This is Going to Hurt

I start to write up my operation notes but instead just cry for an hour.

It’s funny – you don’t think of doctors getting ill

‘Well, you’ve bought him another couple of weeks on earth.’ Come on – give a superhero a break here.

A strange realization that it’s the first time I’ve actually saved a life in five months as a doctor.

Today I meet MM, a Jehovah’s Witness, to consent her for an open myomectomy.* It’s a bloody type of operation, and we should have four units of crossmatched blood in the theatre fridge on standby.
The snag is, of course, that Jehovah’s Witnesses refuse any blood transfusions because of their (fucking stupid) belief that blood contains the soul, and you shouldn’t put someone else’s soul into you. Nonetheless, it’s a free country – so we respect everyone’s (fucking stupid) values and wishes.
MM is bright, charming and erudite, and we have a very interesting discussion. She agrees to have cell salvage* performed during the operation and I give her the specific consent form for refusing blood transfusion, even if needed to save her life. A small possibility but a real one, even with cell salvage – numerous Jehovah’s Witnesses have died because they declined blood products. She signs, though admits part of the reason is that her family would never speak to her again if she received blood. (Even more of an incentive to have a transfusion if you ask me.)

Signing a stack of letters to GPs after gynae clinic when Ernie, one of the registrars – arrogant but funny with it – strides in to borrow an examination lamp. He peers over my shoulder. ‘You’re going to get struck off if you write that. Change it to “pus-like” or put a hyphen in there somewhere.’
I look down at the offending phrase. ‘She has a pussy discharge.’*

An inpatient’s blood results show her clotting is all over the shop for no good reason. Hugo eventually cracks it. She has been taking St John’s Wort capsules from a health food shop for anxiety. Hugo points out to her (and, in fairness, me) that it interacts with the metabolism of warfarin, and her clotting will probably settle down if she stops taking it. She is astonished. ‘I thought it was just herbal – how can it be that bad for you?’
At the sound of the words ‘just herbal’, the temperature in the room seems to drop a few degrees and Hugo barely holds in a weary sigh. It’s clearly not his first time at this particular rodeo.
‘Apricot stones contain cyanide,’ he replies drily. ‘The death cap mushroom has a fifty per cent fatality rate. Natural does not equal safe. There’s a plant in my garden where if you simply sat under it for ten minutes then you’d be dead.’ Job done: she bins the tablets.
I ask him about that plant over a colonoscopy later.
‘Water lily.’

So there we go, the first death I’ve ever witnessed and every bit as horrific as it could possibly have been.

a great doctor must have a huge heart and a distended aorta through which pumps a vast lake of compassion and human kindness.

able to make decisions under a terrifying amount of pressure, able to break bad news to anguished relatives, able to deal with death on a daily basis.