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Hazards of being a Junior Doctor

January 24, 2014

The first hospital job I did was as a House Surgeon. They are called F1s nowadays, but way back then we were House Surgeons. And much of my job involved looking after the patients who had been booked to have their operations. They would arrive for their surgery which would be booked for the following day and I would have to ‘clerk them in’. This is the systematic questioning and examining of a patient to find out what the problems are, check they are fit to have the surgery and do any of the work up required beforehand. Like bloods, put up drips, write X-rays, order enemas.

And most importantly mark the side of the body to be operated on. You may think this is a joke, but it’s not. I had a thick black permanent marker that I would use to draw an arrow pointing to the Left knee, the Right breast or to circle the numerous varicose veins that needed stripping out. Because it is obviously vital to operate on the correct side, but once a patient is asleep they can no longer confirm which side it is and sometimes notes can be poorly written and it can be surprisingly hard to decipher an L from an R. It is also true to say that for things like hernias, they may not be apparent when the patient is lying down, so it is impossible to tell which side it might be even if you examined him under anaesthetic.

Which brings me to one of the most eddifying moments of my career. I was clerking in a guy for a routine inguinal (groin) hernia operation and needed to confirm it was there and mark it up with my big black pen.

an essential piece of kit for young surgeons

an essential piece of kit for young surgeons

He was probably about 35 and otherwise fit and well. I asked him to stand up and drop his pants so that I could examine the hernia. I knelt in front of him as he pulled down his boxers. His erect penis actually hit me on the nose as it flicked past in its bid for freedom. Funnily enough this scenario hadn’t been covered during my five years of medical training. But I did what came naturally. I pushed it to one side with my left hand and asked him to cough whilst I palpated (felt) his left groin. “Ah yes Mr X, I can definitely feel it,” I said, “We’ll soon get rid of that for you.”

He couldn’t tell whether I was talking about the hernia or making him an offer.

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