In July of 2020, a friend of mine from medical school approached me with an exciting new idea. A podcast. About medicine. Needing something, anything, to take my focus off Covid, I jumped up to this opportunity immediately. Very soon a team had formed and as the summer became autumn became winter and 2021 rolled around, we had ourselves a brand new podcast.
Join us, as we discuss the bright ideas that are changing medicine as we know it!
End of Life and Palliative Care: Response to the Covid-19 pandemic –
Ward and Peace
When the world entered a global pandemic, none of us knew what devastation it would bring. But in the grief and sorrow of it, also came a shining light of determination. The community came together as one and helped support those who were at the end of their lives. In this episode, Dr. Rosie Arnott discusses how her hospital in Nottingham, England and many like her’s across the globe adapted their geriatric and palliative care services to better support their populations with focus on having honest, transparent conversations about end of life and incorporating the use of tele-communication to ensure patients and their relatives receive the support they need.
Hearing that there is more to the world than the grim and difficult year that’s just passed has made me appreciate the work of scientists, medics, humans around the globe and the determination of our population to keep striving for the good.
I’m proud of this but more importantly I’m proud of what that means for our future – an enlightened future where today’s discoveries will lead to an improved future for medical and healthcare.
It was my mother’s birthday today. And in line with the current local lockdown rules, I was allowed to see my family in the garden and thanfully the weather outdid it self and though I’ve lately been feeling a little stressed, the day became one of the most gorgeous days I’ve had in a while.
Stress is a peculiar thing. If you’re not stressed at all then how can you respond to urgent/ emergencies/ important events? I need to feel a little stressed in order to meet my deadlines, care for my sick patients, sit exams etc…
But too much and you spiral into a parnoid frenzy or anxious pacing of the room.
Stress is a peculiar thing.
But like almost all things in life, it isn’t permanent. And as lockdown rules start to lift (and god the thought of socialising is a stress in itself), I find myself hopeful that the things I enjoy will be there for me to enjoy despite the 1 + year of perhaps the most stressful experience in all of our lives.
Spring is here. And though I have an exam. Though I don’t know where I’ll be working in August, there is a delicate sense of community and readiness.
I’m going to smell a fresh rose, walk bare-footed on the grass and sneeze as the hayfever hits me…for spring is here and it is here to stay!
I’m carrying the container with someone else’s bloody urine to the sluice and as I lean over to flush it down the sluice the stench of it reaches my nostrils. For a moment I think i’m going to vomit or pass out.
When I moved to London in August last year I was pleased as punch. I’d made it, I thought. The lights, the city noise and even though it was lockdown I still managed to squeeze in many things: Adam Kay’s comedy show, walks to Buckingham Palace, saying ‘hi’ to all the tourist spots, eating weird pizzas in ‘cool’ restaurants and going to all the markets especially at Christmas.
But of course the main thing I was looking forward to was working in a famous tertiary hospital where people from all over the country send their complex patients too for various medical and surgical interventions. I was looking forward to learning from the best in their fields. To sharing space with the directors and presidents of societies. Having chats with consultants who had been recognised by the Queen for their serivce, working alongside seniors who were managing full time clinical work alongside research projects, doing post-docs and bringing up a family. In short I was looking at my dream job in a dream city with the hope that one day I won’t be a guest in London but a permament resident.
Well this isn’t exactly a surprise. A second wave of the pandemic has resulted in another national lockdown. With figures in hospital rising sharply and more intensive care beds being used, it is hardly a surprise that the morale in the country is at an all time low. Its January, no christmas (however bleak Christmas 2020 was) to look forward to, no beautiful and touching New Year’s firework display to feel a sense of community. I’m finding this time round to be a lot more challenging than before. I’m just that bit more tired this time. A bit more jaded. A bit more cynical. A bit more…just done with the pandemic.
I normally save the year's reflection for later on in December. But I've said this often…I don't sit down to write, the writing compells me. For me, writing is a form of catharasis as has this whole year been. A form of catharasis and internal reflections. A chance to find hope, safety, empathy and salvation within myself. A year to define my life. As it has been for so many else.
In Jaunary, working on the south coast, I didn’t know how fundamentally life around for and globally was about to change. None of us did. I was on a medical ward and slowly starting to feel like the NHS was home.
In February, I did something I had always wanted to do. I travelled to New York. I visited a friend I’ve known for as long as I’ve known my own name. It was a week of forging new memories with people from memories of the old. I even met family members I had not met before.
In March, the first hint of a Black Mirror-esque dystopian future made the headlines. People were starting to get sick. Disbelief and misinformation was infiltrating our social media platforms. But other more horrible and scary political events of the early 2020 were still in our minds. Coronavirus was a novel term for the average person.
In April, I staretd on a new firm. Yet again – meeting new faces, new teams, new expectations, new roles, new – well- everything. A particular moment I rememebr is when my consultant said :
“It’s not ever going back to how we knew it before”.
But that’s the truth isn’t it, of life? It doesn’t every quite go back to what it was life before. Instead we learn from it, adapt it, deal with it and at times feel helpless, hopeless, pointless…
In May, I learnt that as clinicians, our duty is to our patients – first and foremost. Deffering to seniors, staying back late at work, not retaliating to a co-worker only is valid if the reason behind it is for the patients we are collectively looking after. But our health – physical and mental- matters because without it, we are not helping our patients.
In June, I realised that Scrubs (which are basically glorified PJs) are the best thing for work. No hassle of bodily fluids getting on your clothes, easy to put on, comfortable to wear, and the fashion choice is taken right out of your hands. It was also particularly beautiful how the community as a large came together. A friend offered to make some scrubs for the hospital for free. When I bought my first pair online, I received with it a small message of ‘Thanks to the NHS’. It lifted my mood.
In July, I started realising I was finishing my first year as a doctor. What a tremendous year to have joined the NHS. From the weekly clapping for the NHS, to Mr. Trump declaring it wasn’t real, to meeting and seeing my first Covid patient die, to the coming together of the hospital, of staff and key workers. In those short months that I had been a doctor, I had seen the NHS at its best and its worst. We didn’t know half the time how we were going to cope but the only thing we knew for sure was if we stopped, then it would all only get worse. Not just us: but the teachers, the grocery store workers, the Vloggers, the community workers. Everyone wanted to make it better and for once it felt that the whole world was joining up for a greater purpsose.
In August, I moved to London to start my new job. This move was a new beginning for me. New attitude, new flat, new outlook to life. I was pumped to get involved at work, in teaching, in research. I was meeting like-minded people. I loved what I was doing at work and my physical and mental health was at its best.
In September, I turned 27. I started an acting course. I continued to learn from my patients. Learn from them the meaning of life: resilience, hope, overcoming barriers, surrendering to grief and importantly acknowledging it isn’t always easy or good. But that it is temporary.
In October, I cried. A lot. From grief, from uncertainty, from being overwhelmed. From feeling it wouldn’t ever stop.
In November, I reached out to others for whom Covid had been worse than it had been for me. For those getting sick, for those whose addictions were worsening, for those who had a relationship breakdown or lost someone they loved. And for those who lost their jobs. Through my patients, I reached out to them. Through my friends, I told them I was here and that I cared. Because someone was doing that for me too.
In December, I dared to look at the lights with a fierce yet vulnerable hope. Can we draw a line under 2020? Can we take the lessons we learnt this year into our future? Can we make the future one worth fighting for?
Well I can’t on my own. But perhaps if we all lift ourselves and work it out together then we can. After all what is more important than saving humanity itself?
I’m a very practical person. Emotional, yes. Empathetic, definitely. But I really am not one to sit down and be unable to do my work. I remember having the flu a few years back and it took the fact I kept falling asleep in clinic for me to realise I really needed to be at home, resting.
I had a massive row with someone I cared about and went into work the next day, perfectly fine.
My grandad died. And I was stunned. shocked. But then I carried on because , well, what else was I supposed to do?
I remember when I was nine, I used to tell everyone that I’m moving to England one day. This was before my dad actually got a job there and we actually moved. I grew up in the southern countryside of England and at each step of my education, I moved just that bit closer to the city.
In secondary school, I would go to social events in the city centre. At university, a lot of my courses, events and friends were in the city centre. Finally, as a F2 doctor, I have the great privilege of living and working in the greatest city in the world (IMO).
Name me a city with more sordid secrets than London. Name me a city more quirky than London. Name me a city with more history than London. Name me a city that is more welcoming than London.
It might be Covid still and a lot of the small businesses are suffering. As are the theatre comapnies, the start-ups, the city’s economy and the heart and soul of London – the tourist industry. But I can’t think of a better time to be here. To be serving the people of London and being part of the community.
Thank you for welcoming me, London. I never want to leave!
Here are a few photos of the housemate and I out on our explorations of the great city.
Disclaimer: Always seek medical advise before using drugs and medications. Please do not eat plants from the wild as their medicinal properties have not been assessed for safety. Always seek guidance if unsure. Plants and drugs approved for consumer use by the MHRA are deemed safe but please check with a professional if suitable before ingesting drugs or plants for medicinal purposes.
In early July, most of the country was still closed and very few places had started opening up. Tired of the Scrubs, the observation charts, the documenting and the Covid chatter, I had taken annual leave and spent it looking for a house for August…
So, not exactly the kind of break I had imagined, but, the family and I did manage to squeeze in a few day trips. We went to an animal safari in our cars, walks around the area and Kew Gardens!
Click here to visit the official Kew Gardens website.
Recently, I passed my first set of competency checks and was granted the official ‘you may progress to the second year of training’ statement. It was rather anticlimactic, I must say. I had a notification on my phone from a friend saying that the results were out. What an ominous statement. It was around 11 am, I was in the middle of the ward round. But knowing that my results were a few mouse clicks away, I couldn’t possible wait another two hours for lunch time to check.
Luckily the ward wasn’t that busy and as the noise of patients, machines, doctors, therapists and others all mushed into white noise, I breathed a sigh of relief at the confirmation. That was it.
And now I’ve entered the final few weeks of FY1 – foundation year 1. Or internship as it was known back in the day! It sounds cliche but it is true when I say that it feels like a lifetime has passed but also as if not a minute has done so. A colleague recently said to me: ‘never stop learning’. And I think this statement is more apt. now than ever before. I’ve made it through the first hurdle of being a doctor and now it’s time to settle in and focus on the true essence of being a doctor – the lifetime of learning and helping.
I applied for my full registration today. Converting my provisional licence to a full one. It was as anti-climactic as I thought it would be. But it’s the small anti-climactic moments that are the building blocks of one day being the doctor I want to be.
It’s the every day small steps that count. The first time a patient thanks you. The first time you recognise heart failure. The first time you make a mistake. The first time you see death. They mould you to become the doctor you are today. The small steps matter more than we think.