General Medicine – First Day
I.III.I
FIRST DAY
Next up would be my rotation in general medicine – having chosen gastroenterology as my subspecialty. I’d be working under one of my favourite consultants, Dr Sugar – with whom I’d had the pleasure of shadowing during my days as a med student. My first year as a doctor was shaping up to be a great one!
Together with William, the kindest and most well-natured higher specialist trainee I’ve ever had the pleasure of working with, we were an intimate firm of three, with some twenty-five patients under our care. After the overall pleasant and relaxed experience that was my neurology rotation, I knew I had to buck up and brace myself.
First of all, I had way more patients. Second, they were scattered all over the hospital. Third, I didn’t particularly like internal medicine. And fourth, I was back to having endoscopy lists. I’d be giving up the warm, comforting embrace of the neuro department for the cold, uninviting sprawl of the entire hospital, saying goodbye to the doctor-patient relationships I’d grown to cherish, and foregoing any semblance of free time I’d enjoyed back in neuro. This was gonna be like my rotation in emergency surgery all over.
But it was gonna be okay. I knew that. I’d been given just one warning from my predecessor – a very simple thing that was guaranteed to put a smile on Dr Sugar’s face. At the bottom of the patient census, I’d have to add a joke of the day. Simple. How wholesome is that, huh? A consultant who also appreciates fun!
So, on my very first day, I rushed to the hospital before anyone else and thought long and hard about which joke to choose. Given that she’s a gastroenterologist, I went with the obvious:
Why is diarrhoea genetic?
It runs in your genes!
Needless to say, she loved it. And it was the perfect way to start off our ward round – one that would be lengthy, to say the least – taking up most of the day and leaving me with just a couple of hours to get everything else done.
It only took one ward round for me to figure out a few things. Like the fact that I’d need sustenance if I was gonna round the entire hospital for four hours straight. I immediately thought about buying a crossbody bag so I could carry snacks, water, and various forms and documents, just to avoid the hassle of hunting them down in every single ward. Then I considered wearing a nappy – or maybe inserting a catheter – for the duration of the round, given we’d have no time to waste. My plans probably needed some adjustment, granted, but at least I was trying to optimise my working conditions.
That said, it wasn’t as bad as I thought it’d be. It was long and seemingly unending, sure, but it wasn’t the nightmare I’d been expecting. In fact, I’d say it was quite the opposite.
Especially so when, at one point, we needed to consult the respiratory team for a patient who required optimisation of his asthma management. He’d been admitted with an exacerbation, and we needed specialist input to manage him better. Having grown used to conducting consults myself, I immediately reached for my pager, ready to phone the on-call doctor, before Dr Sugar stopped me. “No, no, don’t worry. I know the on-call. I’ll just text him myself,” she said.
I was stunned. Not one senior had ever offered to do something like that for me before – let alone a consultant. “Are you sure? It is a house officer’s job, after all,” I remarked, innocuously, my eyes tearing up at the simple thought.
Her reply? “We’re a team. Everyone has to pitch in.” My jaw practically dropped to the floor. Before this rotation, I’d somehow come to expect consultants to sit at a safe distance – issuing instructions, delegating endlessly, and letting the juniors absorb the chaos. That was the image I’d built in my head, and I’d learned to accept it without question.
Working with Dr Sugar dismantled that expectation entirely. Watching her step in, take responsibility, and treat every member of the team as just that – a team – recalibrated what I thought senior doctors were meant to be. It also made me realise how subservient we’re expected to be as juniors. I think, up until this point, I used to accept all the crap seniors used to put us through simply because I respected the hierarchy. I never even questioned it!
That one line from Dr Sugar broke the glass and I could finally understand it. Respect is earned – it doesn’t just come with the title. And so, without realising it at the time, it quietly reshaped the kind of senior I hoped to become.