Mind the Sheep…

The opportunities, experiences and memories that have come from being sent far away from where I wanted to be will forever be engrained into my existence. 

The learning opportunities are unlimited out here. On my first day I was doing my own ward round. On my second day I was using my breaking bad news skills to tell a loved one that their relative was likely going to die in the next few hours to days. On my third day it was Saturday and after a whole day alone on my geriatric ward, I was holding the bleep for medical ward cover, covering 9 wards. It’s a great experience if you want to make a personal difference to patients’ lives from day one.  

In my third week I started my first night of fourteen in this rotation. I was thrown into the deep end, but you can take this an opportunity to get a hands-on experience as a doctor at a very early stage in your career. In my next set of nights, I was doing CPR in a cardiac arrest.  

You learn that it is a good idea to carry a torch around the hospital at night to avoid certifying a death in the dark in between closed curtains, very creepy; you learn to take your water bottle and an emergency snack with you when leaving the ‘office’ as you find yourself stuck on AMU with multiple sick patients for hours or having to take a very unwell patient to CT, as the med reg tells you that if they drop their GCS you need to put out a 2222 call. This can be both nerve-wracking and exciting. 

On geriatrics you learn that end-of-life discussions, when done well, are very rewarding. One weekend I was on what I call the ‘palliative care ward round’, where 5 patients were actively end-of-life. It was emotionally exhausted but I received a card from one of the families addressed to me who were so grateful for me addressing all their concerns and making sure the syringe driver was appropriately dosed to allow a peaceful and dignified death. 

Trauma air ambulance calls take the form of ‘motorbike vs pheasant’, very different from the stab wounds in London. 

Aside from the hospital learning opportunities the countryside is beautiful. You can rent a cute country cottage alone for the cost of a garage in London. The neighbours have a cat who can visit you in your garden when you are feeling in need of some animal love and therapy. You can cycle out on country lanes after work and enjoy muddy walks and it’s the perfect time to invest in some waterproof walking shoes. The skies are beautiful, as I cycle out to my nightshift I can look up at the stars. There are lots of fresh local vegetables for sale such as celeriac, swede, local mint, strawberries, you name it. The country markets in town are cute, the restaurants make amazing Christmas dinners and the local pubs are full of character. You make friends for life as you bond with your colleagues. The people are so kind, in a moment of need you can even hitch hike a lift in a van back with a kind local family (albeit with a chain saw in the back – in case a tree came down on the road in the storm). The town feels very safe. You can learn to row, play tennis, join CrossFit, go to Pilates with the locals or go on long runs in fields. 

I just came back from London, where I spent £9 a day on tube fares. Here I have an 8 minute cycle to work in my scrubs, completely free of charge and a whole lot more reliable than TFL. 

You know nearly everyone in the hospital by name and they know you. You walk through the corridor and people smile – porters, nurses, reges, SHOs, consultants. Even patients you see back in ED, although no one really wants to be there, there is a form of alliance that is unique.  

There are also plenty of locum shifts available but the salary is comfortable enough as it is and I am able to save a good amount because of the long hours you work. 

 The experience brings me very close to my own feeling of being grounded in a world where doing good for others – ‘beneficence’, has real meaning. After a long day I can turn my 200-year-old door key in the lock and I know that in my own way I have done something good, that I have made a few people’s lives better for that moment in time, and that is really special.  It’s the biofilm distance between me and “my patients” that makes my experience in this rural location seemingly very different from those of my friends in more mainstream locations. Nowhere else do I gain the impression that you have such pressure and responsibility thrust upon you at such an early stage.  Nowhere else do I get the impression that you are left alone to deal with so much, so soon. 

So if you find yourself allocated a ranking in the 9000+ range, take heart, gather your forces and be prepared to rise to the challenge. I promise you, you will find your way and you will be a better doctor as a result of it.  

When it rains it floods, when it snows the roads are too icy to drive on, when there’s a storm trees block the roads. It is the type of place that likes to trap you in and getting there can be a mission too. If weather conditions allow, you can escape back to the smog during your annual leave. Although you might find that that your views on life in a remote hospital change the more experience you gain and maybe you will find that the charms of life in the city will fade, and that you think you might possibly stay… 

Tamara Enthoven

F1, West Midlands South Foundation School