My hero: the Medical Sheroe

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Dr Anita Mitra aka Gynae Geek

 

As someone who is still quite early on in their medical career, I’m always looking for the next Sheroe to show me how it’s really done. My medical Sheroe hunting naturally continues into my social media life too where female doctors on social media give me an insight into the things that at times feel just out of grasp.

They’re the ones who are already doing some of the things I want to do. Dr Ailsa, a London based Oncologist, with her two children and her medical family who still makes time to work out. Dr Anjali Mahto, a London based Consultant Dermatologist with a career in medical writing who wrote a well acclaimed no nonsense book to educate the general public on how to get great skin.  Dr Anita Mitra, a London based gynaecologist with her evidence bases education on social media with a healthy side of weigh lifting who has also recently published a book!

 

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Dr Anjali Mahto Dermatology Consultant

 

I’ve never met any of these doctors, but know I can learn a lot from each and everyone of them. Sort of like an unofficial educational supervisor. Some of it I’m going through right now (who knew there was so much to weight lifting) and other things I will come across later on such as balancing having a family of my own and still doing well (trying to anyway) at work.

My education on the medical Sheroe (ahem, stalking) also extends to over the pond too where I have noticed some subtle differences. Whilst the work in America might not be that different their approach  to celebrating the medical woman has some differences and I would argue that we have a few things to learn from out American friends.

 

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Dr Ailsa, an Oncologist with her lovely family

 

I was having a look at my Instagram page a few months ago and saw the hashtag National Women Physicians day which is day held in America to celebrate the female doctor.

A whole day dedicated to celebrating achievement. There were posts from medical students  putting in the hours to badass mums juggling children and demanding careers. All whilst trying to drink 8 glasses of water a day or whatever we’re meant to be doing now, looking like they’ve slept, exercised, done their pelvic floor exercises, replied to all of their e-mail and made sure their children are washed and dressed all whilst trying to get enough fruit and veg in for the day. Yep. The easy life of a medical woman…

It got me thinking. Women do a lot. Women in medicine being no different. Even me in my unmarried childless state with no dependents, I always feel like I’m juggling so many balls. Audits, interviews, exams, simulation sessions, home life, make sure my family are ok. It never ends. So why not indulge in a little pat on the back every now and then and dare I saw it a little internal brag!

Being a doctor is more than a job to me. It’s a life long commitment (that I have happily chosen) but it’s definitely not the easy route and as life get busier, exams get harder and more is expected of me, I just have to do better at each step. This goes for all of us.

All the more reason I say, to stop and smell the roses and pat myself on the back for how far I have already come and how much I have achieved. I might not be doing it all with perfect eyeliner and the cutest outfits like I want to, but every day I get up I try my best. I show up.

So here’s to us. The medical woman. The tired women. The woman trying to balance it all whatever that even means.

Mostly, here’s to the woman who keeps trying. If you’re like most of the Sheroes I have the pleasure of seeing around me everyday, you probably don’t tell yourself enough but you’re doing great.

Until the next post,

Salma xxx

PS: Go and follow these ladies. They are brilliant.

@dranjalimahto

@dr_ailsa

@gynaegeek

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Three minutes to stop and breathe: how an app changed my working life

This blog was written for the BMA.

Exhausted, losing weight, looking miserable. This was not how I had imagined my life as a doctor.

As the F1 on acute medicine I struggled to balance treating my patients well and looking after myself. There is no shortcut to learning how to deal with a patient with severe chest pain, an angry family wanting to speak right away and a microbiology consultant on the phone, all at the same time. In the end the skills I learned – such as how to prioritise – still help me to this day. But that came at a cost to my physical and mental health.

I would bend over backwards for my patients but I wouldn’t prioritise myself, my lunch breaks or my right to hand over jobs. And long term, tired doctors aren’t in their optimum state to look after patients.

I did the best I could, but I knew this couldn’t carry on for two years. I made changes, I went to the gym more, made sure I enjoyed all my time off and started meditating.

No junior doctor gets to the end of two years without major highs and lows. It’s a learning curve, and I learnt the hard way just how important it is to look after myself. One day at the end of F2, I was doing nights, and I had to pack up my house and drive my stuff over 200 miles to my parents’ house, pack for a friend’s wedding and sort out accommodation on the opposite side of the country for my new job. I felt acutely stressed and needed something to help.

I remembered my GP teaching – we’d been recapping treatments for depression and our tutor mentioned the Headspace app, recommending we try it. In my moment of panic, I downloaded it and did a three-minute exercise: sitting on a chair and breathing. Easy, right? Well, harder than you might think actually, but that three-minute pause was what I needed. It got me out of my ‘oh my God’ state and into ‘let’s do this’. Thankfully there was no chanting, no annoying music and no great demand on my time.

It helped me when I was feeling stressed, but also when I wasn’t. ‘Prevention is better than cure’: we say this to our patients all the time, in the guise of ‘what’s your diet like?’ or ‘do you smoke?’, but the same can be said about mental health.

When I was on holiday and waiting to start working in radiology, my friend, also a doctor, found it strange that I would continue to meditate every day. But I knew that radiology and moving across the country would have its own challenges, and I wanted to keep up the habit.

I wasn’t wrong. I’m now a few months into training, working and preparing for exams. It’s both the best and worst thing about medicine: you’re never finished. And then you have life’s ups and downs too.

For me, Headspace gives me time away from all of that. Time just for me; sometimes it’s the only time I get. I use it when I can – sometimes on the park and ride into work, on my lunch break or at the end of the day. All you need is a phone and headphones. Half the time people must think I’m napping! And some days I can’t fit it in, and that’s OK too.

Everyone needs a moment to just stop and breathe. I wish I had used Headspace earlier as a doctor. On those busy crazy days, a three-minute ‘time out’ to regroup would have been really beneficial. It’s easy to be sceptical – I know meditation seems hippy and new age to some people – but my advice is, don’t knock it until you’ve tried it.

 

 

social media sabbatical

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Prevention is better than cure. We’ve all heard it. You don’t have to be a doctor or in any way related to the healthcare profession to have gotten that message. You might even be sick of it by now. All the smoking cessation adverts or the constant media scar mongering.

Some of it is a bit overboard I’ll agree but having worker as a doctor for a few years now, I’ve seen my fair share of patients with conditions that were avoidable in some sense. I don’t just mean physical conditions and the obvious culprits such as obesity I’m also talking about mental health.

Whilst I haven’t suffered depression or a mental health condition myself it has alway been something in the back of my mind that I have been conscious of. Working long hours as a junior doctor, initially in a new area with no real social network of friend or family set up for myself, I was a prime target. I use to think looking from the outside it wouldn’t be surprising if I had a patient who was in my shoes who was depressed. Especially after those exhausting on call weeks!

That’s why I’ve tried to make an effort to notice how I was feeling and how different activities made me feel. I had seen patients with depression who were really suffering and whilst I also was fortunate enough to see some at the other end of the tunnel this wasn’t the case for everyone. I didn’t want to risk it.

Oprah once said your life’s constantly talking to you and when you don’t listen that whisper turns into a ton of bricks falling down around you.

They say it’s not wisdom until you actually implement it into your life and recently I listened to the whispers in my life and a made a few changes.

I took a big step back from social media.

Going with my prevention is better than cure, I started to be more conscious of how certain things made me felt and what role they played in my life. I looked at myself as both a consumer and a part of social media. The truth was I didn’t like what I saw.

For any time I would look on Instagram I would ask myself “what value is this adding to my life”. Looking at the super rich in their amazing clothes and holidays added very little value to mine. Then there were some account which one could group as “inspirational”. In fact there are some pretty great doctors out there making pretty big waves on social media from promoting healthy ways to eat to motiving people to work out more.

But again if I was really honest with myself, how was that beneficial to my life beyond the benefit they have already had? On balance most of the stuff I end up looking at was frivolous and whilst that’s ok at times, these apps are designed to be addictive and 5 minutes here and there soon adds up and that’s time that I wouldn’t choose to use in this way. I would just end up doing so!

Everyone is so happy to show everyone the highlight reel of their life. We all know no ones life is perfect but when you look at those perfectly captures “candid pictures” with Valencia and the perfect amount of brightness and contrast, we forget. Or at least I do. And that I think can be very damaging. Because we compare our reality to someones else perfected squares.

Facebook is the same. For every engagement picture there are triple the heartbreaks and breakups I’m sure. But we don’t hear about that.

And I’m in that group too. I don’t post the crap times of my life either but posting the best bits of my life makes me feel uncomfortable too. I’m not 100% sure why. I guess a part of my feel that it’s a bit dishonest putting one side of the story. Another is I don’t want the world knowing what I’m doing. I guess I don’t find Facebook useful at the moment. I’m not interested in keep up to date with everyone else’s life.

If you’re my friend I already know. We keep in touch in other ways.

Since deactivating my Facebook and getting Instagram off my phone I feel happier. I have noticed my concentration levels have increased and my time feels like my time now. Where I would show off about doing certain thing I don’t have to spend the time to think about which picture to use or which caption. I switch off.

Your mind and your attention are so precious and I don’t want to waste them on things that don’t serve that attention.

I still have my Instagram and my Facebook is deactivated for now. I’m not against social media but I am against wasting time and continuing with old behaviour just because “everyone does it”. I still check Instagram once a day but I’ve taken a backseat to my consumption and uploader status for a while and that’s suiting me just fine.

Whatever your opinion on social media, I hope thing made you think a little. You might love it and get so much out of it in which case carry on! But if you don’t and you don’t find it to be a good thing in your life then perhaps a little sabbatical or just what you need.

Until the next post,

Salma

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Confessions Of A Junior Doctor

 

 

There are a few things that us Brits care greatly about. The great British Bake Off (and the colour of Mary’s jacket). A good cup of tea. The weather. Oh, and the NHS.

(Another) election also means potentially more shake up for the already struggle institution that we all know and love so when it came to watching the first episode of the new TV programme from Channel 4, I feel we all sat up a little straighter.

If the reaction from twitter and my non medic friends is anything to go by, the new documentary following junior doctors in Northampton General Hospital touched a nerve with everyone. For the medics it was a case of “yep, I remember that” and for the non medics it was an unfiltered eye opener.

People relate to people and for all the talk about the much contested junior doctor contract this programme wasn’t about that. It was about the people on the front line doing that thing that they loved and living with the very real consequences of a system under pressure. Like their patients helpless at times in the face of disease, these junior doctors were also visibly helpless to the pressures of the NHS. The 9-5 working day which many doctors know in reality is an ideal more than an often subscribed to reality was demonstrated by the doctors having to stay late at work.The statement of “a large part of it runs on the goodwill of the staff..without that there would be no NHS” rang particularly true.

If there is one thing keeping the NHS together it is the people. As a junior doctor myself I have had some of the hardest days of my life at work. I’ve cried. I’ve run around like a headless chicken. I’ve stayed late. Yet with all of the difficult conditions why do we all stay?

It’s a question I’ve asked to junior doctor friend before. Their confessions weren’t caught on camera but rather in my car, or the canteen, or on the way to the pathology lab because the pod system stopped working. The response comes in many forms but ultimately the answer is something like “because I care”. And that I find universally in the NHS.

For all its flaws and imperfections, it’s filled with some of the best people. People I feel lucky to have worked with. The other day I found a consultants doing a ward round at 7pm on a Friday evening. For those of you who don’t know this is quite unusual. They weren’t being paid for this. They just wanted to make sure their patients were ok. When I went to help I was told it was all in hand and there was “a system” in place (that perhaps I would have ruined!). This is one example of someone going above and beyond their “job”. Everyday I see this. I don’t even have to look hard. I meet a million unsung heroes everyday on the NHS.

If you haven’t already gathered I’m a fan of this programme. For someone who doesn’t own a TV and doesn’t watch any TV programmes regularly, I shall be tuning in again.

The long and short of it the NHS is breaking but people still care. I don’t have a solution but I do know where you can go to educate yourself about the real state of the NHS every Wednesday at 9pm on channel 4. Oh and vote wisely.

Until the next post,

Salma

perception Vs reality: death, the failure to cure

 

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Christmas at the Hospice

A wise person once told me there are only two things in life that are guaranteed. Life and death.

Out of the two, I think we have a problem with talking about one of them.

I love life as much as the next person but I think my views on death are quite different. I think there are major issues with the way we look at death. Both the general public and as doctors.

As a doctor I often get the feeling that death is seen as failure (and sometimes it is when we get avoidable things wrong). But most of the time it really isn’t. People age. Organs tire. Treatments don’t always work. It’s at this point that we have to take a step back and think about what we’re really trying to accomplish.

Our aim changes. There’s a branch of medicine that deals perfectly with this change: palliative medicine. It’s may not be everyones job to treat dying patients, but it’s everyones job and business to recognise when someone reaches this point and to do something about it.

I’ve been working in a hospice for 4 months (really not as depressing as you might be thinking) and no I didn’t spend 4 months trying to save someones life. What I did do was try to help a little. Sometimes that meant treating an infection and other times it was treating agitation at the end of life.

I’ve moved back to the hospital now and it really doesn’t take very long to come across patients who are at the end of life. Yes we can all recognise it but I really think we have big issues in being black and white about it and saying it.

I’m not saying it doesn’t get said. But I think there is often a delay in relaying what we can all see happening and communicating that to the patient and their families.

I think it’s a cultural thing. You go to medical school and you become a doctor to “save lives”. Then you’re faced with a patient with a condition you can’t cure. They may not be imminently dying but you know they will at some point. Your mantra of “save lives” suddenly becomes a bit redundant. I’ve seen a mix of reactions to this from avoidance to a feelings of hopelessness. The end result of this is things don’t always happened as quickly as they should.

If you’re patient is having a heart attack you don’t delay telling them and starting treatment if it’s appropriate. The same attitude should be applied to the dying patient.

It’s can be a difficult discussion but it’s just as important as telling someone about a heart attack. It isn’t always a failure or anyones fault. People die.

I was also one of those doctors who went around with the attitude of “I save lives” (or at least I was trying to). My effort for my patients hasn’t changed but my perspective on what I do has. I now like to think of what I do as “I try to help”. Whether my patients can be “cured” or not, I’m always trying to help them. It makes dealing with the “we’ve reached the end of what we can do to cure this illness” conversation easier and also stops death from being the enemy.

Because if I’ve learnt one thing from my 4 months at the hospice it’s this. We might not always be able to cure disease or avoid death but that doesn’t meant there still isn’t a hell of a lot we can do to give someone the time and dignity to live the time they have left in the way that they want to.

Until the next post,

Salma

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GP land: over the hills and far away

 

In case you missed it and want to have a read, here is a blog post I wrote for a GP magazine on the language we use in healthcare and the importance it might have.

Happy reading!

Salma

xxx

 

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I was a medical student and I was in a clinic with one of my favourite doctors. He had a two-eared stethoscope (the only one I have ever seen to this day), would often hand me the drug chart during bed side teaching and ask me for a differential diagnosis and he called me Faiza for a year because I once sat in Faiza’s chair. He was so nice I didn’t mind that after six months he’s still called me Faiza.

One day in clinic we were trying to contact a GP surgery to get more information for the patient who was in front of us, a confused breathless man. We called several times but the line was engaged and then no one would pick up. No luck that afternoon.

‘No response from GP land’.

 This was the first time I had heard the term and since then it’s not been an uncommon term for me to hear around the hospital.

When I first heard it, it reminded me of something akin to the telletubbies: ‘Over the hills and far away the GPs come out to play?’

Language and choice of words interest me. GP land is banded about all the time. In general conversation, in on call rooms, in multi-disciplinary team discussions, but do the words we have have an impact on how we view certain specialities?

GP land is far away from us ‘the hospital’. GP land is unrelated and like the telletubies say, over the hills and far far away. Once the patient is there they are very much someone else’s responsibility, the GP’s, there to pick up the pieces after a hospital admission at the mercy of a discharge letter for information.

The patient, who every physician will agree is at the centre of their efforts, has interactions with so many different specialities but the ‘us’ and ‘them’ attitude between doctors in every speciality still surprises me. It doesn’t help. Being a junior doctor you quickly move around specialities and you straddle the line between us and them. One day you’re ‘with the surgeons’ and the next you can be in ‘GP land’. Same patient, same you, but a different hat and different outcome even though ultimately we all want the same thing; the best outcome for the patient.

One of the hardest hats to wear is that of a GP’s in GP land. The hats there don’t have the fancy gadgets of the hospital.

In an ideal world patients would move seamlessly between primary and secondary care but as long as ‘GP land’ and the ‘big bad hospital’ attitude exists we as clinicians don’t help things. Yes there are bigger reasons behind the sometimes not so seamless primary to secondary care exchange, but sometimes something as simple as the language we use can shift attitudes a little and change thinking from ‘us’ and ‘them’ to ‘we’.