My two cents on the contracts

Today, after months of negotiations and strikes, Jeremy Hunt, the health secretary in the UK, announced that he will impose a new contract on Junior Doctors in England on 1st August this year. The changes in the contract effectively remove safeguards currently imposed on hospitals to prevent junior doctors from working too many hours so that they don’t become exhausted and thus compromise the safety of their patients. The changes also reduce the overall pay, despite a rise in basic pay of junior doctors by re-classifying normal working hours to include Saturdays and longer weekdays where they would normally be paid extra for working these unsociable hours.

The government has been in discussion with the BMA, the medical union, to negotiate these changes but legally they do not need to agree for the contract to be put in place, Hunt can force it through regardless.

There have been strikes and a strong sense of unity between members of the profession with overwhelming support for the strikes both from within the medical profession and the public.

Now. The government have tried to suggest that the anger with this contract is all to do with the pay, however many medics have publicly and eloquently expressed that in fact it is all to do with patient safety.

What really gets to me is that anyone with half a brain can see that in applying to medical school we commit ourselves to long days of studying, short holidays, working weekends and constant fear of failure. We work our socks off, and in the UK will leave with up to £80k of student debt. On a normal NHS salary progression, I will not pay off my student debt and the roughly 5% compound interest in the 30 years before it gets written off. We are simply not in it for the money.

As it is, FY1s (doctors in their first year after graduating) are at times required to work a full working week, be on-call over the weekend and work the next full week – 12 straight days of work is exhausting whatever you do and your decision-making will suffer and when the decisions you make affect people’s health and lives, it’s pretty scary.

I am happy to take on the debt. The lost weekends. The 5 years of intense study. The constant fear of failure. The late nights. The frankly alarming coffee habit. The constant bloody exhaustion and I’ll miss family and social events. All of it, because I’m working towards my dream job.

But what I ask for in return, is to work in conditions in which it is not certain that my exhaustion will result in the death of a patient, which is exactly what these contract changes will do.

I stand with the BMA. Don’t make me a killer Jeremy.

#notsafenotfair

To which side does Sir dress?

At the end of our previous encounter, we found our sleep-deprived heroes dissembling a human body with rudimentary tools…

We are studying the pelvis. It’s a tricky old area to get to, we are told. Takes a bit of manoeuvring and hard work. And a box saw.

I’m pretty sure the saws we used in woodwork when I was 11 were more advanced than this but hey ho, off we go.

Someone is allocated the task of first removing the cadaver’s torso and then standing the legs upside-down, using the newly-created cross-sectional surface of the top of the hips as a base. Easy enough. A few crunching minutes later and the feet are up in the air, as if doing a handstand. Or, rather, hip stand?

‘Right. Next step, we want one leg, not two, so cut it in half down the middle.’

‘The middle?’

‘Yes the middle.’

‘There?’

Yes there.’

‘Where his…thing is?’

‘Yes exactly, I said the middle didn’t I?’

‘Oh, ok. But, well, to which side shall Sir dress?’

In the end Sir dressed equally on either side, cue winces all round.

Happily the most distressing part of this thrilling tale is still to come as our heroes are required to clean certain contents of the specimen in order to appreciate structural findings.

So I scooped the poo out of the rectum with my finger.

Thoughts from the Dissecting Room

In my many hours spend in the dissecting room, what has most surprised me is the frequency with which the gender of the cadaver is misidentified.

‘How hard can it be?’, I hear you ask. My thoughts exactly.

In our introductory session in the dissecting room, as fresh-faced and wide-eyed first years, we are asked to appreciate the great contribution that the cadavers have made, their outstanding generosity and foresight in life to consider donating their body to aid our education. It is a fantastic contribution, we agree, and so selfless of them and their families to agree to making such a valuable bequest.

We feel honoured, as we remove the coverings, to meet our cadaver, who will be the source of such great learning over the year to come. The bodies are grey and almost inhuman following the preservation process, and we proceed with trepidation, trying to take in the sight before us. The face, for now, remains covered as most will never have seen death in such a way, and it takes some time to become accustomed to it.

‘Wow’, I hear from a fellow student across the table. ‘This woman made such an incredible decision to do this for us.’

I exchange a look with a friend, and we both turn back to face the cadaver lying in front of us. The naked cadaver. Unclothed. As bare as the day they were born. We look back at each other. For before us on the table, in all his glory, lies a man. Most definitely a man. With all the manly appendages and without all the less manly features. No doubt. Unmistakable. Male.

When I applied for medical school I was told it would be tough to get in, they expect top grades, personability, professionalism, common sense, they want the model students of this world who can play twelve instruments, speak seven languages, hike their way through all of the Duke of Edinburgh awards and play international level sports whilst bashing out a publishable personal statement and, oh go on then, why not knock out a few best-selling novels as well, maybe a Nobel prize or two whilst you’re at it. But never, in the highly specific set of requirements do they mention being able to identify the gender of a naked body.

I do not wish to be presumptuous and nor do I claim to have insight into the minds of the interview panels for medical schools, and please, I implore you to correct me if I am wrong, but

I would have thought

When lying uncovered in front of you

Is a cadaver with no gender ambiguity

AND AN INDISPUTABLE PENIS

YOU CORRECTLY IDENTIFY THE PERSON AS A MAN.

This happened on three further occasions that year.

With the same cadaver.

Fast-forward twelve months and find us in the same location, eye bags as dark as our newly-acquired outlook on life, sawing through a man’s groin with a set of tools acquired, surely, from the local discount hardware store; respect indeed. But that’s another story.

A short interlude

A hefty chunk of time has passed since well-intentioned resolutions were made to document my first year at medical school – now a little experience has been gained I have a few stories to tell, reflecting upon the first 18 months of my time studying medicine.

Watch this space!