A Day in the Life

23 – 25 February 2009

A Day in the Life

Amidst all of the traveling and sight seeing I had been doing so far, I was really enjoying my daily routing in England. Many times in the morning, I thought of the Beatles song, “A Day in the Life” as the lyrics go: “Woke up, fell outta bed, dragged a comb across my head. Made my way downstairs and drank a cup, and looking up, I noticed I was late. Found my coat and grabbed my hat, made the bus in seconds flat…” And so my mornings went: woke around 6:45. I was no longer showering in the mornings, as I am accustomed to doing, as the hot water was not ready then. I would freshen up and then make myself a nice cuppa tea with milk. I enjoyed my hot beverage with some butter laden crumpets and jam, and a creamy yogurt. Then I would speed walk the 2 blocks from the flat to the bus stop. Some days if the bus was approaching, I would have to make a run for it, at times, dodging oncoming traffic. Other days, I waited a good 15 minutes for one of my buses to arrive. When the doors would part, and a semi-organized but some what chaotic fashion, we would all cram inside. Most days I was lucky to get a seat which was the perfect time for people watching.

I have to say that London has one of the most diverse populations ever! Everyday I would encounter English, Irish, Polish, Indian, Middle Eastern, Middle Eastern Muslims, Black Muslims, Caribbean, Asian, and so on and so forth… I had heard this part of London had a lot of Pakistanis and Muslims and this appeared true. The women stood out the most, as they were either wearing head scarves or a full burqa, but then men would also wear the long robes and hats. Perhaps it was good to expose myself to all of these Muslim women, because I have to admit that I have always had a problem with the notion that a woman must cover her head, and at times everything but her eyes. It seems oppressive to me. One of the residents I work with is Middle Eastern and she wears a scarf around her head, but I hardly think she fits the stereotype oppressed woman. She is just like any other 20-something year old girl, jokes around, flirts innocently with her co-workers, basically I forget the scarf is even there! Still not sure how I feel about the woman are so cover that all you can see is their eyeballs…

In any case, I have been here long enough that I am also now used to seeing some of the same people on the bus every morning. There is the fashionably dressed 20-something girl, obviously heading into central London. There is the black woman and her 10 year old daughter, who she once referred to as “cheeky.” I see young moms with babies, old men in tweed hats, and hippies with dreadlocks. There are always a good handful of school children, always in some type of uniform, which brings another song to my mind, Pink Floyd’s “Another Brick in the Wall.” They definitely love uniforms here! The hospital staff wears many different uniforms, certainly different from home. The female nurses wear white pants and a fitted blue and white polka-dot top. The male nurses wear blue pants and white tops with little ribbon-type things on the shoulders, looking somewhat like soldiers. The technicians wear a slightly different outfit, housekeeping another, and so on. I sort of like the formality of it all, and the fact that it is easier to identify each person’s role just by looking at them.

My bus ride to work takes 10 to 15 minutes depending on how much traffic there is. Sometimes you get stuck in a line of buses just wishing the driver would open the doors! I pour out of the bus with the masses of people. Most veer to the left and enter the Tooting Broadway Tube station. Some continue past that, to the South Thames College, and a few walk a few more blocks ahead, like me, to St. George’s hospital. There is a lot of hustle and bustle in the halls of the hospital each morning. I walk quickly to St James’ wing where the ICU is located, most days I am running a little later. I sneak into the OR (aka. theatre) locker-room to change into scrubs, and then a join in with the morning rounds. Often times I am not the only one late, I have noticed that the doctors-in-training here are much more likely to be late than the residents I have worked with at home. No one makes a very big deal about this if it even bothers them. Generally, they don’t take life as seriously here.

After the morning rounds, everyone picks a patient or a few to take care of for the day. I have gotten to look after a few different types: elderly who got in a moped accident, old lady with flu plus pneumonia, but if there is any patient with Obstetric or Gynecologic problems, those are the ones I jump for. There have actually been a handful so far, and one very sick postpartum patient who has been there since my very first day on service. There is usually about an hour and a half to two hours to work on our patients which is more than enough time with some left over so that I can look up some more information about my patient’s case. There is always someone around to help if I need it, and as I said, it’s a very low stress process, which is a contrast from what I am used to in the hospital at home.

The official ward rounds happen from 10:30 ‘til about 12:30 and are led by one or more different ICU specialists. There is quite a range of different styles and personalities. There is the Italian doctor who tends to be less aggressive with patient management. Then there is the Indian doctor who is more soft-spoken but efficient. Then we have the doctor with the very dry British humor who usually takes a more aggressive approach to patient management. He calls some of the elderly patients, “old & crumbly.” He basically takes the role of the man in charge, usually quick to step in and say “What the hell were you thinking?” He is the one always quoting the latest research studies, or mentioning his own research experiences. Generally, all of the doctors are very down-to-earth and approachable; he is the only one who is intimidating. He will definitely be the first to tell the residents if they screwed something up. Interestingly enough, all of the residents call him by his first name. I still can't get enough of the fact that we get tea, coffee and biscuits every day during rounds! Although I have been told this is not the norm for most services in the hospital, I think it is a great tradition.

After the official rounds, I take my lunch break. I will eat with the Italian doctor, Gianpaola, when she is there. Otherwise I go alone. I have been eating most of my meals in the main cafeteria. There is usually a good choice of food options and it’s cheap! Everyday there are 5 potato options, usually some sort of curry or Indian food, a meat pie, and I especially love the warm dessert. I have had coconut sponge cake, spotted dick, apple & peach pie, and rhubarb crumble all swimming in warm custard!

After lunch, I return to the wards and take a look at my patient to see if they are stable. If there are any procedures going on like bronchoscopy, central line placement, or tracheostomy placements then I will watch. Sometimes I help with paperwork to get the patient ready for discharge. No one really keeps tabs on me or minds if I stay or go. It is nice to have a good level of autonomy. The longer I have been here, they have given me more responsibility. I usually head home for the day when there isn’t anything else going on. Some evenings I visit the hospital fitness center. Other nights I kill a few hours playing on the internet in the school library’s computer lab. Eventually I head home to Streatham on the bus. Sometimes I see the same commuters from the morning. Inevitably there are always a few people on the evening bus who wobble on, having just come from the nearby pubs. Once home, Charlotte and I catch up a bit. Sometimes her boyfriend, Roger (or “Roo-gah” as it sounds when she says it), is there too. Some nights we listen to the BBC news radio, other nights to the British classical music station. Before I know it, its time to start the day again.