#the first half of episode three genuinely made me feel unwell

[sailor-sylveon]

man it’s actually such a shame that the animation quality of uzumaki dropped so hard because the body horror scenes are absolutely insaaaane.

[glorious-blackout]

Summary of Junior Doctor Life - Surgical Receiving Edition:

Came back from annual leave to find that the pager I left in our doctor’s room has vanished off the face of the earth. Which is honestly a dream come true, until you start the annoying process of requesting a new one.

Surgical Receiving means you’re the junior who covers all the new patients coming in, while also holding the page that accepts GP calls referring patients to the department. We need to either accept or redirect these patients, and if they’re accepted we need to clerk them in and take bloods on top of our other jobs. It ultimately creates far more work than you can physically do in one shift, hence me feeling guilty for managing to grab a whole 20 minute break during my 12 and a half hour shift.

It’s also a seven-day stretch: three 12 and a half hour shifts - which usually end up being 13 hours - followed by four 9-hour shifts. By day seven I was starting to crave the sweet release of death, though I would maybe have settled for a good nap. 

Carrying the Surgical Receiving page means you occasionally get calls from GPs who aren’t quite at the stage of referring a patient, but are asking for advice. I’ll say again: the GP who’s been working for several years has to ask me - the clueless FY1 who’s only been working five months - for advice on a patient I’ve never met. It tends to go about as well as you can imagine.

It’s also an indication that the receiving page should really be held by seniors who can actually make informed decisions about who to accept and offer useful advice to GPs. The only reason we carry it is because the shift is so rubbish that none of our seniors can be bothered.

Six out of ten calls we get from GPs are due to suspected appendicitis (very few of which actually turn out to be appendicitis). The rest is a lovely mix of gallstones, rectal bleeding, bowel obstruction/perforation and abscesses. Who says surgery isn’t glamorous?

It only took five months but I finally have a patient who stuck something up their bum that doesn’t belong there (it was lip-balm...and no, we still don’t know why).

One day two of my patients decided to collapse while on the toilet. The first lady was so dramatic that a peri-arrest call was put out... only for it to turn out she’d had a fainting episode due to dehydration (when I saw her that afternoon she was sitting up and reading a magazine). The other lady had some extensive rectal bleeding which led to her BP dropping into her boots and the need for multiple blood transfusions. We were all a bit exhausted by the end of that shift, not to mention wary of letting any of our patients near a loo.

One of the patients absolutely hates me with a passion, to the point where she groans every time I approach her. Granted, I tend to be approaching her with a needle so from her perspective I probably am a bit of a monster.

(She’s surprisingly tolerant once I explain why I need to take her bloods/insert a cannula for the umpteenth time. It just takes a bit of gentle coaxing :P)

A common phrase you hear during the really busy shifts is “Look, I know you’re swamped but...”. Nine times out of ten the nurses are genuinely sympathetic and the request is reasonable, but there is the odd time where they seem to want you to discard your mountain of jobs in order to deal with their problem.

Case in point: I was paged three times to review a lady who was still nauseous despite having regular anti-sickness meds. She was otherwise well and we’d made a plan for her during the ward-round which I’d only just put in place. This wasn’t a priority compared to my other jobs and I had a more unwell gentleman to review, but the nurse was insistent that I review this lady just for ‘peace of mind’. Which is a nice thought... so long as you happen to have a spare 20 minutes (which I didn’t).

After three days of Receiving you do a Post-Receiving shift: basically you look after the same set of patients but you no longer carry the page or accept new ones. Seeing as all the required surgeries/treatments are usually over by that point, most of Post-Receiving revolves around sending people home. Which on the one hand is lovely because your workload reduces every day, but on the other it results in you having to do fifteen discharge letters/prescriptions in one shift. 

The last day of Post-Receiving should, in theory, be a breeze. Your list of patients has dwindled from 30+ to 9 and most of those nine are on their way out. Sadly my dreams of an easy shift were ruined when one patient who should have been going home selfishly decided to drop her oxygen saturations. C’est La Vie.

The wonderful folk who designed our rota were obviously sadists, because instead of splitting up this particularly exhausting set of shifts, they’ve grouped them together so you have two Receiving/Post-Receiving weeks in a row. Round Two starts on Monday... Yay? 

[gaiatheorist]

Four years.

Four years today, I left hospital after a brain haemorrhage. I usually refer to my ‘discharge’ in snark-marks, and I’m trying very hard to consign the rage to the imaginary file ‘That happened, accept it, and move on.’ There were systemic failings, and personal ones. The last four years started with the ex bringing me some uncomfortable boots, that I didn’t wear often, but he liked, and, once I was in his car, telling me that I might need another operation. That information shouldn’t have come from him, and I shouldn’t have spent the next few days pecking away at Google, trying to figure out what had happened in my brain, and the likely prognosis for the repaired aneurysm-rupture, and the two remaining ones. 

It was, in part, his coercive control. He wanted me ‘home’, and he was going to ‘look after’ me. I accept that my near-miss was terrifying for him, he saw the 10 days I have missing from my memory, he had the medics take him into a quiet side-room, and explain that I might not live through the surgery. I wasn’t ‘there’ for that bit, and nobody knew how much of ‘me’ would make it back. 

I’ve just checked my Facebook ‘memories’, it’s routine now, I originally started doing it when I went off work sick, deleting anything derogatory or inflammatory, it’s as purged as it’s going to be now. I’d posted some confused babble about having been in hospital, but being home, and there were 41 comments, mostly “OMG! Get well soon!” from people I’d not seen for decades. Posting that status update, after two weeks of nothing at all was very important to me, I’m not a particularly sociable animal, the light-touch of social media suits me, I’m also a sarcastic git, so “I’m not dead!” amused me. What didn’t amuse me was feeling that I ‘had to’ make that announcement. I have almost two weeks of my life missing, between the initial brain-fail, the induced coma, the drug-fog, and the ex having my phone. During the two weeks I was MIA, I have no idea who knew what. I do know that the ex bought a charger for my phone, the “Let me know you’re OK?” messages were on the lock-screen when he eventually allowed my son to hand it back to me. Unread, unopened, not-responded-to, the ex didn’t have my pass-code. He’d told me I “wasn’t allowed” my phone, and, when I asked him to bring in my Kindle, he told me there was no WiFi in the hospital. He lied, there was WiFi, it just didn’t occur to me to ask the staff how to access it, I spent ages trying to work-around it myself, on the Kindle, and on the over-bed TV screen, round and round in fruitless loops of ‘information for patients’ and details about pharmacy and laundry services. 

I know he was confused and frightened. So was I. I expect some of ‘my’ people were, too. He deliberately cut me off from the outside world, and then took two weeks off work to ‘look after’ me. The man can barely look after himself, so, as well as suffocating me with his presence, and threatening to ‘strap me to the roof-rack’ and take me to hospital if I deteriorated, he ate lots of toast, and made lots of mess, which I ended up cleaning up. SNAFU. The hospital had told him there might be some personality changes in me, and I genuinely believe that he hoped I might go all ‘Stepford’, and forget my side of the conversation we’d had early in February, about ‘trying’ to make the marriage work. Flogging a dead horse, there, we’d had multiple discussions about ‘staying together’, for our son, for the father-in-law. We hadn’t been ‘together’ for years, when he asked me to ‘try’, I’d explained that I had done nothing but try for the biggest part of 20 years, that I’d bent over backwards to please him, for nothing in return. I’d been cold-clear and he didn’t like it, he wanted tears, and capitulation, and me to suddenly become his subservient shadow again, his housemaid-with-holes. No.

After the brush with the Reaper, he started referring to me as his ‘warrior woman’, and proclaiming loudly to anyone who would listen that I was ‘too stubborn to die.’ He was half-right, I wanted to live, but I hadn’t been ‘his’ anything for a very long time. I pushed him away, physically and emotionally, I started to conceal my pain, because I couldn’t stand his fussing, and I decided I’d go back to work as quickly as possible, despite him suggesting I should sue my employers on grounds that the haemorrhage had been stress-induced. Control-issues, almost two decades of him deciding where I could go, what I should wear, who I could speak to, culminating in him buying me rotten pink ‘shortie’ pyjamas to wear in hospital, knowing perfectly well how much I hate having my skin exposed. 

I misjudged myself, and my capacity for recovery. I was going to ‘get better’ through sheer force of will. Brain injuries don’t work like that, it’s not like a broken leg, you don’t ‘get better’ as such, you just get better at covering up how unwell you are. The ex’s threat about taking me to hospital by force if I ‘got a migraine’, and then, back at work, the feeling that I was inconveniencing other people, not pulling my weight, this year’s Oscar for ‘acting normal’... (Stop laughing, this is my normal.) 

Four years of constant headaches, vertigo, visual disturbances, fatigue, sleep disruption, emotional lability and enormous sensory overload. Four years of muscle tics and tremors, sporadic episodes of weakness in my limbs, and that weird ‘Alice in Wonderland’ thing (Which may or may not be Todd’s Syndrome, I’ll ask at the hospital next month.), where my perception of where an object is in relation to myself goes all hall-of-mirrors wrong. Four years of ‘you were lucky to survive’, and ‘that might ease in time’. For almost two of those years I’ve been wading through DWP/PIP systems and processes that first assumed I was fully-fit, and then decided I was faking being ill. Guilty until proven innocent, 300+ pages of “As she can ‘x’, it is reasonable to assume she could ‘y’.” ‘Reasonable’ goes out of the window with some brain injuries, and I saw a Facebook post the other day of “People with chronic conditions aren’t faking being ill, we’re faking being well.” 

The formal referral for Mental Health support was a little over a year ago, MH didn’t want to take me on until neuro-psych assessment of my functional capacity was complete. Fair point, there wouldn’t be much point allocating me therapy if I was just going to dribble, and eat their leaflets. Neuro-psych assessed me as functional-with-reasonable-adjustments, so MH had no get-out-clause. The poor practitioner was very apologetic about the way the system worked, in order to access provision, I’d have to attend a three-week ‘class’, they don’t say ‘group’ any more. Three excruciating sessions of death-by-PowerPoint, lowest-common-denominator information on anxiety, that I already knew, because I used to be a Learning Mentor. Back for a review, and the therapist doesn’t see any value in referring me for any further therapy, stating that I lack the emotional vocabulary to articulate myself in a meaningful way. (That’s not the case, I’d already answered her question at the start of the session, I shut-down on her because she kept repeating a question I’d already answered.) Next week, I get to explain myself all over again to someone new. I’ll take a note-pad, with bullet-points.

Next month, I have an appointment with neurology. Four years I’ve been living with the after-effects of the haemorrhage and emergency surgery, and almost three years with the after-effects of the second, elective surgery. Statistically-theoretically, there’s a plasticity-plateau 24 months after brain injury. This might be ‘as good as I’m going to get’, but it might not. I’ve compounded the NHS-negligence with my obstinacy, years of no-response and “That might improve over time.” led to me stopping asking for help, there didn’t appear to be any, so I got-on-with-it. There is the potential that some of my symptoms could be relieved with medication. (Not the Nitrazepam in the kitchen drawer, that’s for absolute emergencies, and will probably expire without me ever using it, the ‘common’ side-effects are too similar to the brain-fog I’m trying to avoid.) I’m not naive enough to think it’ll be a quick fix, there’s the possibility of trial-and-error ahead, the somewhat co-morbid existence of physical brain injuries and Mental Health issues are going to take some balancing out, anything MH want to try me on is likely to impact on my lucidity, and anything neurology want to prescribe could well impact on my emotional well-being. Vicious circle, but I’ve tried to self-manage the ‘vicious’ in me for four years, I can’t do it alone. 

I’m deflated, I’m not defeated. I know this is going to be a difficult phase, being ‘under’ 3 different hospitals that don’t communicate with each other, permanently on-edge in case I have a bad spell, and can’t complete my Universal Credit commitments. The PIP-award expires a year tomorrow, and I’ll need to re-apply 14 weeks before that date. I’ll still have brain damage, but PIP/DWP/ATOS might well shift the goalposts of disabled-enough. I was ‘lucky’ to survive, but just-surviving is no kind of life, four years of adapting to life with brain injuries haven’t been pleasant, I’ve done all I can by myself, and now I’m asking for outside help. If they tell me I’m ‘Doing really well, considering.’, I’ll eat their leaflets.