Here’s a toast… to abortion rights, on International Women's Day

I wrote this some time ago (this will become obvious given that it mentions a few news items that are now not so topical), and not got around to publish it. Today, International Women's Day, seems like an appropriate time to share it.


Here’s a toast… to abortion rights 
OR 
This is what a feminist doctor looks like

Ani diFranco’s song Self-Evident, which is mostly about the September 11^th attacks but also about so much more, includes the line:

  

“Here’s a toast to all those nurses and doctors who daily provide women with a choice”

Today I provided a woman with a choice – her choice for an abortion. A termination of pregnancy. I administered and inserted the medication to end her early pregnancy. In practical terms, it was the same as what I often do for miscarriage, there was no difference in the procedure; the difference was that in this case, the embryo/foetus was alive. We were ending her pregnancy because she wanted us to.

I am really proud of this. I am pro-choice and proud of the fact that I can help make abortion accessible to women who want it (following appropriate counselling) and that we live in a country where this is available. I believe women* have the right to choose.

That’s not to say I think abortion is great; it’s a shame to lose potential lives especially when there are so many people in the world who would do anything to have a baby, but the right of the woman to have control over her body and her future trumps any right of some cells and tissue that are only a potential person rather than an actual person.

In a month where the news has been full of debate about Savita Halappanavar, the woman who died in Ireland, from septicaemia due to infected products of conception (infected pregnancy/miscarriage), after she was denied an abortion for a pregnancy that was failing anyway and making her very unwell. Although the Irish law is extremely restrictive on abortion, it appears that they could have ended her pregnancy, and increased her chance of survival, whilst still acting within the law, given that there was “real and substantive” threat to her life.

So this is how I express myself as a feminist doctor – I do the same job as other doctors would, I just get a bit more enthusiastic about it and about the opportunities that this job provides, opportunities for making the world a better and pro-choicier place.

I’d stiill do this even if we had vile campaigners, (such as Abort67, who have recently been targeting university campuses [graphic picture in link]) protesting outside the hospital, although I am very glad that there aren’t any. They’re probably not aware that we do social terminations in the NHS hospital, since it’s not an abortion clinic. The protest groups are deeply unpleasant, wildly inaccurate in the “facts” that they quote, and wave horrific pictures, which must be so traumatic for anyone who has ever miscarried a wanted pregnancy, to see – some of those pictures could bring back very painful memories.

In conclusion, I am glad I can do important things in my job, and please would Jeremy Hunt and vile Nadine Dorries (the jungle could keep her) back right off and leave me to do my job to the best of my ability with the best medical evidence available. Kindly stop spouting rubbish about abortions and throwing your political weight around, when we could be having sensible discussions about how to ensure reproduction rights for women, whilst also considering also the appropriateness of interventions concerning the foetus. Note sensible discussions.

Right, I’m off to a Reclaim the Night march and rally (gender inclusive).This is what a feminist doctor looks like!
(yes, it's not Reclaim the Night time of year, but it was when I wrote this!)

This is a picture I took of the badge display at the Women's Library in London, which I visited recently. It is a wonderful treasure trove of feminist history, I'd thoroughly recommend it! (Visit before 22nd March, when it closes and moves to a new venue in June)

As an aside, I recall a conversation amongst medical students when I was in my 3^rd year of medical school (5 years ago – took the scenic route through medical school) about FY1 junior doctor jobs. We discussed that gynae might be good, and someone pointed out that you’d have to do abortions if you worked in gynae, and that really put me off. I remember thinking that I agree with women having a right to an abortion, but I didn’t want to actually do the abortion myself. I had a different, and rather inaccurate, understanding of what the actual process involved, but I’m very glad my opinions have changed since then. I’m glad the women I look after can have someone performing their abortion who’s not uncomfortable about doing it.

*women and any other pregnant people – people with various trans identities can have anatomy permitting them to become pregnant without defining themselves as women. It wouldn’t be the first time (e.g. the American Thomas Beattie, and the wonderful Jason Elvis Barker). I have frequently referred to “pregnant people” in a range of contexts, rather than “pregnant women” and almost every time, it gets me a funny look, but I maintain it’s more accurate and inclusive.

Personally I’m a lot more comfortable with the term “woman” to describe myself than I was a few years ago (one can be both trans/of queer gender and identify as a woman without being a transwoman, they are not mutually exclusive) but even so, if I were to become pregnant, I might rather be thought of a pregnant person than everything being “woman” somehow. And my own identity and preference doesn’t make me any less of a feminist.


One day, I intend to follow up this post with another post looking into what happens when women are denied the right to abortion, and also what happens when they do have an abortion - there is some interesting research I'd like to collate. Watch this space.

Once a faily student, always a bit faily (or ex-faily)

Was thinking yesterday* how my final exam fail (and other final exam near-fail) probably contributes to why I dont have as much clinical confidence as I'd like, and explains why I'm not as methodical as I should be. Or rather, my lack of logic and method explains why I failed.

Meeting with educational supervisor:

Supervisor: foundation years are a steep learning curve, especially when you've probably always done really well and never failed anything...

me: actually, I failed a final exam...

ES: really? Why on earth did we give you an academic job then?!?!

me: you gave me the job before I failed

ES: oh well, it's not the end of the world

me: it certainly seemed like it at the time!

I guess it's something that I'll never forget about, but the significance will hopefully fade over time. It should stick with me long enough to prevent me getting much too big for my boots anytime in the next few years- I know I could still be capable of screwing up.

However, some days after this conversation, I had a potentially good idea: I know, and documented extensively on the previous blog (here and here) how horrible it is to fail a final exam and to have confidence shattered and to get totally burnt out and have to find some way of picking yourself up and carrying on (or relying on others to pick me up and carry me on – I am still so, so thankful to the wonderful people who helped me prepare for my re-take).

Maybe I can help other faily students to pick themselves up and carry on, help motivate, help practice, help them realise that help might be there for the asking (if their fellow students are as wonderful as mine were). A little investigative work tells me the number of students currently retaking final year at the place where I’m working (I’ve got an academic foundation job – it should come as no surprise that I’m working at a hospital involved with a medical school) reaches double figures, so perhaps there’s a market for this concept, for want of a better word. I just need to work out who to contact about it, and see if the other openly faily F1 doctor (who has of course, now passed, that’s why they’re an F1) wants in on this.

I don’t have training in motivating people, but I think personal experience that would be relevant here. Watch this space…

* Not yesterday, actually ages ago, but that’s how long it takes me to write a blog these days.

I'm not dead, just being a doctor

Sorry it's been forever (well, 6+ weeks) since I last posted. Or not sorry (I did once blog about how I shouldn't feel obligated to blog... but then I also planned to blog three times a week).

I'm not dead, just been busy working. Which is very busy. Though apparently will get worse when I'm working in surgery and moved on from generally-reasonably-well-supervised gynae.

A three day weekend seems to have got my creative blogging juices flowing again, slightly.

Also, I STILL have lack of internet to blame, partially, for my lack of blogging - thanks Tesco totally rubbish Home Pho-one and Broadband (yes I still find it odd and mildly entertaining that the woman on their phone message pronounces phone with two syllables... I have spent FAR too much time listening to her!).

Here's to the blog. Or not.

Down at Frazzle Rock

I've now been a doctor for two weeks. It's not been the best two weeks of my life. I am totally frazzled, exhausted and mentally drained.
                                                                        
The on call weekend was 38 hours work in three days, much of it on my own; the three other doctors away on other wards, at emergencies, and in operating theatre. There was too much work for one F1 junior doctor to manage, including emergency assessments patients of my own. Some pushy nurses didn't help, but kind and helpful nurses can make all the difference.
                                                             
I'm sure it will get better. I'll improve my clinical skills (like blood taking and cannulation - I haven't had a single successful cannula yet), learn to see patients more quickly - hopefully without spending less valuable time with patients, learn to call for help more promptly and to recognise when I need help. And learn to take a break, drink, and eat lunch. I didn't eat til 5.30pm the other day, having started at 8am.
It will get better, at some point.
                                                         
This week's been good, however. More SHOs (slightly less junior doctors) means work is spread more evenly and I leave work at a sensible time. Long may that continue.                          
                                                         
* Frazzled = exhausted, knackered, not burnt out but going in that direction.
Fraggle Rock = muppets-like TV show. I was once told I look like a Fraggle...                                          
The picture isn't a Fraggle, but it's near enough!

The first emergency

My first emergency as a qualified doctor did not come, as one might suspect, in the hospital, but instead on the street, at night, in a different city.

It was a horrible "oh god I think I need to stop... don't I? should I?" moment, not quite sure what to do but thinking I probably should do something. I walked past as if to scout out the situation, and a bystander was on the phone, clearly to an ambulance. When I heard them say "... seizure..." my heart sank as I realised it wasn't just some drunken japes and I would need to get involved.

I was relieved to realise I recognised one of the bystanders, the person on the phone - a medical student who I'd got to know a few months ago, when they were in third year. This meant that hopefully anything immediately lifesaving that needed to be done, such as opening the airway, would have already been done. That's a nice emergency to arrive at.

Though it was all under control, I stayed around, partly because once you've arrived you can't really leave, and partly because I thought the others might want me to stick around. Much as I was relieved to see medical students there, I imagine they were considerably more relieved to see me - if I was a third year medical student attending an emergency, I would have breathed a huge sigh of relief if a medical student or junior doctor two years my senior turned up. So I guess that was a nice role to play, even if I didn't do a great deal medically, except stop the patient from rolling over, check every now and then that he was still responsive (ish) and talk to his relative.

The patient and relative had recently left hospital, and I can't help but wonder if the fact they were still wearing hospital pyjama trousers meant they had self-discharged... I think it's likely, which made me a bit more clued up to the situation.

For some reason the police arrived before the ambulance, even though the students called the ambulance, (maybe they send police to anything that might be alcohol related?). Another thing I don't understand is that the ambulance people on the phone said to roll the patient onto his left. He was nicely in the recovery position on his right hand side, and since rolling him onto his left would have involved rolling him into the road, they left him as he was, but I have no idea why the left would be better.

Anyway, the ambulance person arrived and was happy for us to go, so we left, after I'd had a bit of a catch-up with the medical student I knew, and I hope I made clear to them both that they'd done a good job. I realised later that I didn't tell the ambulance person that I'm a doctor, and maybe, since they were on their own, they might have wanted me to stick around and help had they known that, but never mind - they're experienced at working on their own I'm sure.

Despite the anxiety whilst walking up the situation, I'm quite relieved by the quiet, mild confidence I felt whilst looking after the patient - hopefully that will stay with me when something more traumatic happens in the hospital.

Grey Wednesday?

Tomorrow is “Black Wednesday”, the day when all the brand new doctors start. I should be terrified, but I’m not – tomorrow I have an all-day induction. I may be on call for two hours after the induction, but with at least one other new doctor and the evening on calls seem fairly quiet anyway.

On the one hand, a comprehensive induction is great. On the other hand, it’s just delaying the nervousness until tomorrow evening. I feel like I’m missing out on something – spending the evening with other new F1 doctors, who don’t have induction and therefore tomorrow is their first dose of responsibility and first real opportunity to accidentally kill someone, there was a sense of nervous, slightly excited anticipation. I don’t really have that. Partly because I’m not really starting tomorrow, and partly because in gynae, we’re not really trusted with being allowed to do that much, most things have to be approved by a senior. There is a great deal of discharge summary writing. But, it’s a very nice way to ease into the job.

We realised that we’ll never have this feeling ever again. Never again will we be brand new terrified doctors. Whenever we start a new job in the future, it will just be the next thing, not the whole big new thing. Never again will we be not-quite-doctors and then suddenly actual doctors. One of my new flatmates said she wanted to savour this feeling forever, this moment to last forever, and I wouldn’t quite go that far, but it is an interesting time.

So for me, tomorrow is perhaps Grey Wednesday. For all those new F1s for whom it really is Black Wednesday, good luck, don’t be scared, and remember to breathe. For anyone who has the misfortune to fall ill tomorrow, or in the next week, I honestly wish you the very best of luck, though hope with all my heart that you don’t need it.