It would seem that I am neglecting my blog in favour of others recently, with a guest post on the South Yorkshire WordPress Community blog, and another one on The Blog Up North – but more about that one tomorrow!

Today, I am boasting sharing about my greatest achievement in geekdom so far: I have become a medical expert advisor to Lifehacker.com!

Now, many of my friends don’t know what Lifehacker is. I know this, since the last two weeks has been littered with many conversations along the lines of:

Me: “Hey, ever heard of Lifehacker.com?”
Person: “Err, no? Why?”
Me: [sigh] “Never mind”

Lifehacker, by their own description, is a site with “tips, tricks, and downloads for getting things done“. It appeals to geeks who would like to take the same approach to their life and productivity as they do to their computers. Just as I am not happy when my mouse stops working, or my PC is slow, why should I be happy being overly reliant on caffeine to wake up, or getting poor value when haggling prices?

Anyway, my input to this venerable temple to the ironic procrastination of  20-somethings is a medical opinion on the best way to wipe your bum.

Read the article on Lifehacker to see how they used my input, or see my full article, “Medical Evidence on Wiping Your Bum” over at the MedRevise blog.

More guestpostness tomorrow, after which I promise to return to original material!

Katherine and Joen (click for bigger pics)

Waiting for Joen to arrive was a pain. Actually having him arrive was also a pain (Katherine can attest to that). Luckily we had a huge amount of support, with about a hundred people following the blow-by-blow action on my twitter account.

Thank you to everyone at home following the feed, it really felt great to know so many people cared. Thanks as well to the supportive tweets from people we don’t even know – @pmphillips, @em_cooper and @HeidiSiena especially!

In the run up to Joen arriving, we’d been ready for about a month, every day thinking “this could be the one!” I usually get lifts with people to work, for environmental/financial reasons. After Christmas, however, we felt it was safest I drive, since the due date was the 17th, so I needed to be ready to scoot home when I got the call. In the end, I drove in every day for 4 weeks, each day getting at least one call from Katherine, that I answered with “IS THIS IT? ARE YOU…”, and she would interrupt and ask me if I wanted carrots for dinner.

Sunday night, when she was a week overdue, she had a bad lower abdominal pain, worse than any before. Excitedly, I grabbed my phone and set off the stopwatch, timing between the contractions. When I woke up the next morning, the stopwatch read “7 hours 37 minutes”. I went to work, slightly deflated.

Then, on Thursday, her waters broke. A bit. Maybe. Still, the midwife wanted her in, so I set off home. Or tried to. The friendly driver of a black BMW had parked behind me in the car park. And then disappeared off the face of the earth. After ringing every single room in our unit, to no avail, I got the car next to me to move out, and, borderline levitating my car, managed to escape out of the side. Of course, this was the only time this happened, during a month of parking in the same car park.

Anyway, we got back, went to the hospital, waited around for ages, and they told us… her waters hadn’t broken. We went home, and then, around midnight, Katherine had a contraction. By now I didn’t even believe her. This proved to be a wise decision, as although they kept her awake all night, they became less common and less painful throughout Friday.

Timing contractions on my phone.

Just as we were settling down to watch Naked Gun on Friday evening, the contractions came back with a vengeance. Powerful, painful – it was clear that these were the real deal. I started timing them on my phone, and we called the midwife when they reached a rate of every 5 minutes. She came and examined Katherine, to tell her that she was not even 1 centimetre dilated.

The rest of the night was spent with Katherine moaning in pain, and me trying to find different places in the house to sit that wouldn’t hurt her. Two baths later (not to mention several trips to the bedroom and the nursery laden with fifteen pillows), her contractions were every 2 minutes, and we rang the Jessop Wing, who told us to come on in.

Kat, with a machine going PING!

In we came, where they set up all kinds of machines that go “PING!”, and told us that both baby and momma were well, but that mummy’s cervix was only about 3cm dilated. At 10cm, birth can begin, and generally the rule of thumb is that it dilates a centimetre an hour. We were soon to take that thumb, and stamp on it again and again and again.

From 5am that morning, to 4pm that afternoon, Katherine went through a huge amount of pain, hundreds of drawn out contractions, and a moderate amount of despair at the task ahead of her.

Around 20 hours, Gas & Air much in use.

At 4pm, she was assessed by the midwife again, which showed that all her work, all her sacrifices of blood and sweat over 11 hours had resulted in the cervix widening from 3 centimetres… to 4!

At this point, we became a little depressed. Neither of us had slept at all on Friday night, and Kat hadn’t slept since Wednesday night. Coupled with this, we still had a long way to go, down a road that was already proving exhausting to Katherine, and showing signs that it would be beyond her capacity to withstand pain. So then, reluctantly, we made a decision to go for an epidural. We were reluctant because epidurals have a few rare but serious side effects, and can make labour last longer.

A well earned rest.

The epidural went in at 8pm, after an anaethetist made 5 attempts to get a cannula in, and then gave up! Eventually a colleague got it in, bring Katherine’s total number on cannula attempts during labour to 9! The next 4 hours were pretty good. Katherine was suddenly pain free, and she got some desperately needed sleep, whilst her body carried on getting itself ready. As best it could.

At around midnight, Joen’s heartbeat started dropping, probably because his head was getting crushed by Katherine’s superhuman pelvic floor muscles. It recovered quickly, but it continued to happen, so it was decided that we needed to have this baby soon.

Joen's first skin on skin with Mummy.

Another examination at 3am showed that the cervix had stubbornly stopped… at 9cm. By now, both myself and Katherine just wanted the baby out, and safe; so the decision for a caesarian section was a relief.

And that’s about it. 56 minutes later, after a mere 31 hours of labour, Joen James Lowry entered the world. Ain’t that just fabulous?

At 10:30 on New Years Eve 2010, I was washing up. We had family round, and there were plates, and cups and bowls and spoons and tins and… lots to wash up. So I was in my little kitchen, in my little soapy zen zone, listening to the awesome New Years Eve mix on 6 Music.

I started thinking about how, actually, I was quite enjoying myself. This led to my first Resolution:

1. Spend more time with friends and family this year.

Then I realised that I was having way more fun than I do at work. That I would rather spend 40 hours a week washing up and listening to club classic interspersed with punk epics, than spend it caring for people as a doctor.

In reality, I can’t do this, and more importantly, I shouldn’t want to do this. Hence my second Resolution:

2. Start enjoying my job more.

And then I realised that I was on my laptop at 10:50 writing a blog post, feeling a bit low about life and careers and, the ultimate question – how to clean custard off a frying pan – when I should be next door beating my mother-in-law at Wii Mario Kart. Hence my third and final:

3. Stop complaining so much.

I’m off to enjoy the next year. Please invite yourself round to dinner if you haven’t seen me about, asking me about the world of Medicine, and tell me off if I complain!

Love you all!

PS. A brief glimpse of my soapy haven below…

There is a female bay on one of the surgical wards in our hospital. 6 beds, 6 women. Usually this is fine, people get on well, they chat, they eat, they sleep, they get better and, eventually, they go home. Sometimes, however, there can be problems.

2 nights ago, one of the patients, Doris, an elderly lady with dementia, spent the night shrieking, and making a fuss. This has an impact on everyone in the bay; no one had much sleep that night.

In the bed opposite was Jean, a retired lady with all her wits about her. Sadly, she had hardly had any sleep, and spent the whole day miserable and exhausted. When we saw her on the ward round, she was very unhappy. We apologised and everyone hoped for a better night following.

The next day, we went to see Jean. She looked much brighter, and said that the night had been much better – Doris had been noisy at first, then relatively quiet. All seemed normal, until one of the nurses had a word with me…

“Last night,” she said, “We noticed the curtains around Doris’ bed were shut. We thought that was a bit odd, as none of us had done it. So we went to see why.”

“Why? What happened,” I said, with mild trepidatation, hoping that Doris hadn’t passed away in the night without any of us noticing on the ward round.

“About 10pm, Jean got up, walked across the bay, closed the curtains, and thrown a full jug of cold water over Doris!”

I walked back over to Jean’s bed. “Jean, err… was there an *ahem* incident, with a jug of water last night?” It was quite funny to see Jean’s reaction – she went bright red, like a guilty schoolgirl caught flicking elastic bands in class.

“I don’t know what came over me!”, she exclaimed. “I just couldn’t stand it anymore, it was so unfair, and I was so angry, and… I just had to do it!”

It was hard to maintain a stern manner, especially since all three doctors (myself included) started gaffawing. The shame of having to own up seemed to do the trick anyway, as she cringed and said “I was really hoping no one would ask me about it!”

With a promise from her that she wouldn’t do it again, we left her to the rest of her day. As Aristotle said, “The virtue of justice consists in moderation, as regulated by wisdom“. Fairly sure, in the circumstances, a single jug is still classed as moderation.

NB. I am thoroughly committed to being a great doctor, which includes respecting patient confidentiality. All information about patients on my website is anonymised, and often altered drastically so that whilst it still makes a good anecdote, it is unrelated in sex, time, location, age and/or ailment from the original facts.

This weekend, I worked the Freudianly named “graveyard shift” at Chesterfield hospital. Three nights, 9pm until 9am, Friday, Saturday, Sunday.

Whilst a great time to get some real hands-on experience, there is a key problem in working nights. It goes thus:

1. Most of us are not naturally nocturnal.
2. Most of us have jobs in the day time.
3. Night shifts usually only have a day’s grace between day shift and night shift.
4. It takes more than one day to completely upend your circadian rhythm.
5. Therefore, you always feel completely, exhaustedly, hungover-jetlagged-coma-after-a-trainwreck tired.

There are two methods for attempting this changover. One is to try and stay up as late as possible the night before, sleep all day, and go to work (hopefully) refreshed. I tried this. The result was that I was so tired on the first shift that I started having visual hallucinations about 4am, attempted to wear a commode around 5, and woke up the next morning completely naked in the middle of the M45.

The other method is to sleep normally the night before, stay up all day, and have a two hour nap before the start of the shift. My SHO used this method. The result was that he became so tired that he began to have paranoid delusional beliefs around 3am, attempted to order the demolition of the hospital library about 6, and woke up the next morning on a ferry to Bergen, with a new tattoo. Of the Queen. On his face.

Obviously there’s a bit of exaggeration there, and neither of us actually developed first rank symptoms of schizophrenia, but we were very tired. Aside from this, the weekend was actually fairly enjoyable. There’s a bit less red tape and paperwork on the night shift, and less distractions.

One highlight was a tired A&E clerking on Friday night from another doctor, who had written “Patient is a resident in a residential home” twice in three paragraphs. Some would say that this is not particularly useful information, even when written twice. The doctor had failed to mention that the woman was profoundly deaf, and severely demented. Which would you rather know?

My most memorable event of the weekend came at about 5:30am Monday morning. I was hungry, so I went to the vending machine to get a packet of crisps.

5:30 I put in my 45p, and selected some Prawn Cocktail Walkers. They fell out of the holder, and got stuck halfway down the machine.

5:31 I got annoyed, and tried to shake the machine. A lot. It didn’t work, the crisps remained stuck.

5:32 Rammed the machine again, and another packet of crisps fell out, Cheese and Onion this time. It also got lodged. Right next to my other packet. Nudged it again, to no avail.

5:34 Tried ringing the vending machine company, asking for a refund of my 45p. Oddly enough, no one there when its barely dawn.

5:36 Decided I *needed* crisps, so used my might again. This time a Capri-Sun fell out.

5:39 Having drained the last drop of the Capri-Sun in a contemplative manner, I hit upon an rational plan of action – purchasing the chocolate bar directly above the crisps will cause it to fall, thereby dislodging my crisps!

5:40 The Kit Kat chunky holder turned, and then the chocolate bar twisted out, began to fall and then… got stuck in the mechanism.

5:42 I finished screaming, and decided to whack the machine again.

5:43 Still whacking.

5:44 Another Capri-Sun fell out, but still neither crisp packet nor chocolate bar is released from the vending machine’s iron grip…

5:45 After a final heave, the Kit Kat fell, dislodging both packets, and I left the machine clutching half a newsagent’s in triumph. (Feeling a little guilty at my windfall, I later went to the reception desk in the hospital, who congratulated me on my honesty, but told me to keep the food!)

There ends my summation. At 9:15am Monday I left the hospital after 36 hours of attendance, with mild tooth decay and a mite more experience as recompense. Plus I think I’ll get paid at some point too, but right now I’m more excited about the Capri-Sun.

NB. I am thoroughly committed to being a great doctor, which includes respecting patient confidentiality. All information about patients on my website is anonymised, and often altered drastically so that whilst it still makes a good anecdote, it is unrelated in sex, time, location, age and/or ailment from the original facts.

On Wednesday, after five years apparently spent preparing for the experience, I started work as a doctor in Chesterfield hospital. A real doctor. With a stethoscope and everything!

My first job is a four month stint in Cardiology, and my first ever day as a doctor was a 12 hour emergency on call. It was a sharp learning curve, with little prior explanation of even the simplest proceedings.

My first hurdle was the “bleep”. Your bleep is your electronic dog lead; anyone can use it to make you heed to their beck and call. Obviously that’s good if someone has a heart attack, and you are needed for resus. It’s less good if a secretary the other end of the hospital wants your signature on some mildly unnecessary form, whilst you are trying to finish a ward round.

This combined with my non understanding of the system on the Emergency Admissions unit to make me look an absolute idiot in my end of day handover. Day rating: 7/10.

On Thursday, I wasn’t on call, but I did have to conduct the ward round and all the ward jobs all on my own, with my SHO, Registrar and Consultant all on leave or busy. Whilst this was mega intense, and frankly not a lot of fun, I did manage to get everything done, and went home (nearly) on time. My Consultant seemed happy enough, so I’m not too worried, although I would like to have lunch at lunch time more often, rather than eating a sandwich on the toilet at 3:30pm, combining two time occupying jobs into one. During the last hour of my shift, I turned on the CD player in the nurses station: the only CD we had was one of Christmas hits. The tacky music alone made this an 8/10 day.

Friday started out very well. By lunch time – and it says a lot that I was even having lunch – we had finished the ward round, and started on the patient care endless paperwork. And then I discovered I had to attend a compulsory 2 hour introduction, hand washing and blood taking lecture. I got back to the ward, and almost immediately got bleeped to go write a TTO for a patient I’d never met, who needed a slightly complicated bit of warfarin prescribing. I was also approached by rather a large man, looming over me as he asked:

Large man: Are you a doctor then?
Me: Well, yes, just about.
Large man: Can you write me a prescription then?
Me: Err… are you a patient here?
Large man: Yes.
Me: In that case, what for?
Large man: Can you prescribe me a hug?

Needless to say, both of us ended up with a hug. Unfortunately, by the time I had finished on that ward, returned to my own, and finished seeing all the patients, reviewing all the drugs, and filling out all the bits of paper, it was 6:45. I only get paid until 5, but I suspect the NHS aren’t too bothered about that. Despite the lateness, I got a hug off a somewhat threatening man, so the day has to get a 9/10.

So far, the best thing about the ward is all the wonderful nurses, pharmacists, receptionists and porters. Without them, I would actually still be in the hospital, probably gibbering quietly, and completely naked except for drug charts sellotaped all over my body.

Stay safe kids, and remember – don’t get sick in Chesterfield!

It happened. I have graduated. View some more pictures over in my facebook photo album.

I’m going to listen to the Slackers now, and drink some coffee. See you soon!