Saturday, 13 September 2008

The Dr. Scot Junior saga (2).....are these fuckers for real???

Posted by: Dr Thunder

So, a lot of people are aware of the "Dr. Scot Junior" saga. Jane Doe's post below outlines a lot of what the case is about. Essentially, a scottish junior surgeon was posting his views on the doctors-only password-protected website

On one of the mesage boards, he called Dame Carol Black "A shit". This is because Dame Black was heavily involved in the "rearrangement" of junior doctors training in the UK. This training revamp has pretty much destroyed the training of British doctors, and has had huge impacts on their personal life. Pretty much every British junior doctor thinks Carol Black is a shit. Her and her colleagues get called much worse in doctors' scabby tearooms across the country every day.

Anyway, Dame Black's mate, Professor Gillian Needham, up in Scotland, decided to ban Dr. Scot Junior from practising surgery there.

Now, I worked in Scotland for several years. Healthcare there is the pits. There are parts of Scotland where the life expectancy of males is 64. That means some Scottish males are expected to die before retirement!!!!!

The Scottish health service cannot afford to ban doctors. Not because they were a bit cheeky, anyway.

So, there were apologies. Dr Scot regretted his choice of words, and asked for his comments to be removed from the website. Professor Needham had no real choice but to reinstate him and allow him to continue practising. Especially as the Medical Council tells us that doctors should only be banned from working if their actions put patients at risk. There are no rules covering doctors who cause offence to your coffee-morning pals.

But she was pissed. This upstart has mocked her friend. Needham and Black have helped fuck up the lives of junior docs all over the country, by, for example, advocating a sytem which tells married couples with kids and mortgages that they have to move to opposite ends of the country to work until 2010, as part of the "training revamp" This is on top of making lots of doctors unemployed.

I left Scotland to go to Oz because of these gobshites. I will never go back. Scotland isn't exactly overflowing with paediatricians either.

As Prof Needham was angry, she decided she wasn't finished with Dr Scot Junior. So, she's suspended him again!!!!
The poor guy had only been reinstated 3 days!!!!

This time the reason is being kept private, but it relates to something he apparently did years ago, just after he qualified from medical school.

It didn't seem to be an issue before now, until he offended Needham's coffee buddy.

So, while the waiting lists in Scotland are out of control. Be safe in the knowledge that the medical hierarchy are looking after you and your loved ones by suspending the man who might cut out your colon cancer just before it spreads, or remove your appendix before it bursts. Be safe in the knowledge that no man who has the tenacity to call a superior "a shit" will be allowed anywhere near a scalpel in Scotland.

The NHS is in good hands.

Dr. Thunder

Tuesday, 2 September 2008

When do we stop? Should we stop?

Posted by: Dr. Thunder

It's 2pm, and the emergency pager goes off. "Emergency, ward 4" flashes up on the screen.

We all drop what we're doing and run to ward 4.

When the emergency team arrives we're greeted by a flurry of nurses running around little Dylan, a 6 year old boy with severe brain damage. Monitors are beeping loudly, there are tubes everywhere, and Dylan looks crap.

He has pneumonia. For the 6th or 7th time this year. This time it's really bad. This happens to him every few months without fail. Now that it's winter, he suffers a lot more than usual.

The problem this time seems to be that he has very severe pneumonia and is struggling to keep his oxygen levels up. After examining him, it becomes obvious that he's punctured one of his lungs now, and it looks like some of the bacteria in his lungs have made their way into is bloodstream, causing septicaemia.

He's a very sick boy.

So, we stick a tube into his lungs, through his chest wall, to drain out the excess air from his punctured lung. We give him a lot of fluids intravenously to help with his low blood pressure. We give him lots of oxygen. We pump some more antibiotics directly into his bloodstream.

This all helps, but it's not enough. Dylan is really struggling to breathe now, and he needs to go on a life support machine. This involves putting a tube into his mouth and pushing it into his lungs, allowing us to take over his breathing for him.

We managed to stabilise him where he is, and transfer him to intensive care. He stayed there for a number of days, and is now back in his old ward. He still has his pneumonia, and he's still very sick. He'll be in hospital for a while. When he goes home, he'll be back within 6 weeks.

The reason I bring up this incident is because there's a number of staff who don't think we should have resuscitated Dylan. This kind of thing happens to him several times a year, and he's always pulled back from the brink.

But in the interval, Dylan has really no functional capacity whatsoever. His mum think she can make out when he's trying to smile, but that's about is. He has no speech. He can roll his eyes around, but he's mostly blind. He gets fed through a tube in his stomach. He can move a bit, but not much. He has seizures most days, and they are almost impossible to control.

His mother remains very calm when he gets sick. She's been asked whether she wants all these intensive measures when he gets ill. She does. But there are a number of people who believe that this choice should be taken out of her hands.

They argue that, in the last few weeks, he's taken up a hospital bed for 4 weeks, and intensive care bed for 4 days, aswell as a stack of staff-hours and medication costs.

Personally, I don't like getting into the realms of deciding who's worthy of resusciation, and who's not. Dylan is a good example of how there are differing opinions. So, I just get on with it, and try not to think about it too much.

But I was just wondering what people thought. Should people like Dylan have a right to the same healthcare as the rest of us? Should the final decision rest with their parents? or does there come a time when the hospital should step in and call time?