A Quest for a Normal Life

In the UK more than half of the people affected by Cystic Fibrosis (CF) will live past the age of 41. As a parent of a child with CF you have various statistics in your mind at various times, but most of the time you try not to think about it. A few months ago I questioned that statistic as we thought that our Minty wasn’t going to make it through her chest infection aged just three. I can write about it now, but that was a shocking moment. 41 years old seemed like an eternity. As doctors my husband and I knew she was seriously ill. Her respiratory rate hit 70, heart rate 180, temperature was 41, she needed oxygen to maintaining her saturation and had not passed urine in 24 hours. She sustained this for hours and I wondered how her little body could keep going having had a general anaesthetic and bilateral lung collapse. We thought she was going to have a respiratory arrest. Those days were bleak and cystic fibrosis had taken over her life. But she recovered. We recovered.

It’s interesting to see how a three year old perceives her condition. She knew she was ill and knew that hospital was where she needed to go. Her choice of clothing that day is reflected in this poignant picture. She had planned this outfit to arrive in hospital. It was her best party dress. She walked into the ward proudly and then sat on the bed. She looked down and tears filled her eyes. I asked her if she was scared. ‘Yes, mummy’, we paused, snuggled and then she jumped down holding back her tears and played with her dollies.

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She choose this dress specifically to go to hospital. She walked onto the ward proud, sat on this bed. When she looked up, there were tears in her eyes and she said she was scared. She then, held them back and started playing. Tough.

This week she completed her first lung function tests, getting 110% of predicted. She’s getting ready to start nursery soon and we’ve written her care plan. I thought I would share our philosophy for living a normal life, with normal activities and hopes and dreams.

‘We believe Minty is a magical little girl! She inspires us daily and is tougher than we imagine. She is independent, funny, caring, sociable, exuberant and extremely adaptable. She does not see herself as ill or suffering. She sees herself as any other little girl, but sometimes she goes into hospital and every day she takes medicines to keep her well. This is her normal life and we make it normal for her. Even when she is really ill and goes into hospital, she goes there to get better and in her last admission she knew she needed to go to get better. CF is a journey that we all learn from all the time but we have developed a philosophy that we hope anyone who looks after her shares. Minty is number four of four children, she has one older brother and two older sisters.

We only use positive language surrounding the condition. She is living with it, she is not suffering, she is not ill. Medicines are not ‘yucky’ or inconvenient. Avoiding certain things are to keep her healthy not ‘stop her from getting sick’. Physiotherapy is to keep her fit and healthy. When she doesn’t want to do it we suggest that she wants to feel great or well. She remembers what it’s like to be unwell and go into hospital, she is able to make the connection and will always pick to do the things that keep her healthy if she needs a bit of encouragement.

When talking to others in her presence about her condition we remain positive in our wording and attitude. This enables her to remain positive in her attitude to treatments, and by her engaging actively that will give her the best chance of a healthy long lifetime.

However, CF is a life shortening condition with a life expectancy in the 40s. With good care, children like Minty are looking forward to much longer life expectancies. It is also important to allow her to feel rubbish, angry and sad. It is important to remember that Minty getting a cold most of the time will be fine, but frequently may result in two weeks of oral antibiotics or sometimes a hospital admission with a general anaesthetic, PICC line insertion and 2 weeks of intravenous antibiotics. She has had 3 admissions so far, we hope to keep them to a minimum by following good CF care. There are many treatments in development, gene therapy, medications and more. As a family we keenly await these for her, we fundraise for CF Trust and keep an eye on research.’

Here is Minty running a toddler race. She may be last but she’s living life to the max.

Follow Magical Minty fundraising efforts on our Facebook page or twitter @magicalminty_cf.

 

Being a Junior Doctor & Parenting a Child with Cystic Fibrosis

Last week junior doctors staged another strike in opposition to the proposed enforcement of Hunt’s Junior Contract. A contract which most doctors believe will endanger patient lives and destroy the NHS. On the eve on the third strike, while my daughter recovered from anaesthetic I wrote the following piece.

“My husband and I are both junior doctors. Unfortunately, we cannot join the picket line this time.

We aren’t there because we are in hospital with this little one.

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Smiling despite low oxygen saturation and high fever.

Our three year old daughter has cystic fibrosis. She’s not been well recently and she’s in for a general anaesthetic, bronchoscopy, fixed intravenous line and two-week course of heavy duty antibiotics. The NHS is so vital for her care and future. We have no doubt that she will be well cared for the next two strike days.
The junior doctor fight is for every patient and every person working in the NHS. Doctors looking after her (and everyone else) should be well rested, motivated and valued. She starts nursery soon, we’d like to see her and our other children at weekends. We already work many weekends away from them. CF shows us that life is precious; it is too short.

Doctors involved in her care over the next two weeks will be many; junior doctors, respiratory consultants, anaesthetists, radiologists and microbiologists. But also ward nurses, recovery nurses, operating department practicioners, specialist nurses, student nurses, ward clerks, pharmacists, pharmacy technicians, porters, health care assistants, domestics, dieticians, psychologists, physiotherapists, radiographers, play specialists and more. Behind the scenes are lab technicians, estates workers, IT staff, medical secretaries, central sterile services team, theatre managers, ward managers, volunteers, security staff and a huge long list of others.

We all work together for our patients. We make something pretty amazing. To think that adding just junior doctors to the ward at the weekend is all that is needed ignores the rest of that amazing team.

When times are tough, we remember this phrase, ‘Dum Spiro Spero’. It means while I breathe I hope. Perhaps one day there will be be a cure for CF. We try to remain hopeful about the junior doctor ‘fight’ too.

Junior doctors are standing up for the future of the NHS. Let’s all stand together. Good luck, we’ve got our badges and banners on the ward ready for tomorrow. She says a big thank you for everyone looking after her.

Mr Hunt, I request that you engage with us and take our concerns seriously.”

Since then, she has been recuperating in hospital and faces further treatments prior to discharge home. The contract in short, may mean many doctors simply cannot afford to work in the NHS, whether financially or emotionally. Minty’s story was featured in The Independent and on Doctors of the NHS.

As always, fundraising for the CF Trust is a goal. Minty’s Godfather and family friend aim to cycle from London to Paris to raise money. Find out more about Magical Minty Cycling Team on Facebook or donate here.

To understand more about the Junior Doctor contract this recent Facebook post is an excellent summary. 

Raising a Little Lioness

‘What’s your name?’, we ask her. ‘Lion’, she replies and adds a lion roar to confirm this. Ask her again two hours later. ‘Lion’, she will reply, roar and laugh with glee. She knows her real name well. But on day 13 of 14 of our dear friends tobramycin, ceftazidime, flucloxacillin and colistin visiting if she wants to be a lion then so be it. You roar and you laugh as loud as you can. For you are our brave lioness.

Dolly has a PICC line too.

Dolly has a PICC line too.

Smiling with family!

Smiling with family!

Lioness bed hair!

Lioness bed hair!

Play in hospital with my brother. He misses me.

Play in hospital with my brother. He misses me.

Tonight after her last dose of IVs at 10pm, her PICC line will be removed and she shall come home again. This is her second hospital admission, her second GA and second course of strong IV antibiotics. A not welcome beast has arrived – pseudomonas. A pseudomonas complete with antibiotic resistance and a mucoid layer. Scum. Learning she had pseudomonas was in some ways similar to receiving the initial cystic fibrosis diagnosis. Shock, anger, upset, guilt, hopelessness and powerlessness. One of the few bugs we absolutely did not want her to get. Where were you lurking you ba**ard? Why her?

She fell asleep to Peppa Pig as the anaesthetic took control for her PICC line. She blinked only when the toe pricks were taken for her tobramycin levels. She carries on as normal. Her wee smells (ceftazidime), she’s gone off her food and has been separated from her siblings for two weeks. Yet, she has the energy and self-determination to throw her very expensive nebuliser across the room. She’s refusing this necessary treatment that she will take for the next three months. Play therapists have been deployed to make ‘it fun’. (Tips welcome.) Whilst not ideal I encourage her determined spirit, for it is that spirit that she needs to live with this awful condition.

It’s been hard at times to imagine the future. We are filled with fear. For the moment our hope has been dampened and we are full of worry. Worry is the reason I am awake now when I should be asleep. Worry is the reason I am cleaning every nook and cranny of the house with medical grade sterilisers, even though we cannot eradicate the bug from our home. I cannot wipe every page of each book, every lego brick and cuddly toy. But I feel at least I am doing something. Worry is the reason I follow orphan drug blogs, medical journals, CF research sites avidly. Worry is the reason that I believe her ongoing cough that remains despite these antibiotics means she has not cleared pseudomonas. Worry is the reason I am finding it hard to imagine the future. I am waiting you see. Waiting for the moment I read an article or piece of information that will change her future. A drug, a treatment, a cure even, that her life and future can be returned to her. For Pseudomonas makes her future bleaker. Time is precious. A cure or treatment cannot come fast enough. Around 50% of those with cystic fibrosis die before aged 40.

I was a person who really never did any fundraising before this, didn’t often donate either if I am honest with you. Now, if someone is running, swimming, baking or who knows what else I know the passion they feel for their cause and want to give what I can. Fundraising makes me feel like I am doing something. It removes some of that sense of powerlessness over the condition. It is something for her future AND the future of all of those with cystic fibrosis. For their parents, grandparents, sisters, brothers, cousins, aunts, uncles, friends and family. By giving one person a better life you are affecting all of those people. I have no active fundraising at the moment but we have an ongoing page here. 

But one thing you need to know about lions, they are considered a vulnerable species by the International Union for Conservation of Nature. They are endangered and we must protect them. Like my lioness her future lies in the wider global community of researchers and pharmaceutical companies (like Vertex). But we carry on for now at home. We love her, cherish her and live life ‘as normal’ supported by the excellent care provided by her CF multi-disciplinary team.

I shall leave with this video by OneRepublic.  Please watch and be inspired, thank you for sharing the story of this amazing teen with CF.

P.S. Many thanks to our amazing family and friends who have supported us through the difficult weeks. Every message, meal and hug has been appreciated.

Home from the Hospital

So delighted to bring Minty home from her hospital stay, a few days earlier than expected. Down to failed IV access and difficulty getting lines into her chubby feet, arms and hands. Her cough resolved after taking longer we would have liked. Home on high dose oral antibiotics (which she really doesn’t like taking) and extra physiotherapy. I worry slightly about her being home and not getting the full dose of IV antibiotics. But overall, absolutely ecstatic that she can sleep in her own bed, rough and tumble with her brother and get her routine back to normal. She did brilliantly well in hospital, fared much better than we did! I am now left dreading the time until her next hospital admission . One week, one year, three years?? Who knows.

The hospital stay was a bit of an altered reality. We came home to try and resume normal life again. We had our first family meal last night, all six of us sat around the table as usual. Chat was around exams, Bieber, friends, food and our upcoming family holiday.

I leave absolutely determined again to raise funds for research and support for those with CF. Sunday is our skydive – yikes!! This is our last few days of fundraising, so if you’ve been meaning to give, never given to charity before or want to support Cystic Fibrosis Trust the time is now! We cannot wait too long for a cure. I cannot bear the unknown future for Minty. I want her to have a normal life. A life that her cheeky little face and snuggliness deserves. Donate here. Thank you so so much for your support and kindness. That’s it for now.

Back to work tomorrow.

P.S. If anyone has any tips for surviving hospital stays and remaining positive, do please share!

 

'Chest is clear, with equal air entry throughout. No added sounds'.

‘Chest is clear, with equal air entry throughout. No added sounds’.

Bedspaces

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So the good news is… no growth from bronchoscopy. Relieved. However, due to her cough persisting despite domestos antibiotics we are in for another 7 days.

So this had me thinking. As a doctor I often look at the patient’s bedspace. It tells you a lot about them and who their friends and family are. It’s your ‘home’ when you are in hospital. Fruit and chocolates may remain uneaten. Cards and photos displayed. Sputum bottles, urine bottles and who knows what else. I took a picture of Minty’s hospital table today. Cards, medicines, high calorie food, toys, drinks and much more.

I’d love to see other photos and put them up for others to see on this blog. If you are a patient, take a pic of your bed table (with appropriate permissions) and send it to me. Tweet it to @morefluids. Let me know your age and a bit about you. Thanks for sharing!

Impatiently Waiting

Dolly is getting a wash.

Dolly is getting a wash.

Still no microbiology results. It’s been a week since her admission. I started to worry about the lateness of this results. Largely in part due to her newborn screen taking three weeks as they verified her rare CF gene. I started thinking they are repeating things. Something must be bad. But apparently everyone’s are delayed due to the bank holiday. I hope so. I really hope so.

One week down and I cannot wait to pack up her things and take her home. The thought of one more week is driving me mad. I feel that the family is fragmented into small bits and we are all apart. Zac is being looked after by our lovely nanny Jema, he’s managing somehow. Minty wakes up each morning and calls Zac through the door. My older girls are trying to keep themselves busy this half term, largely looking after themselves as I cannot take them anywhere really. It feels like I’ve not seen them at all in weeks. I miss them all. I just want us all together in one house at the same time. It’s made worse by both my husband and I have a particularly bad run of shifts at work. We’ve not had a weekend together as a family in two months. But that’s another story.

Minty has changed in the past week. She has grown up. I’ve changed. We’ve all changed but I don’t know how. You would never know in looking at her what she is taking in her stride. Her long line is still leaking but still in place. Her wee smells bad, one of the antibiotics I assume. She’s coping well in one small room. The room is hot. Stifling at night. It’s hard to sleep. It’s no wonder patients spike temperatures all the time. We run in and take cultures when perhaps all that’s needed is a open window! She’s taken to cleaning the room with baby wipes, then sucking them. This is driving my CF mum and infection control side bonkers. She wipes the bins, under things, cupboards, then wipes her face, sucks it and laughs. Argh!! When I take away the offending wipe she screams in utter fury. How dare you, she looks. She then wipes the floor, our shoes and then her face. My mind boggles with MRSA, E Coli and who knows what else. The more I try and stop her, the more determined she is. She sees the cleaners in the room several times a day and is copying them. She gives meds to her dollies and who knows, perhaps one day she will be a doctor or a nurse (I hope not!)

Being on the other side of ‘doctoring’ I am so much more aware of how patients must feel. We wait. We wait all the time.

For results.

For medicines.

For ward rounds.

For time to pass.

For medicines to work.

For tests.

For going home.

For drinks.

For meals.

For discharge plans.

For discharge letters.

For discharge meds.

We learned in medical school how patients adopt the sick role. To a certain extent you have to as everything is beyond your control you have to accept that you will wait and rely upon those around you. The waiting is of no means a criticism of the staff that are caring for her. They are caring for loads of other patients too. We are all flat out. It’s the way the system seems to operate, the culture of being in hospital. I never fully realised when you sit there waiting all day to chat to the doctors, the few minutes they come in and out is a flash in a very long day. You always are left with questions.

On a positive note, we’re learning some great new physiotherapy techniques from her twice daily physio sessions. She’s enjoying them and we can’t wait to add them to our routine at home.

Tomorrow our Magical Minty Skydive Team is collecting money for the CF Trust. Very exciting indeed. A permit has been granted by the council, so in Park Street and Queen’s Rd, Bristol buckets and t-shirts are out. We may try and pop out if we can. It’s only 1/2 a mile or so from the children’s hospital.

Thank you to everyone who has supported us so far. Thanks for messages and emails x

Magical Minty – Early Days of First Admission with Cystic Fibrosis

This is my magical Minty. At 16 months she is showing me a thing or two about life, always smiling and just carrying on with things despite facing things many adults with never face.  But today I am feeling angry. No wait.. tearful, optimistic, scared, exhausted, worried. I’ve no idea really. A mixed bag of emotions. I would say the past few days have been unpleasant. Though the extra snuggles and joy I’m getting from Minty make it better. As does watching her cheeky face wave at babies in neighbouring hospital rooms or her stern glare when nurses or doctors try to talk to her.

Friday was the worst day by far. She was nil-by-mouth from the morning, wheezy and waiting for a bed. At 11.30 am still no bed. Then the bed managers juggled and she had a bed. On the list for general anaesthetic and bronchoscopy at 2pm. Bags packed for a long hospital stay (10-14 days expected on IV antibiotics) we arrived. Taking her down for anaesthetic was scary. Holding her in my arms as she was put to sleep was awful. I tried to remain calm for her, snuggling and kissing. Truth was I was 20 times more scared than when I’ve had my own anaesthetic. Leaving her in the care of others and walking away in tears. We passed the time with difficulty. Uncertain what to do. Coffee?? Stomach couldn’t digest it anyway. After 2 1/2 hours of waiting we became very anxious and just wanted her back in our arms. The bronchoscopy was done, the thing that took the longest was inserting her long line. They couldn’t get a PICC in due to her chubby arms (lovely things they are) and had to settling for a Leader Cath (never heard of it), sort of a short long line. It won’t last her length of antibiotics so we will cross that bridge when we have too. But I fear it involves another GA.

Having her back in my arms screaming and smelling of sevoflurane was a huge relief. The first night was terrible, she thrashed and had a chest sounding like a bag of wet sponges. She spiked temps, had a fast respiratory rate and fast pulse. I tried to sleep in the pull down bed next to her, but found myself staring at the monitor and numbers all night. Pulse 116 – good. 168 – not good. And so it went on. Being a doctor and a mum can be a worrying combination.

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Messing about with daddy!

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Trying to escape – Day 2

 

Dose of steroids and some salbutamol and in the morning she was much brighter. She’s on Tobramycin, flucloxacillin and ceftazidime for antibiotics. She’s almost back to normal now. But she’s exhausted and running on adrenaline. Her nap routine and sleep is totally obliterated and she’s all over the place. I have stayed with her since Friday night and had a guilty night home last night when daddy has stayed with her. I’m getting ready to go down as soon as possible as I don’t want to miss the ward round. She’s cultured haemophilus influenzae so far. No idea what this means in terms of her normal prophylactic regime. Was hoping she might get discharged early, but probably not so. Counting the hours until she is home and normal family life resumes. Just want her home. Good thing is she comes home between doses. From about 11.30-5 we are at home, which is great. I am incredibly grateful we live 15 mins away from the regional CF team. The hospital is very good and nurses and doctors have been lovely. Thank you.

Her siblings miss her terribly. She wakes up in the morning shouting their names as if they are also in hospital ready to play! Better go now. But some leaving thoughts from being on the ‘other side’.

Bed managers are important, people are waiting at home to come in. Whole families waiting on news of a bed.

Be considerate when talking loudly during night shifts. The hospital is our home for a couple weeks and being woken constantly is terrible. Sleep deprivation is terrible. Same goes for noisy families – keep it down PLEASE!!!

Discharge letters are important. I overheard an SHO responding when asked to do the TTA. ‘WE ARE ON THE WARD ROUND. IT WILL JUST HAVE TO WAIT’. I heard the tears of an anxious mum and lively 5 year old desperate to be home for the weekend. The fact that the TTAs cannot be processed after 2pm may not be important to you, but that meant that child could be home on a bank holiday weekend and that bed would be free for another waiting patient. I’ve been guilty of this ward round business. Perhaps we should have a dedicated discharge letter doctor somedays. It would be a rubbish shift but have an amazing impact in many ways.

With regards to our skydive. Minty’s hospital stay has lead to a few changes. She’s going to be discharged a few days before and will need one parent at home with her. Doesn’t feel right leaving her. So I am jumping with the skydive team and my husband will jump 2 weeks later. Her hospital stay has made me EVEN MORE DETERMINED. This is a lousy illness, it is unacceptable. We must must must find a cure or support people and their families with cystic fibrosis. If you have a pound or two to spare, please donate to our Magical Minty Skydive Team – we’ve raised over £4400 so far. AMAZING and thank you soo much for every single penny. If you haven’t seen our fundraising video – have a peek!

More soon… By the way. I had thought about not posting as I don’t want to be constantly bombarding people with woe is us news. But lots of people have been asking.

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Waiting for her IVs – Day 3

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After her GA. Washed out

Journey into Medicine – Roses

She was quietly in pain. Silent as she moved her body to the bed, grimacing with tears in her eyes. I helped her up. I looked at her unsure what to say. She reminded me of my mother. With silvery grey hair, she has bought a black knitted hat and blanket from home. We took a series of 6 or 7 hip x-rays. She moved her body the way the tech asked. She was so eager to please. She could barely hold back her tears.

I wheeled her to wait for the hospital porter. Finally, she could no longer hold it in. “Not everyone can do this job”, she said, “I want to thank you for what you did in there. Thank you”. I hadn’t really done anything. The tears began flowing. She had been in and out of the hospital with cancer for the past 18 months. She looked at me, looking for my understanding and said “I do not want to live any longer, I do not want to live with this pain. I just want to be able to say when enough is enough”. I saw her pain and wanted to help her. We talked for a while, I patted her shoulder. She seemed relieved; she just wanted to talk to someone. She just wanted to tell someone she couldn’t stand it anymore. I felt privileged that she told me, she shared her most intimate desire. She was not suicidal or hysterical, she was rational and clear.

I asked her how long she had been in the hospital for,  ‘just three days this time’ she said. She wanted to go home. Her daughter lived one and half hours drive away and would not be here this weekend. We talked about the house she has lived in for 40 years, her garden, and her love of where she lived. I took her up to her room and she was grateful. Climbing back to her bed, she looked happier, no longer alone in her moment of darkness. I do not know what happened to her. I think of her in her garden, enjoying the warm sun, the sweet scent of Jasmine, and pruning her white roses. This is where I hope she is now, and for the rest of her days.

Journey into Medicine – Snapshots

Polo-shirt, pants, white tennis shoes, hair tied back and off I go. I haven’t been in a ‘uniform’ in 12 years, last time was working at a supermarket stacking freezers. Feels strange. I kiss my kids and husband goodbye and leave the house ready for the next phase in my life. Scared. Excited. Standing on the edge of something I do not know.

In the four years since I decided to become a doctor (I know why not sooner) this is the first time I have entered a clinical setting as a ‘professional’ and not a patient. It is absolutely essential to experience this for me to finalize my decision. I am embarking on a one year (or more) journey into medicine, volunteering at a local teaching hospital.

Tonight I am to spend much of my time in the emergency room developing x rays. (This is 2002 and we are still developing films.)

I arrive one minute late at 7.01pm, no sign-in sheets available, I know we absolutely have to sign in, what should I do? I’m off to a bad start! I introduce myself to the techs, I feel like I’m 14 years old.

One guy races through the procedures, showing me the ropes.

“Put the x-ray here, make sure the bell rings, don’t open the door, replace film in the cassette, 11 by 14, 11 by 12, 8 ½ by 10, extremities here, here is duplicating film, this goes here. This is the flasher, put the sticker in here, check it”. And it goes on.

I listen intently. I am truly in a new world. It’s so second nature to him, yet alien to me. Barely one hour ago I was picking up rice off the floor, putting toys away and negotiating dinner with my three and one year olds.

No time to think we’re off to our first patient. A repeat chest X-ray on an elderly lady in ER. I wonder who she is, why is she alone? Is this how we will all end up? Alone in a hospital, weak and in pain. I truly appreciate the responsibility of our tasks as ‘caregivers’ in this woman’s life.

Then it’s on to the next patient, the next and the next. Two young adult men with constipation, another young male with a nail gun injury. Then a lull. Then off we go again, two more women in their 80s or 90s both with fractured hips. A young 11 year old boy with his mom, scared, sick and confused. I see the look in the mom’s face, “what’s wrong with him, how long till we know?” she asks

It is only then I am surprised by how little I know of each patient I have just spent brief moments in time with. Seeing her reminded me of who I am and why I decided to go into medicine. Only then I realized how motherhood affected my ability to communicate with this woman. Up until that point I was so busy, helping and learning that I had forgotten I too was a mom. I could tell what she was thinking by the worry in her face. I could tell how her son felt during the x-ray as mom waited outside. I wanted her to know that I was a mom and could understand what she was going through. I didn’t tell her.

We went upstairs to another floor. Another x-ray. We woke a woman with our bright lights and big machinery. This is where she may spend the last days of her life, being poked and moved, loud TV sitcoms blaring and hospital food. I remembered when I was in hospital having my girls, being woken up at all hours, blood pressure, this, that and the other.

I was surprised how many came into the ER alone. A 90 year old woman brought in by paramedics, her clothes stained with faeces, urine, a mint green dressing gown, tattered brown shoes, thin and all alone with no one to care for her. “My leg hurts, oh my leg hurts. What’s wrong? I’m cold.”

I can understand what they are feeling as patients. Barely 10 days earlier I had a chest x-ray, my underwear exposed by the open gown, not sure how to stand, am I straight enough, should I breathe now. Am I doing this right?

Now I am told that this empathy for patients can be erased from your psyche as you progress through training. In fact I was surprised how I quickly saw the patient as an acute abdominal x-ray series or whatever the term for their x-ray was. I saw these people for around 10 minutes or so. As the x-ray blinked taking a snapshot of their injury, I too was seeing only snapshots of their lives. Yet, there I was seeing right through their hearts and bodies and trying to understand their minds.

And so it began. By the end of the evening I’d developed several x-ray films, changed sheets, undressed a patient, talked with patients and families, made them feel at ease, seen bloods, guts and not that much gore. My shift over I left and the CD came on in my car…

“From the day we arrive on this planet
And blinking, step into the sun
There is more to see than can ever be seen
More to do than can ever be done”

** These are based on events, but genders, details and so on have been changed to protect identities. When appropriate, consent was obtained.