ABOUT YOU FEATURE
Day in the life of…an
F2 in Haematology
Dr Samar Mahmood recalls how
working in haematology can
teach you a lesson or two when
you least expect it
I
t’s Friday morning and have to hope I get lucky
I’m looking forward to the next time round! Thank
weekend, but there’s still you for everything you’re
a ward round and day of doing,” she smiles.
haematology to get through We continue to see
Samar admires his patients’ optimism
– so I’ll hold that thought. Our patients and review their
team, led by the consultant, haemoglobin and neutrophil
moves onto the first patient counts: never before had find hardest about being an F2 been refusing to come into
of the day. I start to present a set of numbers (with the – you are, ultimately, an SHO. hospital until now.” Yes, refusing
the case. “This 65 year old exception of junior doctor When it comes to being on- until 6pm on a Friday night.
lady was admitted feeling working hours) been cause call, taking referrals or seeing So I, somewhat
unwell after chemo. She… ” for such detailed discussion. patients in clinic, your mere begrudgingly, go to see this
My consultant knows the Four hours and 18 sets F2 status doesn’t excuse next patient. By the time I
case well; he can take it of blood results later, we’re you from having a lack of complete my work-up, two
from here. “Yes, she had her still on the ward round. experience. As the SHO, the things are apparent – one,
second cycle of chemo seven Slowly losing the will to live, I expectation is that you know the patient has neutropenic
days ago. Her haemoglobin hear the sound of my bleep what you’re talking about. sepsis, and two, gone are
last admission was never going off. An excuse to It’s not all bad, though. my plans for an evening
more than 8.5 and neuts leave the round for a while. Bleep requests have out – I was supposed to be
were always around 0.02, I answer, “Hello, it’s the changed from being abrupt meeting a friend at 6.30pm.
even after GCSF. Check she haematology SHO here.” and mundane as in F1 (“I “What’s the verdict,
hasn’t had a temperature.” “Hi, I’m one of the ST2s need fluids and a cannula for doc?” he asks me. “Can I
As I reach for the obs in gen med. Just wanted a patient”) to polite and, on go home?” “I’m afraid not.
chart, amazed yet again at some advice about one of occasion, interesting (“I’m You’re going to need to stay
how my consultant knows our inpatients, please.” He sorry to bother you doctor, in over the weekend for
every one of his patients and tells me about a lady with could you kindly review intravenous antibiotics.” He
their blood results inside out, cellulitis and CML, whose a patient with thyrotoxic looks visibly upset. “There
he begins the consultation. platelet count has shot up and storm?”). Okay, I exaggerate. goes my holiday then,” he
“Good morning, Ann,” he possibly caused a thrombosis. After a non-stop afternoon says. “I had the hotel booked
says. She replies cheerily, There’s a long pause I finally have the chance to and everything.” Then he
addressing the consultant on my end. “ST2 did check the time – 5.45pm. shrugs his shoulders. “Never
by his first name – one you say?” Would it be Already running late mind, I’d sooner get better
of the privileges held by unprofessional to suggest (fortunately not a regular now than run into trouble
patients on this ward. that the ST2, soon-to-be occurrence), but I’m almost later.” There it is again, that
“I’ve had a look at your CT medical registrar, must know done. Just then, I see an optimism. I think sometimes
scan and unfortunately your more about haematology elderly gentleman being we doctors can learn a
tumour hasn’t shrunk much than I ever will and that his wheeled onto the ward by lot from our patients.
since we started treatment,” phoning me is useless? two paramedics. Everything I finally leave the hospital,
he tells her gently. “We’ll try “It’s probably worth me seems to go in slow- exhausted (after the nurses
a different chemo regime but running a decision past my motion, as does my heart have opportunistically roped
it’s like I said before, there reg,” I say, trying to imply as it starts to sink – I know me into doing random ward
might come a stage where that I know the answer exactly what this means. jobs). It’s nearly 7pm, but
we run out of options.” and simply want a second My registrar tells me he I feel surprisingly happy
Despite the bad news, the opinion. “Okay, just bleep would like me to clerk in this and optimistic – I still have
patient – like most haem me and let me know.” He new admission. “He’s got AML Saturday and Sunday, after all.
patients – remains upbeat doesn’t sound convinced. and has been spiking Dr Mahmood is an F2 at
and optimistic. “We’ll just This is one of the things I temperatures all week. He’s Lincoln County Hospital.
www.mps.org.uk NEW DOCTOR | VOLUME 3 - ISSUE 1 | 2010 15
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