold it at bay. There are no shortcuts even at 3am. They value their patients and the families above all else. And I love them for that.

That’s what the NHS means to me. Service that comes full circle.

I treated someone’s mum like they were the only person in the world that mattered right then. And later on that night, some other kindly fatigued uniformed intelligent gentle soul did the same for my mum. And sometime during those 24 hours someone was late to pick their kids up from school or collect their dry cleaning – because an ambulance with the most valuable person to someone else, closed off the road they were on as it whizzed past.
That. is Healthcare delivered as a right, not a privilege. That is humanity. So the only question, Mr. Hunt. (And anyone else who backs the sham of making an understaffed workforce doing the best it can to work twice as long for two thirds of the pay, and ensuring that women who have families and researchers who seek to cure terminal conditions like my mother’s can’t do their job, which is what they value – ) the only question is – What do you value above all else? Money? The bottom line? The shareholders? Your mates who run companies that want private contracts? A shot at being PM?

None of that will matter to you when you are ill, Mr. Hunt. I promise you. At that moment in time. You will value your health above all else.

More than that, you will want a team of dedicated well trained NHS employees to value you above all else.
Value.your.health.service.”

Being a Paediatrician

I knew I wanted to be a doctor when I was about 4 years old. I can’t explain now how I came to that conclusion or why I was so sure. I just knew and now I am a doctor. In my 2nd or 3rd year of medical school, as part of career guidance we were given a link to a website where we could input our data and get a psychometric analysis done on us. I had to answer a series of questions about how I felt about certain things, my beliefs, my principles, how I solved problems. Eventually, I answered the numerous questions and it took a minute or 2 to load. Then it gave me the list of medical specialities ranked according to the ones I am most suited. Pathology and neurophysiology came last as I would have expected but I was taken aback by the top 3 choices. It said: Paediatrics, Palliative Care and Neonatology. I poo-pooed the test and dismissed it. When I went into medical school, one thing I was certain of was that I loved children and I never wanted to see them sick and suffering. Therefore I sort of ruled out paediatrics very early on. Back then I thought I might end up being in Obs & Gynae (obstetrics and gynaecology) because it was a good mix of medicine and surgery and I thought the variety and acuteness would suit me. I also thought I could be a GP because it retained the versatility of all of medicine without having to make a choice.

During my Obs & Gynae posting as a medical student, I found that although it was interesting the speciality did not set my pulse a-racing. There was no eureka moment. The specialists were nice but I didn’t feel any kinship with them. My paediatrics was my last medical school posting and the moment I stepped into the Children’s Hospital (BCH), I felt an excitement. Even though most of it went over my head and there seemed to be a lot of calculations and there was the issue of small people who were not well, I felt right at home. Over the 6 week placement, I grew to love BCH. I loved the patients, the child-friendly wards with their play areas, the kindness of the nurses and most especially, here were doctors I wanted to be like. Who I enjoyed spending my time with. Who seemed to derive pleasure from their work even as they were rushed off their feet with the number of patients. By the end of that placement, the career puzzle for me was solved. I was going to be a paediatrician. And to my surprise, the patients I loved spending time the most with were the little premature babies born with complex problems needing surgery to survive.

As an FY1 (first year after graduation from medical school), I met a patient in her 30s who had inoperable incurable ovarian cancer. We bonded as I tried hard to get some blood out of her for some tests her consultant had ordered. When the ordeal was over, I thanked her for being patient and she called me back to say she thought I had a way about me that would be perfect for palliative care. She said she didn’t know if I already had my career mapped out but that I should think about going down the Palliative care route. I thanked her for her kind words and left in a reflective mood. Despite my psychometric prediction, I had never given it much thought. I considered it over the next few days and concluded that although I was a listener and when it came to my patients very patient (unlike in my personal life then), I wasn’t sure I could handle all the emotions that are linked with patients who are dying. So I filed the idea away under ‘unlikely’ and didn’t give it any more thought until just recently.

Earlier this year, I stumbled across an online course on paediatric palliative care and signed up to it. As I worked through the course modules, I realised that I was into all the issues that were being raised and although a lot of it was challenging, it was exactly the kind of challenge I relished. A lot of it was to do with talking about options and choices. About spirituality and counselling. About co-ordinating care. About letting the dying patient and their relatives dictate the terms about how these last days/weeks/months should be handled. I realised that palliative care is not just about the advanced care pathway which outlines what to do when death is imminent but also about actively keeping the patient well enough to reach certain goals. It is about enabling the patient to die in a way that is most acceptable to them. It is about being there for the patient and their family so that when things become scary or unexpected, there is a comforting presence to guide them through the darkest hours/days. So I have come full circle and now I know that I would like to sub-specialise in paediatric palliative care. I wish I knew where my Obs & Gynae patient was so I could share the news. I wonder if she is still alive today.

I love being a paediatrician by the way. If I don’t end up sub-specialising, I would happily be a general paediatrician. There is a different vibe on a paediatric ward or in a paediatric hospital like BCH. There is a friendliness that is missing in adult medicine. People seem to go out of their way more to be helpful in the paediatric world. Nurses do not seem to be as difficult or as disconnected as they can be in adult medicine. The paint on the walls is brighter happier colours. There are toys, music and games everywhere you go. The best bit about my job is the children. It is such a privilege to work with kids. They are amazing little packages, mostly untainted by the negativities that come with growing up. They come out with the best statements and questions that make you stop and think or laugh until your belly hurts. Their bravery is comparable to none and watching them as they struggle with illness and develop ways of coping is inspiring.

Of course paediatrics is a complex speciality by its very nature. Our patients are often too young to tell us how they feel and exactly what their symptoms are so we have to be more observant than our adult counterparts and we have to go on what other’s (parents/carers) impressions are more than the patient’s own words. Many do not understand why they feel poorly. They just know that they are not happy and they want it to be fixed. Parents are often not at their best when they meet us because they are anxious and stressed about their sick child and are frustrated because they have no solution to put them out of their misery. So yes, it is often the most difficult part of the job having to face irate upset parents who want to find someone to blame for their helplessness. Who want to take out their frustrations on someone else and make demands because it makes them feel they are doing something…anything. Sometimes, these parents do cross the line of anxious and stressed parents to parents who are abusive (mostly verbally but occasionally physically). Unfortunately, it comes with the job but we deal with it in our own way. Usually by being patient and reasoning with but where necessary we call on services to support and protect us. Luckily, these horrible encounters are not an everyday occurrence.

I have so many examples of the beautiful little people I have come across in my job but I will tell you about a recent one. I was on-call over a weekend and covering the haematology ward (haematology deals with diseases involving the blood cells). A 2½ year old boy with severe haemophilia B came in with bruising which meant he needed an injection of factor IX (the bit of blood he doesn’t make enough of which is essential to prevent you bleeding without much force). It was my job to treat him so with his parents and a fellow doctor assisting, we held him still and I injected the medicine into his vein. He cried as I did it and when it was done (it only took a minute), his parents prompted him to say thank you. Through his tears, he turned to me and said ‘thank you’. Then as I tidied up, they got their things together to leave and he waved and said to me ‘bye lady’. With no resentment. Despite the fact that I had just poked him with a needle for reasons he was too young to understand. I thought wow! Only a child would be as forgiving as that. The momentary feeling of guilt for making the gorgeous little boy cry passed with that exchange and off I went, to do more things to other children which might make them cry in the short term but looking at the bigger picture, everything I do is in their best interests so when I go home and I go to sleep, I feel happy and satisfied. And thankful for another day where I have done all I could to make another child’s life that bit better.